English Major and Pre-Med: Reconciling Medicine and Literature through Stories

By: Stephanie Koo

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“Death Found an Author Writing His Life” (Creative Commons/ Flickr)

It’s a normal day at the hospital. I, a valued member of the Emergency Department translational research team, approach a patient to enroll them in one of our studies (read: extremely socially awkward girl, wearing scrubs too big for her, bothers sick and crying kids and their sleep-deprived parents, to ask them questions about the types of food they like to eat or what they think about marijuana.)

Sometimes, the parents ask me if I’m an undergraduate student, and what I’m studying. I dutifully reply, “English and Biology,” and there’s usually a remark like “Oh, what a strange combination!” and if they’re receptive enough, I launch into a speech that basically apologizes for being an English major: that I want to be an effective communicator as a physician; that sometimes scientists lack the people skills, and I felt that physicians especially should empathize more; that I think that science needs to get out of its ivory tower and reach the public better—and what better way to do that than through writing?

This time, however, I approached a patient who is there for a mental health emergency and has been there nearing on three days. The exhausted parent is less than friendly when they exclaim, “Why the heck would you want to be an English major? How on earth does that teach you about medicine?”

I’m not really in the mood to explain myself today, and not to this parent. Today, instead of going on my spiel, I say simply, “Ma’am, I just really like writing.” And I think that’s the most truthful answer I’ve given.

I’ve tried different costumes since I’ve arrived at UConn. Feeling insecure about entering as an English major without a job in mind, and not really wanting to be a teacher, I switched into Animal Science with the intent of being a vet. But horses kinda scared me, and I was an Asian from the suburbs with no intention of running a pig farm, and I was frustrated at the lack of pet legislation and how veterinary medicine as a system was run.

I added my English major back as soon as I could and felt a rush of relief: I knew how to do this. I wasn’t looked at funny when mentioning my love for creative writing. I could write a 15-page essay the night before and present a mostly coherent argument. I could scoff about the patriarchy and racism and learn ways to address it through writing. I could read and write scholarly articles about fanfiction and video games and have it recognized as legitimate, never mind that pretty much everyone else would be thinking, “Jeez, English majors…

But science wouldn’t let me go—I had enjoyed my biology classes too much. So, as some writers do, I launched myself into nature. I always liked the outdoors. There were lots of nature writers, so it was fairly easy to imagine myself among them—Rachel Carson, Ralph Waldo Emerson, Aldo Leopald. Who knows—maybe I could go into nature documentaries be a David Attenborough, not that I could ever have the old British man voice necessary for that job. Never mind that I couldn’t name a bird by its call to save my life.

Three months later, after a summer internship with a wildlife refuge, and scarred from head to toe by poison ivy (it somehow even got inside my shirt?), I reconsidered. I had abandoned veterinary medicine, but never really gave human medicine full thought, thinking that it was stereotypical of me to want to become a doctor—my parents never pushed me towards this career, but I was self-conscious that other people would think that my “culture” forced me into this role (not to discount fellow Asians who did grow up in families that strongly emphasized the career). But something clicked within me.

I was drawn to the stories, and they were familiar because health has been an integral part of all our lives. The stories, past and present, of women who fought for the rights to their own bodies. I was angered by the injustice of things done to vulnerable populations in the name of medicine, but also proud of writers for exposing them, like Rebecca Skloot and the story of Henrietta Lacks. I read different views on disability, arguments for and against medicalization and what “quality of life” might mean in different contexts. And stories about death and loss, especially.

There’s something poetic about the art of medicine, and how, ever since our existence began, we’ve been fighting death, knowing fully well that we are always going to lose.

I wanted to become a part of that messy system, problems and all. I want to be that researcher, the physician—to understand the scientific process— but also read and write about it. And maybe that will affect other people. And I found that, like nature writing, there were also physician-writers. Even though they were mostly men, I now saw that as a challenge.

I think that I decided to do this in a good time—I’m not going to be the only English, arts, or humanities major when I eventually get to medical school. The medical community recognizes that there is a disconnect between the public and science, especially now, and the need for more empathetic physicians. A recent article by the Association of American Medical Colleges wrote that “medical students with undergraduate degrees in the humanities perform as well as pre-meds with science backgrounds but tend to have better empathy and communication skills, and a more patient-centered outlook,” and more medical humanities-specific majors are emerging to specifically address this growing trend.

The MCAT (medical school admissions test) even was changed to include more topics such as sociology. My pre-med advisor says I “will kill the CARS (critical analysis and reading section) on the MCAT” solely based on my being an English major—not that he has ever seen any of my writing. I’m looking at medical schools with the option of learning about narrative medicine, such as the one in Columbia, which is multidisciplinary in nature, as medicine should be: it “seeks to strengthen the overarching goals of medicine, public health, and social justice, as well as the intimate, interpersonal experiences of the clinical encounter.”

Double majoring isn’t easy. I can’t write my novel when I have a biochem exam to study for, and science doesn’t come as naturally to me as English does. But seeing science through the context of medicine, and medicine through the context of stories and a larger human experience, helps explore connections past the boxes we sort ourselves into.

Reflections on writing, medicine, and more with Nikki Rubin, former LRR Poetry Editor

Interview by Steph Koo

I had the opportunity to speak with Nikki Rubin, LRR alum, survivor of UCONN medical school, newly-minted doctor extraordinaire, over video chat this past weekend. Our talk ranged from writing experiences, to her decision to choose OB/GYN as her specialty, to my own anxieties over choosing the pre-medical path. Here are a few things that we talked about, and that I am happy to share with our literary magazine community! Whether you are interested in pursuing medicine as a career or not, everyone is impacted by the decisions of our doctors, and realize that there are more literary doctors than may be stereotypically expected!

On her undergraduate experience:

As an undergraduate, Nikki stayed away from the pre-med group and became involved in her other interests. Nikki’s focus has always been on the people she serves, and she double majored as an individualized major in Human Rights and biology. She has always wanted to be a doctor: “I would watch the show ER as a kid, and my parents would say, ‘Don’t tell your preschool teachers I let you stay up until 10pm!’”

On the lit mag scene:

The writing bug bit her in her middle school years, her first experience with literary magazines. Back then, it was “a typewriter, a copier, and a bunch of staples” holding their work all together. She continued writing throughout high school, and came to UConn, looking for a writing community. After friends and winning a couple of the Creative Writing Department’s contests brought her into the Creative Writing community at UConn, she became involved with the Long River Review. Nikki spent her sophomore year on the poetry panel, and her senior year as poetry editor — Long River Review 2010 and 2012. Her prize-winning poetry can be found on our website in LRR 2013, 2011, 2010, and 2009.

When she entered UConn Medical School, she found that she was not the only one in her class with a creative flair. “The medical community is far more creative than the stereotype of a medical professional lets on,” she said, accounting for the musicians, writers, and artists she met in the next four years of her life.

She was a part of the founding of UConn Health’s literary magazine, Anastomoses*, meaning the reconnection of two previously connected branching structures, like blood vessels (link: anastomoseslitmag.com). Anastomoses is an online-only literary magazine for the UConn Health community. She describes Anastomoses as “a different experience from Long River Review. We were a smaller magazine and were less selective.”

On writing:

I asked about her own writing. Among working, studying, research, and extracurriculars, Nikki describes herself as “not the best model for regimental writing,” but she has found that writing has always come across accidentally. She notes that as a medical provider, “it’s a lot harder to write poetry when you’re used to writing medical writing, which is often restrictive.” She recounted looking forward to journaling for a class during her first year in medical school, which allowed medical students to reflect some things they may not have been ready to process. Narrative medicine often helps with processing and contemplating upon the experiences that people experience within medical situations, from seeing a cadaver to watching a suffering patient or having your first patient pass away.

On Medicine:

I was interested about picking a specialty, and Nikki gave me an overview of her decision making process. “I came into medical school thinking about pediatrics, but being able to choose

The stimulation of the OR (operating room) was something that peaked her interest before deciding on the OB/GYN path. “As a woman with an interest in surgery, I felt as if I had an obligation to pursue my interest,” she said, but ultimately, “my interest in human rights, and the interactions I had with my patients, were more important to me.”

Nikki said that if she wasn’t a doctor, she would maybe be a teacher, do social or nonprofit work, or work within public health. We also discussed that if she could change anything about th emedical system, she would remove barriers patients and doctors have to healthcare, such as the large influence by money-driven insurance companies. “There’s always a third party in the room, and they’re not as invested in patients as you are. They are driven by the numbers.” This effects how a doctor can interact with their patient, from the types of healthcare practices that can be implemented to the amount of time a doctor can see a patient.

For a student who wants to become a doctor like myself, this may be the most comforting piece of advice: Do what you want to do, not something that you think you’re supposed to do. Your passion and your interests will carry you through.

“You have a rapid shift in identity in medical school,” Nikki said. “You’re in this really weird world where you’re not a layperson or a doctor.”

Steph Koo is a third year student majoring in English and Biology. She is the editor of the Fiction panel of Long River Review.