January 04, 2007

Organic Sour Grapes

If it were not for organic chemistry, I would be a doctor today.

Oh, I turned out okay. Murdered a few billion fruit flies watching legs spring from their heads, for which I earned a PhD in genetics. Lectured students, counseled patients. Cranked out articles and textbooks read by, ironically, doctors-to-be. Paradoxically, I even did a stint as a pre-med advisor at SUNY Albany. Today I satisfy the MD within by volunteering for two hospice organizations.

An article by Ezekiel Emanuel in a recent Journal of the American Medical Association about the evolution of pre-med requirements, and the correspondence it inspired, sent me back to those harrowing days when “organic” meant a killer college course and not a pesticide-free vegetable. The scene: SUNY Stony Brook, circa 1973. Hundreds of we the last cohort of true hippies, after years of being brainwashed that the alternative to medical school was death or at least disinheritance, sat stuffed into a lecture hall, watching overheads of C’s and H’s and O’s flash before our sleep-deprived eyes much faster than a cannabinoid-soaked human brain could perceive. After, we’d duly line up at the lone copier in the library and then truck stacks of incomprehensible lecture notes depicting said C’s, H’s, and O’s back to our dorms, where some of us might try to make some sense of it. Seeing the professor for help was a joke – the lines were too long. My grades in the lecture course earned me the nickname “D orbital”. Yet somehow I managed to get A’s in the lab, despite the efforts of one notorious Keith M., who would not-so-surreptitiously spit into the experiments of others to eliminate competition.

If organic chemistry was meant to “thin the herd” of medical school applicants, it sure worked on me. Despite my sour grapes, I’m not sure this unnatural selection actually picked the very best people to take care of the sick. The article in JAMA, 30 years too late, seems to agree. Dr. Ezekiel Emanuel’s new recipe for a premed education:

DROP organic chemistry
ADD psychology
molecular biology

He urges that medical schools cooperate to institute these changes, and that the MCAT follow.

One of the letters challenging Dr. Emanuel caused me to reconsider the value of organic chem, albeit fleetingly for I still occasionally have nightmares featuring Morrison and Boyd, the classic organic textbook author team. Daniel Kramer, MD, of Massachusetts General Hospital, pointed out that organic chemistry teaches one to recognize patterns and apply a set of rules to new situations to solve complex, multidimensional problems. It all made sense, but I was so much younger then, I’m older than that now. My 19-year-old brain was too panicked with exiting the D orbital to see any inherent value in problem-solving with a bunch of CHO’s, let alone discern a life lesson in applying those skills.

Dr. Emanuel’s recommended changes may solve the worst part of the traditional pre-med path – the chemistry, physics, and calculus left no time for anything else. Instead of history and philosophy and art and music, we bio majors of times past were stuck fulfilling our mostly useless and endless requirements. We were in lab when our pals tore up the dorms. And so today, I don’t know much about history, don’t know much about the French I took, etc. etc., to quote the old song that ironically starts “don’t know much biology” – the one thing I know perhaps too much about. My kids can walk through an art museum and identify everything; I haven’t a clue.

If Dr. Emanuel’s recommendations had been in place at SUNY Stony Brook circa 1977, I’d be an MD today. But I’m glad I took a road less traveled.

Meanwhile, as premedical training finally reinvents itself, I have to wonder, how many of you out there would have been doctors but for Organic? Shall we form a club, the Organ-nots? What have we become, those of us once deemed too dim to master medicine because we couldn’t tell an aldehyde from a ketone? Let me know! (by email) Maybe I’ll write an article!
- Ricki Lewis

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