Why We Research

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"You're a teenager. There's no way you know anything about what you're talking about. Go home kid." - random guy in crowd at research symposium as I presented a paper on "a design for bi-leaflet mitral valve prosthesis operated with artificial muscles that maximizes laminar flow". These were some offensive words. But not the first time I had heard them. I'm a student researcher. It all started when I was searching around on the web for a quadratic equation for cubic functions. I was introduced to the study of linear algebra (higher calculus) and I started to read more research. My interests branched. Starting in math (btw, I used a matrix-solution algorithm for cubic equation x-intercepts that even my math major teacher didn't know about and got a 100 on the subsequent test that took me 16 minutes to finish- ha!), and moving onto economics, english, computer science, physics, engineering, politics, biology, and finally medicine. In medicine, I found the most advanced research (more funding, more interest, smarter people, more papers, more opportunities, more application, etc.). It was amazing. There's an online database of articles called PubMED. It's the most popular database in medical research and it's open for public use (many times this is not the case in research). I started to read more and eventually was accepted to a summer research program at a local university. I went there, and worked on real hearts. This wasn’t some ad hoc, half-baked program that existed so a department could claim they have opportunities for rising scientists, this was the real deal! I was treated as an intellectual equal. Even though I didn't have an M.D. or Ph.D. people knew I was more than capable of understanding that particular subject of research at their level. True, I didn't understand everything at once (unlike some of the other newcomers). But every morning, I read more papers and more chapters from textbooks until I was good enough to discuss at the PhD level.

When the ignorant old man told me that I had no clue what I was talking about, I was enraged. Here was me, a kid who was smart enough to not only come up with the project idea, but also see it through and ask for all the help he needed until he got it done (I won't lie, it wasn't easy. I asked probably a thousand questions to researchers in my lab and tried to learn as much as I could. I had help from 10 different people and asked ~30 professors from the project field about their results and insights, of which 2 replied and only 1 gave his results. I burnt my midnight oil and was the first one in the lab and the last one to leave. All the time being made fun of by some of the lab members and being laughed at when I asked a basic-level question or added a useless comment that was otherwise considered a given in lab meetings. It was hard to put myself out there, but I persevered. Fast forward to the day of the symposium, in front of me was a condescending man, despite probably being an accomplished scholar, wouldn't accept my knowledge and aptitude for the subject. I didn't know what to do. Whenever I used to explain my research to friends they wouldn't understand so I had to dumb it down, use analogies, and often still they couldn't get the scope of what I was doing. There's a big learning curve in research so, of course, they weren't to blame. On the other hand, adults doing the research also didn't think I was good enough (they probably thought I was just given the chance to speak and memorized a speech and some basic answers). I faced a time when I felt alone because there was nobody my age who could relate to me.

As teenagers, we face situations of alienation all the time. Most psychologists attach these feelings to puberty, which might be partially true. But I think it’s because in the process of developing oneself, it’s not easy to find other people at the same stage. I have witnessed belligerent teens harangue their parents, and adults about their views- in defense against authority. The debater in me sees, however, that both sides are correct. If adults accept everything kids tell them, then few people would wash their hands or take out the trash.
But I’m nothing if not a visionary when it comes to things like this. I still believe in inherent good and, in fact, I think our generation can change these views altogether. Take an example I have closely studied: healthcare.

Healthcare, especially in America, has become a topic of heavy discussion and controversy. Most people have identified the major need for change: the number of PCPs (primary care physicians) is too low to support the growing technological advancement of medicine and demand for medicine (growing population mainly). At the same time, the cost of a medical degree is rising beyond proportion.

The average Medical student debt is $170K. For a young adult, the expectation to lay down the next 10+ years of their life to become a great doctor (which they actually want to do), but then ask them to specialize in something they might not want to specialize in (family care, pediatrics, etc.) on top of a low compensation. It's simply not financially or academically rewarding, and is certainly not effective.

Ironically, PCP-specialty doctors have the greatest impact on saving lives. Insurers employ PCPs to deal with the masses. The PCPs make prognoses and send patients to the appropriate specialist (surgeon, cardiologist, sleep specialist, gastroenterologist, etc.). In this sense, their initial judgement can impact the treatment course of a patient- and ultimately holds the biggest value in the process of seeing a doctor(s). Despite the benefits, these doctors still often see patients complaining when there aren't any real symptoms or excessively angry moms that won't vaccinate their children. They are equally susceptible to malpractice, and are less likely to get medically interesting cases. Keep in mind, that when I refer to salary, I am talking about the fair amount one must earn to at least afford a decent life while still paying off egregious debts. 

So what to do? Nowadays, you never hear someone way they want to become a PCP. It's always radiologist, neurosurgeon, etc. The high-pay, high-reward, Grey's anatomy-type doctors. Statistically, the same number of people will become neurosurgeons- despite a significant growth in interest (only the top 1% of medical students make it to neurology-related specialty because of cost of training and requirement for exceptional diagnostic prowess), so when people realize they won't make it into the top 1%, they drop out. It's bad however. Someone must do the middle work; lest the system collapses and people do not get adequate treatment. But nobody wants to do that because, for the level at which we train our doctors, this is too easy a task (and doesn't pay enough if this is all you do).

Because of this discrepancy, most insurers are paying much less than the qualification level (and proportional cost of service) from a specialized doctor. The doctors are complaining that they are being sucked dry (which they are) all the while, doctors are in debt longer and the government is trying to solve it. I’m not advocating that all doctors have enough money to pay off debts and still drive a Ferrari to their luxury mansions. However, I do see the need for reform if society doesn’t want this to become another 2009 market crash/ housing crisis.

So what's my solution? Change the system. Instead of training doctors to be great at everything- organize them in such a way that they only superspecialize in one type of disease or one surgery. In his book “Complications: A Surgeon’s notes on an imperfect science” Atul Gawande writes about a clinic in Toronto of surgeons that exclusively specialize in hernia repair, and have a world- best 1% complication rate. Here, hernia repairs take only 30 minutes on average, instead of 60, and they are better than what most Ivy-league trained doctors can do. This would not only solve the problem of expensive training (and reduce med school costs) but it would also have better care for more people, which is always good.

So, we wait. Until a day that millennials like us can make the changes we know will make the world a better place. We wait for our turn and band together- to ensure that our views and our principles of equality and non-judgement reach all corners of the globe and change the human race as we know it.

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