Wednesday, November 9, 2011

Raise the song...and your voice

This is the time of year when I see a lot of people who have recently decided to change majors for one reason or another. A huge percentage of them tell me they want to go to medical school or to become a physician assistant—both very noble, honorable professions, to be sure. When I ask them what make them want to become doctors, nurses, or PAs, many of them respond with lengthy explanations about how they’ve always loved science and biology in particular, how they had a pediatrician they loved, how a PA helped diagnose their asthma or a nurse took care of a sibling who had been hospitalized, etc. A good many of them, though, give me the same, vague answer: “I want to help people.”

This is a noble calling, too; don’t get me wrong. I am all in favor of the give-back-pay-it-forward-leave-the-world-better-than-you-found-it philosophy. My problem is with their very, very limited definition of “helping people.”

As I started writing this a week ago, I intended to write about the many ways in which you can help people outside of medicine. Then I saw a documentary on he replications of the original Stanley Milgram studies on authority. Milgram's original studies brought volunteers into the lab and paired them with "learners" who were really research assistants. The "teachers" were told to give increasing electric shocks to the learners sitting in a remote booth when they made mistakes on the task given. Even when the learners screamed in pain and complained of heart trouble, a lab coated investigator asked the teacher to keep going. Milgram found that the vast majority of people were willing to give what they thought might be dangerous shocks to another human being just because someone told them to. In one version of the replications, teachers came in to the lab in pairs. One of the pair was another research assistant who, in half the cases, was told at one point to refuse to administer any more shocks. When that person refused, far more of the subject teachers were willing to also refuse. One person standing up and saying "No. This is wrong." is all it takes to inspire others to do the same.

Shortly after watching this special, news broke about Jerry Sandusky's heinous acts and the horrible cover up that ensued at Penn State. The most shocking, and for some of us most heartbreaking, part is that so many people seemed to have had the chance to stand up and say "No. This is wrong," but no one did. People did what they believed they had to, but no one did what they should have. I have no doubt that their failure to do more than they did will haunt Mike McQueary and Joe Paterno until the day they die.

So here is my charge to all of you, future clinicians or not. Want to help people? It's this simple: Be the one who stands up. Be the voice that says "No. This is wrong. I won't go along with it." Be the one who inspires others to stand up and do the right thing. Be the one who insists that we are all better. Be our pride, not our shame. No matter what you do after that, you will have helped everyone. Not a bad day's work.

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