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Facing Your Own Cynicism in Biomedical Professions

Woman thinking deeply by the window.

When I started graduate school at Hopkins, it was easy to get drawn into the burgeoning field of cancer immunotherapy. New immune-boosting drugs are now curing deadly cancers at rates never seen before. The excitement was (and still is) palpable. The cure is within reach — it’s just a matter of who and when. Newly aligned with the cause, I dove into the field — immersed myself in the literature, engaged in countless discussions with my peers and colleagues, met with leaders in the field, and conducted my own experiments based on what I’d learned.

However, as I learned more, instead of illuminating a solution, the immensity of the barriers to curing cancer seemed to intensify. Cancer is incredibly complex and infuriatingly difficult to target. Even the best new treatments have less than a 30% success rate under ideal conditions. Furthermore, most new treatments only marginally prolong life and are accompanied by a variety of painful side effects, not to mention an extremely hefty price tag ($100,000-plus). Despite the enthusiasm surrounding my field, over my years of study I have found myself questioning if we are actually helping people, or just condemning their families to a life of debt for a treatment that will most likely not work.

Just how the enthusiasm of my colleagues is infectious on good days, I’ve also found camaraderie on days when my doubts take over — sometimes in unexpected places.

At a recent blood drive on campus, as I was indulging in my post-donation snacks, I began chatting with another donor. I soon learned this man was a senior Hopkins physician, and after making the connection that we both studied head and neck cancer, we spiraled into a philosophical discussion on the injustice of cancer. He told me stories of healthy patients who had smoked their whole lives, and of others who lived pristine lives but died of terrible cancers that usually plague smokers.

Although I’d heard many similar anecdotes, in that moment his stories struck me. My underlying cynicism bubbled up.

I responded, “Well I suppose it all boils down to math in the end. Even making all the best life choices, your risk for cancer is never zero, so you might as well enjoy life while you can. … It’s not like our future is looking too bright anyway with the state of our planet.”

Then he paused, looked down, and said “Yeah … sometimes I wonder if we’d all be better off if we just shut down all the hospitals.”

My heart sunk suddenly. That was dark. Although, through that darkness one fact shone clearly. This stranger grappled with the same bleak apprehensions about his professional contribution to society as I did.

Diverting from his accidental soul-bearing remark, we segued the conversation into global warming and then found a way to terminate our chat on a more chipper note before going on with our days.

As I walked back to my lab, I contemplated our weighty conversation. Proudly exhibiting my donor armband, I was struck by the overwhelming irony of the whole situation. Despite our preoccupations with the futility of our work and the grim future of humanity, we had just taken time out of our days to donate blood so we could help save lives, and then both continued back to our jobs trying to cure cancer. Yes, dark thoughts penetrated our professions, but our dedication to the betterment of humanity is undeniable.

I began to ponder; maybe the triumph of gaining a Ph.D. is not purely achieving expertise on a particular topic through grueling work. Perhaps the true feat is fully realizing and internalizing the immense barriers to achieving your goal, facing them, and persisting anyway.

The cure for cancer may not be as tangible as I once thought, but regardless, I know that if my work helped even just one person, it would be overwhelmingly worth the struggle.

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