by syaffolee

“Eh. He gives a lecture here at least once a year.”

This apparent nonchalance was directed toward Dr. C. Everett Koop–a Dartmouth graduate, well-known pediatric surgeon, medical school professor, and 13th Surgeon General of the United States. And no wonder. Although it was open to all biomedical Ph.D. and medical school students, there were probably less then ten grad students of my ilk in the whole auditorium. (I guess I shouldn’t be too surprised. A few years ago, I went to a seminar where Venter announced the sequenced human genome, there weren’t any other undergrads around. Not one.)

There was no indication on what Koop would talk about, but I went anyway, partly because I was curious, and partly because this was, well, the former Surgeon General of the United States. I remember his image on billboards during the 80’s and it is particularly interesting to note that during his term, conservatives accused him of promoting promiscuity and homosexuality when he stated that using condoms would help prevent AIDS.

The title of the talk was “Everything That I Needed To Know About Medicine and Health I Learned While Eating Pizza In Medical School.” As you can imagine, most of it was a mixture of dry humor, seriousness, and preaching about not smoking (did you know that the most effective way to get people to stop smoking is not the glamorous advertising but just having your doctor telling you point-blank, “Stop smoking or you’re going to die”?).

The salient topics being discussed, however, were public health, prevention, and chronic disease. A rather startling statement was, “Most Americans consider prevention to be un-American.” I always thought prevention was supposed to be common sense–but Koop reasoned that people thought prevention was un-American because it gives them no choice. They’re forced to say, “No.” Instead, people want the freedom to make choices for themselves, even if they’re bad ones like taking up smoking or not wearing a seatbelt or over-imbibing.

But choices aside, in today’s technology, people are living longer–some not due to good health, but to medicine’s “success” at treating acute disease (which would kill the patient outright) so that patients will “only” have to live with chronic disease. However, chronic diseases pose their own problems, such as long-term care. How on earth are we going to care for the elderly population? I’ve read somewhere that very few medical students go on to specialize in geriatrics. The majority of nursing home care is abysmal. And family, certainly, won’t be able to cover everything–especially with the aging baby boomer generation. Koop remarked that perhaps the baby boomers will help change the system, especially since there are so many of them and they are beginning to realize that, yes, they are getting old (about one baby boomer is turning 50 every 7 seconds).

I could be like all those other grad students and say, “Eh, who cares about all this stuff?” and bury myself back into work, but the truth is, I have to care even though I’m not a medical doctor and don’t plan to become a public health official. I have parents too, and I knew since I was very young and my grandmother was still strong enough to hold me in her arms, that I would have to take care of them when they are old. And in the end, when my turn comes, who is going to take care of me?

An Additional Observation: So when Koop mentioned the CDC, I overheard medical students whispering to each other, “What is the CDC?” Good grief. What are they teaching in medical school nowadays anyway?