As someone on the other side, who left academia as a career path at the end of my extensive training, the eulogy is not something one hears only upon a death; it is how academics now define themselves. The prizes, the publications, the promotions, peer prestige, the phunding, (the 5 P's) is what that academic life is about. A Chairman of Medicine asked me recently, "how can we make our department of medicine more "innovative"", which I immediately took to mean, how can we rake in more money from licenses, fees, royalties, etc. I replied with what they probably regarded as Absurd...."To be innovative you need time to read and think -- give faculty back time. Imaginative minds wander so you need to be able to cross professional disciplines rather than be relegated to your professional rut. You need to limit the number of publications so they are not scrambling to be authors on yet another paper -- how about 2 a year and no Reviews!!"
Universities are simply businesses. Many labs in well known places are little companies trying to develop the next gee whiz technology or generate the next antibody. I find it fairly reprehensible that academics use public money with the hope to strike it rich. The public rarely gets anything in return.
Because I am interested in science and medicine very broadly, I had no home in the Academy. It is the home of specialization. Being a mile wide and an inch deep is a terrible liability in the Academy. In the real word, it can be an asset. Ironically, breadth is what is sometimes needed to connect disparate dots.
One can justifiably lament the intrusion of Pharma in Academia but academia's acquiescence says a lot more about those on the take than those that hand it out. After all, Pharmas are businesses who simply find willing "buyers". Institutions love the inflow of capital, wherever it comes from: donations, foundations, industry. It's all money. There is no question the system is corrupt. But to my mind, it is that academics have reduced themselves to statistics and making money is a way to assuage their degradation and just another form of prestige.
I’m hearing faint echoes of a the words of a fellow whose academic credentials were peerless:
Ecclesiastes 3:9-13
9 What do workers gain from their toil? 10 I have seen the burden God has laid on the human race. 11 He has made everything beautiful in its time. He has also set eternity in the human heart; yet no one can fathom what God has done from beginning to end. 12 I know that there is nothing better for people than to be happy and to do good while they live. 13 That each of them may eat and drink, and find satisfaction in all their toil—this is the gift of God.
Whatever your religious affiliations, it has the ring of truth.
The last years [come] ̷s̷ around faster than I expected. (A warning to make the most early if one can.) Also, I had not realized that bathroom mirrors go bad, but they seem to.
Minutes ago, I was just considering including mention of 'The Exorcist', the novel, in a tweet back to Sidney Powell on her victory at the Texas Board of Disciplinary Appeals. I indicated my enjoyment reading her book, 'License to Lie'. I was going to add that I read it like a novel, using 'Exorcist' as an example.
How uncanny is this?
While we are at it, my favorite line from the film involved Fr. Karras (also the psychiatrist) eagerly beginning to supply a list of diagnostic details regarding various manifested personalities from his prized "toolkit," and the elder Fr. Merrin snappily retorting: "There is only one," [the Devil, that is].
So, I must confess what must be my density, are we talking about the demons of "beauty" and "ugliness" in the mirror---similar to the advice regarding ignoring both flattery and disparagement both as impostors.
We do not know about the economics in the realm of the demons, but humans sure do pay a price, in the here and now, for their immediately "much easier" path: tangled stories, the burden of memory and ever more complex narrations, etc.
When Steve Coutre, at Stanford died, I was sad. Because he was a kind, generous man. I was a drug rep, and he treated me like I mattered. I would bet that his patients felt truly cared for, his colleagues remember him with affection, and his family mourns him tremendously.
You are right--we should remember and memorialize people because of who they were to those around them. I came to know many hematologists as a rep--and the thing that struck me was how deeply they cared about their patients. This is what matters.
Onco guys and gals, take it from a layman who has lost a brace of loved ones to cancers: A single encouraging comment or honest, compassionate encounter with a family will remain engraved on our hearts for a lifetime. If we were invited to your funeral, the metrics mentioned here would be gibberish to us, but with tears of gratitude we would recount the time you looked in on Dad and held his hand toward the end, you, the big guy with the fancy credentials.
VP, this is why we come here. You, Adam, and John are champion humanitarians. That was egregiously lost by many physicians (especially those with a voice) during COVID. Thank you for this reminder. After all, no doctor ever laid on his deathbed thinking, “I should have billed for one more visit.”
This is a refreshing ray of light...expressing the humanity with which most entered medical school but which all too often became overtrodden by years and layers of oppressive "priorities". Thanks, Vinay for unearthing this worthy shift of sentiment and priority.
Beautifully written- as an End Of Life Doula and grief specialist... in the greater Boston area, you have framed an aspect of my work that when present, represents the push-pull of status, local societal agreement and acceptance....vs heart and truly meaningful. It is so easy for a family to automatically author for a loved one this way, especially within certain social strata.... Thank you for your clear and candid writing. Perhaps an opportunity may arise for others reading, as a result your heartfelt expression!
I have long felt that modern medicine has lost its single most important feature- the sacredness of the physician- patient interaction. Otherwise stated, it’s humanity. No amount of technological prowess, detailed EHR documentation, attention to Press Ganey scores, or billing of massive RVUs can substitute for taking a proper history, performing an informed physical exam (think laying on of hands), and sitting down for an honest face-to-face discussion that informs and makes the patient a participant in their care. Out predecessors of only a few generations back would be ashamed of what medicine has become even while admiring our “progress” in technology, pharmacology, surgery, etc. Great essay.
I attended a funeral for a family member recently who had been with the same family-owned company for 43 yrs...unheard of these days. He had a prominent position in the company, and for whatever reason, the CEO wanted to pay for the service (we learned later that it allowed him to control who spoke and when). As the family sat and listened to story after story of his work life, which really was a reflection of themselves and their unmatched dedication, long hours, mtgs at 7 pm, it made us all depressed. We also knew that his wife did not get enough of his time in the previous 20 yrs. There were two family members who spoke, not about "the employee" but the man, and they were warm and funny and made our hearts swell with love for the guy we knew. I was glad my 20-something kids were there to see/hear and our discussion afterwards on the imbalance of how he was eulogized (they also expressed frustration). Perhaps they gleaned a bit of what is really important in life.
My mother also never read it.
As someone on the other side, who left academia as a career path at the end of my extensive training, the eulogy is not something one hears only upon a death; it is how academics now define themselves. The prizes, the publications, the promotions, peer prestige, the phunding, (the 5 P's) is what that academic life is about. A Chairman of Medicine asked me recently, "how can we make our department of medicine more "innovative"", which I immediately took to mean, how can we rake in more money from licenses, fees, royalties, etc. I replied with what they probably regarded as Absurd...."To be innovative you need time to read and think -- give faculty back time. Imaginative minds wander so you need to be able to cross professional disciplines rather than be relegated to your professional rut. You need to limit the number of publications so they are not scrambling to be authors on yet another paper -- how about 2 a year and no Reviews!!"
Universities are simply businesses. Many labs in well known places are little companies trying to develop the next gee whiz technology or generate the next antibody. I find it fairly reprehensible that academics use public money with the hope to strike it rich. The public rarely gets anything in return.
Because I am interested in science and medicine very broadly, I had no home in the Academy. It is the home of specialization. Being a mile wide and an inch deep is a terrible liability in the Academy. In the real word, it can be an asset. Ironically, breadth is what is sometimes needed to connect disparate dots.
One can justifiably lament the intrusion of Pharma in Academia but academia's acquiescence says a lot more about those on the take than those that hand it out. After all, Pharmas are businesses who simply find willing "buyers". Institutions love the inflow of capital, wherever it comes from: donations, foundations, industry. It's all money. There is no question the system is corrupt. But to my mind, it is that academics have reduced themselves to statistics and making money is a way to assuage their degradation and just another form of prestige.
So much truth here.
As I've told my kids so many times...follow the money and you'll better understand most things.
I’m hearing faint echoes of a the words of a fellow whose academic credentials were peerless:
Ecclesiastes 3:9-13
9 What do workers gain from their toil? 10 I have seen the burden God has laid on the human race. 11 He has made everything beautiful in its time. He has also set eternity in the human heart; yet no one can fathom what God has done from beginning to end. 12 I know that there is nothing better for people than to be happy and to do good while they live. 13 That each of them may eat and drink, and find satisfaction in all their toil—this is the gift of God.
Whatever your religious affiliations, it has the ring of truth.
Why does Dr. Vinay Prasad have the best damn takes?
The last years [come] ̷s̷ around faster than I expected. (A warning to make the most early if one can.) Also, I had not realized that bathroom mirrors go bad, but they seem to.
Good insights. I liked this.
The demons lie.
Yes, but they also tell the truth in order to gain credibility for their lying.
If you are so willing, I would enjoy your expanding on your terse, provocative reply.
Line from The Exorcist, I use it often. Seems like a truly multipurpose statement!
Thanks.
Minutes ago, I was just considering including mention of 'The Exorcist', the novel, in a tweet back to Sidney Powell on her victory at the Texas Board of Disciplinary Appeals. I indicated my enjoyment reading her book, 'License to Lie'. I was going to add that I read it like a novel, using 'Exorcist' as an example.
How uncanny is this?
While we are at it, my favorite line from the film involved Fr. Karras (also the psychiatrist) eagerly beginning to supply a list of diagnostic details regarding various manifested personalities from his prized "toolkit," and the elder Fr. Merrin snappily retorting: "There is only one," [the Devil, that is].
So, I must confess what must be my density, are we talking about the demons of "beauty" and "ugliness" in the mirror---similar to the advice regarding ignoring both flattery and disparagement both as impostors.
Yes to both. The demons do whatever it takes to get their way. Much easier than the righteous path of hard truth.
Thanks.
We do not know about the economics in the realm of the demons, but humans sure do pay a price, in the here and now, for their immediately "much easier" path: tangled stories, the burden of memory and ever more complex narrations, etc.
The metadeception of deception.
Right! How do you fix bathroom mirrors when they're glued to the wall?!!!?
Removing the wall is one option.
When Steve Coutre, at Stanford died, I was sad. Because he was a kind, generous man. I was a drug rep, and he treated me like I mattered. I would bet that his patients felt truly cared for, his colleagues remember him with affection, and his family mourns him tremendously.
You are right--we should remember and memorialize people because of who they were to those around them. I came to know many hematologists as a rep--and the thing that struck me was how deeply they cared about their patients. This is what matters.
Onco guys and gals, take it from a layman who has lost a brace of loved ones to cancers: A single encouraging comment or honest, compassionate encounter with a family will remain engraved on our hearts for a lifetime. If we were invited to your funeral, the metrics mentioned here would be gibberish to us, but with tears of gratitude we would recount the time you looked in on Dad and held his hand toward the end, you, the big guy with the fancy credentials.
You’re such the philosopher and revolutionary and I appreciate you so much 🤩🙏🏻
VP, this is why we come here. You, Adam, and John are champion humanitarians. That was egregiously lost by many physicians (especially those with a voice) during COVID. Thank you for this reminder. After all, no doctor ever laid on his deathbed thinking, “I should have billed for one more visit.”
This is a refreshing ray of light...expressing the humanity with which most entered medical school but which all too often became overtrodden by years and layers of oppressive "priorities". Thanks, Vinay for unearthing this worthy shift of sentiment and priority.
What a beautiful essay. Thank you.
I am truly moved by this piece
Could not agree more with this article. If not the best one I have read from you, it's close.
Beautifully written- as an End Of Life Doula and grief specialist... in the greater Boston area, you have framed an aspect of my work that when present, represents the push-pull of status, local societal agreement and acceptance....vs heart and truly meaningful. It is so easy for a family to automatically author for a loved one this way, especially within certain social strata.... Thank you for your clear and candid writing. Perhaps an opportunity may arise for others reading, as a result your heartfelt expression!
I have long felt that modern medicine has lost its single most important feature- the sacredness of the physician- patient interaction. Otherwise stated, it’s humanity. No amount of technological prowess, detailed EHR documentation, attention to Press Ganey scores, or billing of massive RVUs can substitute for taking a proper history, performing an informed physical exam (think laying on of hands), and sitting down for an honest face-to-face discussion that informs and makes the patient a participant in their care. Out predecessors of only a few generations back would be ashamed of what medicine has become even while admiring our “progress” in technology, pharmacology, surgery, etc. Great essay.
Lovely essay, as always.
I attended a funeral for a family member recently who had been with the same family-owned company for 43 yrs...unheard of these days. He had a prominent position in the company, and for whatever reason, the CEO wanted to pay for the service (we learned later that it allowed him to control who spoke and when). As the family sat and listened to story after story of his work life, which really was a reflection of themselves and their unmatched dedication, long hours, mtgs at 7 pm, it made us all depressed. We also knew that his wife did not get enough of his time in the previous 20 yrs. There were two family members who spoke, not about "the employee" but the man, and they were warm and funny and made our hearts swell with love for the guy we knew. I was glad my 20-something kids were there to see/hear and our discussion afterwards on the imbalance of how he was eulogized (they also expressed frustration). Perhaps they gleaned a bit of what is really important in life.