Public Health

Karen Lona Allendoerfer ravena at
Mon Jan 19 15:28:40 EST 1998

Hi, I hope everyone's back from Christmas and having a good new year! 

        I wanted to bring up a topic I haven't seen discussed yet on this
group; it's a big factor in a career decision for me, but the way it's been
handled so far in my education isn't making sense to me (yet).  I was
wondering whether others who might have similar interests could share their
thoughts or experiences.

        I have been interested in public health for a long time.  I read
the "personal health" columns in magazines and newspapers religiously, and
always have an opinion on health matters (sometimes to the annoyance of
friends and acquaintances).  Along with Marie Curie, other heroes I had
when I was growing up were Elizabeth Blackwell and Dr. McCoy from Star
Trek.  Oh, and Quincy.  

        I wanted to do "medical research," and was pre-med for a while, and
that's where this whole "problem" started.  I was dissuaded, rather
strongly (it seemed, anyway) from going into medicine by the pre-med office
of my undergraduate institution.  They said things like "if you really want
to do research, the time spent doing actual research, rather than getting
an M.D., would be better for your career."  The culture surrounding
"pre-med" was really rather appalling, in any case.  It seemed as if no one
liked pre-meds (sometimes for good reason).  
        And when I was applying, back in 1987, for medical school, they did
ask me a lot of questions about topics that I had little to no interest in,
 questions about HMO's and managed care, and my lack of interest in these
sorts of topics did make me think twice about becoming a physician.  And
when one interviewer asked me why I wanted to be a doctor, and I told him I
wanted to do medical research, the look on his face was sort of as if he
had stepped in something unpleasantly aromatic.  Another interviewer kept
trying to get me to get in touch with my feelings during the interview.  He
wanted to know how it "felt" to give a violin lessons to a 50-year-old
beginner (something I had mentioned in passing in an essay on
extracurricular activities), and told me I came across as too "in my head"
in the essays.  I've since wondered, in my head as opposed to where?  In
his head?  
        When I talked to a few people who'd gone through MD-PhD programs, I
became convinced that such a program wasn't for me, mainly for physical
reasons.  I need too much sleep.  In fact, I've never been able to stay
awake for 36 hours straight, and the one all-nighter I pulled in college
made me physically ill.  When one interviewer in an MD-PhD program
described the "exhilaration" of being pulled awake in the middle of the
night in the on-call room to get a patient's heart started for the third
time that night, I thought I was talking to an alien.  I felt vicarious
pain and sympathy for the patient, and only a bit less for my imagined self
as a resident unable to get any sleep.  But exhilaration was the furthest
thing from my mind upon hearing that story.  
        So, for reasons like that, I decided against the MD-PhD, and went
on to get a PhD.  I thought that I could still pursue "clinical" interests
and "medical research" through getting a research job at a medical school. 
But here too the culture was alien.  Few in the PhD culture I was immersed
in seemed to have much respect for having clincal interests.  There was the
attitude of "we have to make our work relevant to a disease so it can get
funded," but if one was actually sincerely interested in the clinical
implications of one's work, then one wasn't a serious scientist.  
        Basic scientists did science because they were "curious about how
the world works," and "liked to solve problems."  Not because they wanted
to "help people."  I was involved for a while in a debate against animal
rights activists.  Many of the scientists cautioned that we shouldn't make
too much of how biomedical research using animals has cured diseases,
because most scientists didn't do research with this in mind.  They were
right.  And if I had a dollar for every time I have heard, in the past 10
years, from PhD's, that "M.D.'s don't do good research" or "MD-PhD's often
get a second-rate PhD," I'd be rich by now.  How much of this is true, and
how much is it jealousy of M.D.s' higher prestige and pay for the same
work?  I've never really been able to evaluate that.

        So now I find myself again in a strange position.  I am applying
for a position where "clinical interests" should be a plus, and finding all
of the sudden, again, that I might not seem "clinical" enough.  I am always
feeling like a fish out of water, that I don't fit into the clinical world,
nor the basic science world, and that my dual interests are considered more
of a liability than an asset in either place.  Either I'm a cold
intellectual, too in my head for the MD's, or a naive dreamer without the
proper drive and intellectual curiosity in the eyes of the PhD's.  And I
still would like, somehow, to use my scientific talents and education to
"help people."  The public, by and large, supports medical research very
strongly.  The NIH has done well even in the budget-cutting years, and may
do even better if the government actually balances the budget or has a
surplus.  It seems like it ought to be a no-brainer to figure out how to do
something that there's so much support for, but I'm having a lot of

        I've come up with a few thoughts, from less to more adventurous. 
One of the more extreme thoughts was to engage in a complete career change
and get an M.P.H.  Another was to try to get a research job in a medical
school in something like an Alzheimer's Disease center.  Another was to get
a job in the biotech industry working on drug design.  
        I applied for a AAAS fellowship to work with Congress a couple of
years ago, but was turned down, and that made me realize how unprepared I
am for making this decision and carrying out the necessary steps to achieve
my goal of doing medical research with benefits to the public health.  I'm
sure the selection committee received applications from much
better-prepared, more thoughtful, and more well-directed applicants than I
was--and I would like to become better prepared, more thoughtful, and more
directed myself.  But I am having real trouble knowing even where to start.
 Does anyone have any ideas or thoughts?



Karen L. Allendoerfer, Ph.D.
Dept. of Physiology, Columbia University P&S
630 W. 168th St.
New York, NY 10032
(212) 305-3691 (phone)
ka143 at

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