Big Pimpin'

Today in the clinical cancer center, I got pimped. Or, I suppose more like – I became a participant in the pimping process. I know you’re all thinking, “But Julie, why is that worthy of writing about? How is that any different from your normal activities?” Alas, that certainly is the crowd I roll with on the weekends (as long as my biochemistry homework is finished!) but this is a very different kind of pimping than the aforementioned recreational activity. Medical pimping involves the process of doctors publicly belittling medical students, proving that they know nothing and are in no way qualified to be a doctor.

While waiting for the elevator today in the cancer center, Big Pompous Oncologist, M.D., was pimping his third or fourth-year students completing a rotation, asking them about the genetic cause of chronic myeloid leukemia. The medical students stood around, looking at the floor, while Big Pompous Oncologist went on a rant about how unprepared they are to enter the medical profession, and he would never want them as his doctor. Finally, he just yelled in the forum “Christ, Doesn’t ANYONE know what causes CML?” Standing in my corner awaiting the elevator, I muttered under my breath, “a t(9:22)(q34;q11) translocation”. Either Big Pompous Oncologist has super-hearing abilities, or I need to work on muttering under my breath less distinctively, because apparently, he heard me. “Thank god there’s intelligence somewhere in this hospital,” he replied. “How about you say it loud enough so maybe these students can learn something? Or are you just trying to make yourself feel smarter through your unwillingness to share your knowledge with others?” Ouch!

“A chromosomal translocation between 9 and 22, q34 to q11,” I state louder and more confidently. The medical students all had the collective “Ooooh” moment, like the knowledge all just flooded back into their brains. Big Pompous Oncologist wanted mechanisms as well, asking, “What in the translocation process causes CML?” No response from the med students. I hope none of them plan on going into oncology – it’s not like CML is some rare form like hairy cell leukemia that they wouldn’t expect to see in patients. Before being accused of trying to hoard knowledge again, I spoke up. “The translocation results in the Philadelphia chromosome, creating a fusion protein BCR-ABL, in which part of the gene BCR from chromosome 22 becomes fused with the c-ABL on chromosome 5. The BCR-ABL protein is controlled by the BCR promoter, which is constituatively active, creating a problem because ABL is a tyrosine kinase, therefore increasing proliferation and protecting the cell from apoptosis.” Next Big Pompous Oncologist asked about treatment, and finally one of the medical students spoke up, identifying Gleevec as the targeted therapy of choice, but not knowing how it works, once again leaving me to reply how imatinib mesylate blocks the active site of ABL, preventing ATP biding and thereby preventing ABL from phosphorylating.

After belittling his medical students a little more, Big Pompous Oncologist asked what year I was. When I replied that I was a first year PhD, he looked appalled. At that precise moment, the extraordinarily slow elevator finally arrived and I stepped on, just in time to hear Big Pompous Oncologist turn to his medical students and say in disgust: “A first year PhD student knows more than you. A PhD student! Someone who wasn’t able to get into medical school in the first place is now more competent than you. You should be ashamed of yourself; you’re more intelligent than her.” It’s a good thing for my future career that the elevator doors were already closing, because I surely would have punched him in the face. All the PhD students in my program are there by choice because we are committed to research, not because we didn’t get into med school, and I think we are every bit as intelligent as medical students. Like I said, it’s a good thing the elevator was there, because I’m fairly sure that I would have been kicked out of the program for punching him in the face – I don’t think I’m pimptastic enough to get away with something like that.