Is it worth it?

[bsneuroscience]

Hi all, I am currently a junior in undergrad on the premed track and I would appreciate some guidance on my path before I continue forward. I posted this in the r/premed forum but I wanted to get more insight. This pandemic has given me a lot of time to think, reflect, and soul search.

One of my parents passed away from Huntington’s Disease a couple of years ago, it’s a neurodegenerative disease that over time kills your brain cells making it harder to think, talk, move, etc (to put it simply). Many physicians and scientists have said that HD is a mixture of ALS, Alzheimer’s, and Parkinson’s into one. Worst of all, there’s no cure and it’s fatal- most die within 20 years of getting diagnosed but every year the symptoms worsen and patients eventually get bedridden.

Now how does this affect me?- Huntington’s is an autosomal dominant disease meaning that every offspring of the affected has a 50% chance of getting it. There are genetic tests to see if I have the HD gene (multiple CAG repeat), but the test is over 2,000$ dollars and there’s no guarantee that my name is safe from insurance companies who want to give my future employers a glimpse of if I have the disease and not hire me. I’m also a bit scared of knowing since I’m still young and I want to not have such depressing thoughts every day if I am positive for HD. Also, long term and life insurance comes with most full time/steady jobs - which I DON'T have. I've been told I'm too young to get tested and it's important to be covered before you get tested or the insurance companies will rack up the costs

I didn’t know I always wanted to become a doctor but during middle/high school, I began to appreciate science more and the world around me. I never really understood how important science was and how cool research can be. But I knew from a young age I wanted to be in a profession that worked closely with people and I want to improve their lives in some way. I felt like the medical path was the best for me. I want to know as much as possible in my field, I want to guide others, spread knowledge, and lead a team. I especially want to help people like my father. And I want to be able to do research in creating more treatments/therapies for people with HD and come closer to finding the cure.

“So what’s your dilemma??!? Just be a doctor!”

Well... let’s say I do get into medical school. I’ll be around 27 years old. Let’s say I get into a surgical specialty and a fellowship (4-7 years total). I would be around 35. If I did have HD, my symptoms would be kicking in slowly and I would risk injuring patients. The worst symptom of HD (at least in my opinion) is the uncontrollable movements- and obviously you have to be steady with your hands if you're dealing with patients. I feel like it would be selfish of me going into this field KNOWING I could possibly have this disease. I think I’m presenting some symptoms (even though it’s WAYYY to early to tell and it could just be my paranoia), but I’m not sure.

“So you’re scared of interacting with people and harming them? Just get a Ph.D. and do research so you don’t come into contact with anyone!!!!”

The thing is I want a profession that allows me to work with patients and medicine, a Ph.D. wouldn’t allow me to do that.

I’m honestly considering going to the PA route because I’ll be able to start working immediately and won’t have to worry about my symptoms for a while (if I am (+) for HD) and I can pick which specialty I want. The only thing is it’ll be harder for me to do research and I won’t have all the knowledge/training I’d like for my profession.

I’m so sorry for the long story. I’m scared for my future, but I am working hard as an undergrad. I’m involved in a neuroscience lab and as a sophomore, I currently have a 3.91 cum. GPA. I would like some guidance on what I should do? Or if you were in this situation, what would you do? Again I feel like if I pick the long, medical school route, I’m being selfish because of the possible reason I could get HD in the future.

My underlying question is... is it worth it? The death of one of my parents from HD is one of the biggest factors onto why I am going into medicine and I would feel fake if I didn't put it.. but it's still risky and could be considered just as bad as an IA because I'm technically a liability. Won't I be discriminated from applying to certain schools and have my application shredded? Again, I cannot imagine going into any other field (happily). My life goal with going through medical school is to ***hopefully*** become a neurologist that does research on the side about neurodegenerative diseases. :')

Thank you all for the reading, I hope you all never have to go through this situation or have to experience it first hand.

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[Hzreio]

I don’t know how to advise you exactly, but I can’t even imagine the weight you live with in considering these things for the future. I’m very sorry for your loss. I’m sure none of the decisions you will make regarding this will be easy, but I truly wish you the best of luck and health.

 

[Orangekiwi]

Hey OP, I won’t pretend to understand what it’s like to carry that burden and no one can decide what the right decision is for you except yourself, but I ask you this- if you wind up not to have Huntington’s and you don’t pursue getting your MD, do you think you’d look back on that decision with regret? It’s not selfish for you to pursue the profession that calls to you, and I would caution you not to let a disease you’re not even sure whether or not you even have define what you can and cant do.

Marcus Aurelius said “It is time now to realize the nature of the universe to which you belong, and of that controlling Power whose offspring you are; and to understand that your time has a limit set to it. Use it, then, to advance your enlightenment; or it will be gone, and never in your power again.”

Whether your time is limited by Huntington’s or just by the nature of being human is not under your control, what is under your control is how you choose to spend the time that you have. You said that being a PA would not provide you with the knowledge and training that you desire, and that you can’t picture yourself being happy as anything other than a physician, and for me that’s all I see here that matters. You have as much right as anyone to the pursuit of happiness.

To paraphrase from MA again, someting that I think often gets lost in our world is that human beings are notseperate from the natural world. You are a part of nature, and nothing can stop you from acting in accordance with nature, always. I hope that whatever you choose to do you choose because it’s right for you, without worrying about things that are outside of your control, and good luck!

 

[lumya]

Hi OP. I'm so sorry for the situation you're in. I think the questions you're asking are outside the depth of what SDN can offer. Is it possible for you to talk to a counselor of sorts? I know some specialize in talking with physicians or other caregivers. They might be able to offer you some perspective. I know for some health insurances, they can provide their services over the phone or online, especially now with covid. I wish you the best of luck and I hope you find peace with whatever decision you make.

 

[LizzyM]

You have a lot of "what ifs" in your essay. What if you take it one day at at time for now, be thankful that there is a test that lets you know if you have inherited it. (This test wasn't available when I was in college and one of the students on my hall had a mom with Huntington's. Because of that experience it has always been close to my heart.)

You may want to learn more about federal law that protects against some forms of discrimination

Genetic Discrimination

In 2008, the Genetic Information Nondiscrimination Act was passed into law, prohibiting discrimination by employers and health insurers.

www.genome.gov

You may also want to consult with a genetic counselor at the point when you are old enough to consent to genetic testing, able to pay for the test out of pocket, and have long term care insurance and disability insurance policies in your name.

In the meantime, pursue your dream. If you do develop a disability, you may be able to practice within a field that values your powers of observation and your ability to speak (dictate) rather than your ability to perform procedures. There are many satisfying roles within the field of medicine and you have some years to figure that out.

 

[Rogue42]

First, I am so sorry about your loss. That is tough, no doubt. The burden that you must carry on not knowing yourself must also be heavy, and I know that I can not even fathom that weight.

With that said, let me say, I will never discredit the all-powerful LizzyM because she is a highly intellgent, much older and wiser person than myself, but I have a different view;

Medicine is hard. It is a long, grind it out process. There are no guarantees. There is a LOT of stress. A lot of sleepless nights. A lot of missed opportunities. A lot of nights in, when you'd rather be out with friends. A lot of missed family events. A lot of "look at all the great things my friends my age are doing / have" which includes a list of buying houses, and cars, getting married, having babies, traveling, etc. A lot of "missing out" in your 20s. Don't get me wrong, medicine IS worth it. Thats why we all do this right? But, we also do it knowing that we have 25-30 year careers of the best moments of our lives ahead of us.

BUT, I can tell you that if someone came along and said, "Rogue, you can go into medicine, you'll have to go through / give up everything that was just listed, and by the way, when you're done, you only have about 5 good years left before you cognizantly decline. Meaning that you will miss out on all of that AND not get to reap the reward of the work that you put in for the last decade of your life," then I would walk away from medicine without blinking.

Your question, "Is it worth it?" is all in the eye of the beholder. Ultimately, medicine is worth it in the long run. Physicians on average start off way behind their peers in terms of net worth, families, housing, vehicles, etc. People choose this because they make up for it quickly, and then get to watch all of their wildest dreams come true while helping thousands of people throughout their lifetime. You don't really get the "feel" good aspect of medicine until residency anyways.

But I can personally tell you that I would not do this path if I knew that I did not have that 25-30 year career ahead of me. Medicine isn't worth giving up your life, to graduate residency, and not have the cognitive ability to practice - IN MY OPINION (in the case that you laid out above). EVEN for a PA I wouldn't do it because if you went for 2 years, at age 27, then you are only getting 6 years of practice time in before the decline which isn't worth it IN MY OPINION (again, in the scenario that you laid out). Personally, I'd much rather find a job that I could do, a wife, start a family, make a little bit of fun, enjoy the smaller things in life, and make somewhat of a life for myself until things got rough.

So, I say all of that to say this. You have to decide what you want out of your life WITH or WITHOUT Huntington's Disease. If you went to medical school, got through residency, became a board certified physician, was diagnosed with HD relatively soon after residency, and you were still happy with the life choices you made, then do it! Go chase that dream. But seeing that you posed the question of whether or not it is worth it makes it seem that you must be having those same thoughts that I have just laid out. In which case, if you go to medical school, go through residency, became board certified, was diagnosed with HD relatively soon after residency, and you think you wouldn't be happy with the life choices you made, then I would tell you to hold out. However, I would tell you to keep working to be in the position to apply, just in case you decide you would be happy or test negative.

Woah that was a lot. Just my perspective though, and I am nothing more than a 25 year old medical student.

 

[LizzyM]

Medicine is hard. It is a long, grind it out process. There are no guarantees.

There are no guarantees for any of us. Would Paul Kalanithi have pursued neurosurgery if he had known his fate while still an undergrad? (He died due to cancer at 37 years old; his autobiography When Breath Becomes Air was published after his death.)

Each of us needs to decide how to spend what the poet Mary Oliver called, "your one wild and precious life". Making any assumptions about the estimated length of that life is a fool's errand.

 

[Goro]

Hi all, I am currently a junior in undergrad on the premed track and I would appreciate some guidance on my path before I continue forward. I posted this in the r/premed forum but I wanted to get more insight. This pandemic has given me a lot of time to think, reflect, and soul search.

One of my parents passed away from Huntington’s Disease a couple of years ago, it’s a neurodegenerative disease that over time kills your brain cells making it harder to think, talk, move, etc (to put it simply). Many physicians and scientists have said that HD is a mixture of ALS, Alzheimer’s, and Parkinson’s into one. Worst of all, there’s no cure and it’s fatal- most die within 20 years of getting diagnosed but every year the symptoms worsen and patients eventually get bedridden.

Now how does this affect me?- Huntington’s is an autosomal dominant disease meaning that every offspring of the affected has a 50% chance of getting it. There are genetic tests to see if I have the HD gene (multiple CAG repeat), but the test is over 2,000$ dollars and there’s no guarantee that my name is safe from insurance companies who want to give my future employers a glimpse of if I have the disease and not hire me. I’m also a bit scared of knowing since I’m still young and I want to not have such depressing thoughts every day if I am positive for HD. Also, long term and life insurance comes with most full time/steady jobs - which I DON'T have. I've been told I'm too young to get tested and it's important to be covered before you get tested or the insurance companies will rack up the costs

I didn’t know I always wanted to become a doctor but during middle/high school, I began to appreciate science more and the world around me. I never really understood how important science was and how cool research can be. But I knew from a young age I wanted to be in a profession that worked closely with people and I want to improve their lives in some way. I felt like the medical path was the best for me. I want to know as much as possible in my field, I want to guide others, spread knowledge, and lead a team. I especially want to help people like my father. And I want to be able to do research in creating more treatments/therapies for people with HD and come closer to finding the cure.

“So what’s your dilemma??!? Just be a doctor!”

Well... let’s say I do get into medical school. I’ll be around 27 years old. Let’s say I get into a surgical specialty and a fellowship (4-7 years total). I would be around 35. If I did have HD, my symptoms would be kicking in slowly and I would risk injuring patients. The worst symptom of HD (at least in my opinion) is the uncontrollable movements- and obviously you have to be steady with your hands if you're dealing with patients. I feel like it would be selfish of me going into this field KNOWING I could possibly have this disease. I think I’m presenting some symptoms (even though it’s WAYYY to early to tell and it could just be my paranoia), but I’m not sure.

“So you’re scared of interacting with people and harming them? Just get a Ph.D. and do research so you don’t come into contact with anyone!!!!”

The thing is I want a profession that allows me to work with patients and medicine, a Ph.D. wouldn’t allow me to do that.

I’m honestly considering going to the PA route because I’ll be able to start working immediately and won’t have to worry about my symptoms for a while (if I am (+) for HD) and I can pick which specialty I want. The only thing is it’ll be harder for me to do research and I won’t have all the knowledge/training I’d like for my profession.

I’m so sorry for the long story. I’m scared for my future, but I am working hard as an undergrad. I’m involved in a neuroscience lab and as a sophomore, I currently have a 3.91 cum. GPA. I would like some guidance on what I should do? Or if you were in this situation, what would you do? Again I feel like if I pick the long, medical school route, I’m being selfish because of the possible reason I could get HD in the future.

My underlying question is... is it worth it? The death of one of my parents from HD is one of the biggest factors onto why I am going into medicine and I would feel fake if I didn't put it.. but it's still risky and could be considered just as bad as an IA because I'm technically a liability. Won't I be discriminated from applying to certain schools and have my application shredded? Again, I cannot imagine going into any other field (happily). My life goal with going through medical school is to ***hopefully*** become a neurologist that does research on the side about neurodegenerative diseases. :')

Thank you all for the reading, I hope you all never have to go through this situation or have to experience it first hand.

Get tested and then make your career plans accordingly.

Be sure to get long term disability and care insurance