His day job may not be nearly as dramatic as it is portrayed on television and film, but as David Epstein, MD, explains, the non-fiction version of the medical field is still intriguing. Which is why Epstein brings his knowledge to the small and silver screen as a consultant for The Exchange. We caught up with him recently to ask him a few questions about his background in pediatrics, what his average workday looks like, and what, if any, similarities exist between fictional medicine and real medicine.
Tell us about your background. What sparked your interest in medicine and pediatrics?
My memories are a bit foggy regarding my early childhood, but my parents remind me that I wanted to be a physician since I was 5 years old. I think that they thought that I was going to be a surgeon because of the way that I dissected my food at the table. But my first recollection of wanting to become a doctor stemmed from my grandfather passing away from cancer when I was 12 years old. At the time, it was a very painful experience. Being exposed to the hospital environment and seeing someone very sick for the first time really inspired me to want to make people well again.
As I entered into medical school, I really had no idea about what kind of physician that I wanted to become. I gravitated toward pediatrics because of the honest, lighthearted nature of children and their resiliency, even in the most extreme circumstances. One of my first experiences being significantly involved with the care of a critically-ill child was during my rotation in the intensive care unit (ICU) as a pediatric resident. I was helping care for a young boy who was very sick. One night when I was on call, he had a cardiac arrest. I was the first responder and started the resuscitation with the help of experienced nurses and respiratory therapists. By the time the attending ICU physician arrived, we had just about stabilized the child. I will never forget how quiet and serene the environment was when the staff was working during the code. It was the ultimate scene of teamwork and professionalism. I was impressed by how everyone performed his or her job with such focus and speed. I knew then that I wanted to become a pediatric ICU physician and be part of a team like that.
Could you explain for our readers what you do on an average day?
As an academic physician, my days are variable and depend on my clinical, research, teaching, and administrative responsibilities at the time. When I’m on clinical service, I spend a week at a time in the intensive care unit. While I enjoy all of pediatric critical care medicine, I have a special interest in cardiac intensive care and I mainly help care for children with heart disease, both congenital and acquired. Most of the care revolves around preoperative and postoperative management of these children and I work with a multidisciplinary team of cardiologists, cardiothoracic surgeons, specialized nurses and nurse practitioners, respiratory therapists, social workers, nutritionists, and many other health care professionals to move infants, children, adolescents, and their families through this most difficult time in their lives. I work in a pediatric ICU in an oncology hospital, where there is a different type of patient population with its own special characteristics and needs. It is the variety of clinical work that keeps me intellectually stimulated and striving to learn more.
Because I work in an academic center, I am responsible for and thoroughly enjoy teaching medical students, pediatric residents, pediatric critical care fellows (sub-specialized training), and nurses both in the clinical arena and in formalized teaching sessions. It is very exhilarating to be able to share what I’ve learned with others. When I’m not on clinical service or actively teaching, I am involved with research activities. My area of interest is health care disparities and how they relate to critical illness in children. There are many barriers to accessing health care that have nothing to do with a patient’s ability to obtain insurance and it is important to identify these barriers and remove them. Finally, I have administrative responsibilities that have me engaged in performance improvement activities in the intensive care unit and hospital committees. This gives me the opportunity to improve the care of children from a system or organizational standpoint. The diversity of activities really keeps me engaged in the medical field in a way that makes my work gratifying and fun. So, in answer to the original question, there is no average day at work and that is what I like about it.
Were there any films or television shows that sparked your interest in science as a kid?
I enjoyed watching medical dramas because of my interest in medicine. I specifically enjoyed watching St. Elsewhere. It was my first window into the physician-patient interactions. The characters and stories really exposed me to the emotions and feelings that I imagined a physician would experience.
How did you become involved with The Science & Entertainment Exchange? What do you think of the program?
The public, at large, enjoys watching medicine on television and in movies. Part of their education about medicine (just as I had as a child and adolescent) is through these entertainment platforms. Patients and their families subsequently bring the perceptions and expectations of medicine, formed by what they view through television and movies, with them to the medical encounter. Because I am an educator, as well as a clinician, I feel that being involved with the entertainment community is an excellent way to send relatively reliable medical information and portray the medical field accurately to a large public audience. I sought out a venue to do this and found The Exchange. I have had an excellent experience with The Exchange and the entertainment community that I have had the opportunity to serve. The Exchange has fulfilled my goals of educating and is a valuable service to the public by encouraging the accurate depiction of science.
What’s a major difference between medicine as seen on television/film and medicine in real life? Are there any similarities?
The medicine in real life is not quite so dramatic all of the time. There are a lot of unexciting things happening, just like any job. There are many times, however, that real life is stranger and more exciting than what can be portrayed on television or in film. The similarities lie in the people who are in the medical field. You see a lot of different personalities in the hospital and can often relate to the characters that are shown on television or film. But, I do have to relay the old cliché, “Truth is often much stranger than fiction.”
Thinking of the next generation of filmmakers and scientists – what message would you like to share with them?
I would let them know how exciting it is to collaborate on projects together. I have learned a lot about creative development from the writers that I have come in contact with and I’ve had the opportunity to use parts of my brain that I didn’t know existed. It is a great chance for both parties to explore science reality and science fiction. Science and entertainment are not mutually exclusive worlds and both can benefit from each other in ways that they would not be able to benefit alone.
What inspires you?
The thing that inspires me the most is being creative in my work. I enjoy asking clinical questions and performing clinical research. I also have found that the medical aspects are interesting, but the interactions with patients and their families, as well as the systematic practice of medicine, are even more interesting. Anyone can practice medicine, but it is the way in which you deliver care to patients and families that really makes the big difference.
Read more Scientist Spotlight interviews here.