agonyaunt | (no subject)

(no subject)

Dear Prudence,

I’m a college student and I’m about to graduate. I’m very excited about this, but I’m writing to you about a friend I made in school. She’s really kind, and the smartest person I know, but she’s severely lacking in social skills. She was homeschooled in a rural area, and her house doesn’t have the internet, so her pop culture knowledge is basically zero. She still lives with her parents, and commutes an hour each way to school daily. She has the political opinions of my Mom, i.e. the type of white middle-class lady who is totally incapable of seeing any flaws with the Obama presidency and generally seems stuck around that era of social understanding. Like she took my coming out as bisexual with grace, but I’ve had to explain pronouns to her. Several times. But I think she understands now, and she is genuinely a really nice and smart person.

Anyway, she’s looking at attending medical school after graduation, and she definitely has the grades for it. I thought this was great, and when we were discussing after graduation plans, she mentioned that she was going to take the year to apply to med schools and take the M-CAT. I put her into contact with Sarah, another friend of mine who was planning on doing the same, as I figured they could study together and look over each other’s applications or something. I think I felt a little guilty because I had a job lined up after school and I was moving several hours away, and I wanted her to have a friend that wasn’t her mom. So maybe I put too much pressure on it, but now I’m in a pickle, because Sarah recently told me that my friend has no chance of getting into med school and she didn’t want to hang out with her anymore. Apparently Sarah thinks that my friend is incredibly smart, and definitely has the grades for med school, but that she’s never going to get past the interview stage because she’s so socially stunted. Sarah had to explain the Fentanyl crisis to her, which I agree is definitely something a potential doctor should be aware of.

My friend has the same knowledge of drugs as my Mom as well; I’ve taken her to the clubs a few times so she has drunk alcohol (she dressed like a time traveler from 1990 and didn’t know any of the music), but I never would’ve smoked a joint with her.

What is my duty to my friend here? I don’t want to discourage her dreams in any way, but Sarah literally said that if she were a patient she would never trust my friend because she’s so sheltered and generally naive that she wouldn’t be relatable to patients. And honestly, I kind of agree, but I was assuming that moving out of her parents’ house would solve that issue. I don’t want to say anything, but Sarah says that if I don’t, she will, and I’d hate to have Sarah break the news to her in such an abrasive way. Especially if she lets it slip that she talked to me first. So do I stay silent and hope that Sarah does as well, or do I try to deliver the message in a kind manner?

—Straight A’s but No Street Smarts

Dear Street Smarts,

Give this girl a break! The thing about becoming a doctor is that it takes many, many, many years. Many years of growing, maturing, meeting new people and expanding your horizons. I refuse to believe she’s the first naive and sheltered person to pursue a medical career. It sounds like Sarah has some very helpful concrete advice for her that is not “Give up on your dreams because you’re totally clueless and patients will never trust you.” Why doesn’t she just provide some actual advice on passing the interview stage? “It’s going to help to be able to weigh in on current events in public health and social issues that intersect with our work. I recommend taking in some news every day, reading the following publications, and listening to these three podcasts to get yourself up to speed. This will also benefit you when it comes to relating to treating patients in the future.” Even if she doesn’t have the internet at home, a lot of this could be accomplished on her commute. Can you ask Sarah to pass that on?

https://slate.com/human-interest/2023/06/dear-prudence-girlfriend-obsession.html

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Well, this advice misses the mark. LW doesn't give both friends a name, so I'm going to arbitrarily designate the formerly homeschooled friend as Hazel.

No, LW should not "ask Sarah to pass that on", because - well, first, because that's weird. LW is Hazel's, LW is the one who got the advice, LW should pass that on. Also, Sarah apparently dislikes Hazel. That, or she's got even less social skills than she thinks Hazel does, because literally nobody appointed her the bearer of bad news. If Hazel does badly on med school admission interviews, she won't need anybody to tell her that she did badly. She'll figure it out all on her own when she doesn't get in anywhere. There is no need for Sarah to be so unkind. It's sufficient for her to just slowly fade out of Hazel's life with claims that she's too busy to socialize with anybody she's not close to. She doesn't need to be mean about it.

Which brings me to my second point, which is that unless I'm missing something here, all these people are the same age and at the same point in their lives. Which means that Sarah has no more insider knowledge of med school admissions than anybody else. She hasn't been to med school yet. She hasn't done the round of interviews yet either. What the hell does she know?

And since she's decided that it's very necessary for people to speak their opinions, no matter how harsh they may be, then somebody needs to share that with her. She's being needlessly unkind, for no reason, and also, she's talking out her ass.

Are we even talking 'social skills' here? I'm not sure that's what bothering LW as opposed to 'she is not terminally online and doesn't get our meme allusions'?

Okay, I think it's reasonable that Sarah doesn't have to be that person in the time-travel novel who explains How Things Are In This Here Future, but she just doesn't sound sympatico with LW's friend. It was a nice thought to try and build friendship links, but she doesn't sound the right person and I wouldn't rely on her judgement.

1. Sarah's a bitch.

2. I wonder if Sarah feels intimidated by Awkward!Friend and is trying to dissuade her from applying.

Yeah, I thought that too! Sarah is not in med school herself, Sarah does not work in med school admissions! There is no "news" for Sarah to "break." Hazel will get in or she won't, but Sarah has no special knowledge here, she's just assuming that her own experiences are prioritized and valorized. Sarah does not have useful and concrete advice. Sarah has her own prejudices about how people in general should always be.

If Hazel gets into med school, they'll teach her about fentanyl. If Sarah gets into med school, she'll find that a great many people there think President Obama was the bee's knees--or disagree with her about why. They both have a lot to learn. But it turns out that "I never would've smoked a joint with her" is not disqualifying for med school! Today LW learned!

The other thing LW should have learned is "not all your friends can be each other's friends, and that's okay, but if one of your friends doesn't like another of your friends, the answer is not 'oh no, fix yourself so she DOES like you!'" SIGH.

+1 I'm pretty sure as a patient I'd rather speak to Hazel, who is apparently very kind, willing to learn, has made significant efforts to move outside her original background, and holds mainstream liberal US views about a recent Democrat president. In comparison, Sarah is obviously massively judgmental and possibly vindictive. She would be a lot harder to confide in honestly if feeling vulnerable as a patient, and since she is clearly at least as sheltered as Hazel, in a different way, I'd be a lot more worried about her response to learning something new.

Dear Awkward Friend: I will be your friend.

Dear Sarah: someone here has poor social skills and it’s not who you think.

+1 Frankly I'd much rather have a doctor who listens to people and is good at learning new ideas than a doctor who is indoctrinated with mainstream views on things like "the fentanyl crisis" and thinks she knows everything about everything.

the type of white middle-class lady who is totally incapable of seeing any flaws with the Obama presidency and generally seems stuck around that era of social understanding. Like she took my coming out as bisexual with grace, but I’ve had to explain pronouns to her.

and

My friend has the same knowledge of drugs as my Mom as well; I’ve taken her to the clubs a few times so she has drunk alcohol (she dressed like a time traveler from 1990 and didn’t know any of the music), but I never would’ve smoked a joint with her.

kind of made me blink. All I see is wall to wall young people who are about to find out that the establishment does not share their opinions or care about the same things they care about, and honestly Prudence would have been way more helpful to start with that. Also, yeah. Don't give "advice" that bypasses the LW to give an action item to a third party. Complete amateur move for an advice columnist.

Yeah, "able to admit she doesn't know things" and "willing to listen and incorporate new info" are really important social skills! For doctors and for everyone else! (God knows I've suffered plenty of doctors who don't have them.)

Not knowing pop culture references isn't a personality flaw, but declaring someone "socially stunted" and therefore hopeless at life and unworthy of friendship... sure says something about Sarah. Would hate to be her patient and watch her sneer at how unfashionable my clothes are or whatever other bullshit she and LW think is appropriate to judge other people for.

Honestly I hope Hazel finds some actual friends who don't view her with contempt or patronizingly treat her like a project to be molded. LW doesn't respect her at all, and should just let go of this idea that they need to manage Hazel's life in any way.

Yeah. I've had an MD who was too ignorant of relevant experiences to give me appropriate medical advice off the top of their head - but it was okay because they were like, I will look this up and email you & then did w/in a day - and have received substandard medical care from an MD who believed they were fully knowledgeable and correct on these issues. Like, don't get me wrong, it would be better to have had neither & had a doctor who was trained and knowledgeable about working w/ my demographic & concerns but.... the first one's still better than the second.

Hey LW, if you’re so set on believing that someone can never grow after having been homeschooled and raised in seclusion from pop culture, there’s a lot of memoirs I can recommend. I’d start with “Educated” by Tara Westover.

+1 A willingness to learn is much more important than being up to date with the current cultural zeitgeist in the long run.

I'm going to dissent here a little.

Honestly, Friend really does sound kind of incurious about or unaware of current events issues that relate to her chosen profession (trans/gender-affirming care; opioid use; and, possibly, legalization of cannabinoids for various purposes; I wonder if she's also unaware of, say, the effect that the repeal of Roe v. Wade has had on her chosen profession?). Which doesn't mean that LW's not a pop-culture snob/extremely online and that Sarah's not the kind of person who... well, some of them do make good medical researchers and surgeons, as long as they don't have to do that pesky bedside manner thing. But Friend also doesn't seem like the kind of person who, if you will, knows that she doesn't know what she doesn't know about issues relating to her chosen field. (I'm on like my third draft of this and I've done my best to condense it down to the bare-bones version.)

It is entirely possible that you're right on that. But Sarah still needs to keep her opinions to herself.

Yeah, Sarah needs to bow out gracefully--- speaking of professional-social skills and dispositions, practicing how to withdraw from a professional relationship, whether doctor-patient or colleague-colleague, is a good one to practice! ;>

Wouldn't it be hilarious if Hazel was admitted to med school and Sarah wasn't.

Poor, prejudiced Sarah.

Word.

I dunno. I'm not sure LW can discern and thus convey the difference between "unknowing" and "incurious" , but then I don't really love LW as her comments about Obama remind me of the kind of leftist who prefers Trump to Biden.

It can be really hard to realize/get a framework for what one doesn't know, especially coming from a very sheltered background, but I think going to med school (if she gets in) will help teach Friend that, if she's willing to learn. I don't see enough evidence that she's not willing to learn, and Sarah definitely isn't helping. I don't think LW is either as much as she wants to. (Which is why the advice should have given her some thoughts on how to help more succesfully.)

I kind of wonder if LW's mom might laugh like a loon at the idea that her generation doesn't know anything about drugs. I mean, I am sure most people have never thought of me as a stoner, but the idea that I didn't know any stoners is pretty ludicrous.

Honestly, Friend really does sound kind of incurious about or unaware of current events issues that relate to her chosen profession (trans/gender-affirming care; opioid use; and, possibly, legalization of cannabinoids for various purposes; I wonder if she's also unaware of, say, the effect that the repeal of Roe v. Wade has had on her chosen profession?).

This. If LW is going to bring this up with her friend, it's better to come at it from a place of concern - because it is a concern: "Is this really something you are passionate about and will be content with at least long enough to pay off the school debt? Is this really something you can realistically see yourself enjoying for up to 60 hours out of your week?" Assuming LW and friends are from the US, college isn't cheap. If Friend is going through medical school in hopes of getting a job that pays well, college debt is still going to eat into that pay for quite a few years. It's better to be broke in a job that you can at least tolerate than rich in a job you may not be fully invested in.

Heh, LW reminded me of the sort of Bernie-or-bust leftist whose end result is ultimately the same as the kind who actually prefers Trump, but we agree that LW is not the sort of leftist either of us loves.

And, yeah, one of those multiple drafts of my first reply to this included some more detailed ideas of actual sources of possible help for Friend, and also possibly for Sarah, for that matter--- if the career counseling center at their school is not in fact the sort that makes the rounds at AAM for deserved horror and mockery, they might be able to ask some useful questions at least. And if their school has any sort of a pre-med program or equivalent, there might be some useful types on the faculty there, ditto any recent grads of the program that have, unlike Sarah, already been accepted to med school, if there's any kind of an alumni network (whether and how to access this varies widely and wildly from school to school).

And I don't think that Friend is necessarily not willing to learn but if LW's even half right she does seem sort of passive about learning--- it sounds like she waits until someone tells her stuff rather than wondering if she doesn't even know what she doesn't know. I can actually believe that Friend could be the product of parents who are reasonably liberal and well-educated and pulled the kid out for homeschooling so that she'd get academic enrichment/acceleration beyond what she could have gotten in other settings and possibly to avoid bullying (this could be a reason for no at-home internet, along with the assorted logistics of getting internet access in rural areas, including but not limited to the financial). If she's used to parents who actively provided her with an enriched but highly theoretical (and possibly at least somewhat "behind the times" with the most current of current affairs--- or with controlled substances, didn't necessarily want her knowing about them) learning environment and then in college she had professors who did something similar, the idea that the older educational authority figures in her life are no longer going to put everything she needs to know in front of her and that she's going to have to start learning what she doesn't already know and seeking it out might be a new one. Anyway, that's a possibility I got from "left-leaning and homeschooled"--- had parents who were really good at teaching her as far as that went and precisely because of that she's not used to the idea of an educational or professional life in which she's expected to go looking for things she doesn't know. (I keep thinking about continuing educational requirements for doctors to keep their licenses--- it was in several of those drafts I mentioned and it keeps coming back to me. And I will confess that LW's specific examples leapt out at me as places where Friend's apparent absence of awareness of these issues at all just made me wonder if she's genuinely interested in, well, medicine as a field beyond, "I'm smart and good at school so maybe I should be a doctor"? Because I'd think if you were reading on your own spontaneously about medicine as a career and what it's like to be a doctor today and so forth because it's something you really want to do you would have stumbled over Fentanyl at least, and possibly a few news articles or similar on the "trans bans" or something.)

Yes, this! I think you got at one of the things that was bothering me more succinctly than I did, though I got at it a little more in my reply to

minoanmiss above: is Friend really interested in medicine as a field--- much less interested enough for the kind of investment of not just money but self that the field tends to require? As you say, there are jobs you can do without that kind of investment of time, or for that matter money, especially for someone who's good at academic kinds of things.

Edited (HTML, typo) 2023-06-16 03:41 (UTC)

An LOL moment, absolutely. The naivete about what markers mean people are in the know here is just so painfully young. And the idea that a medical school would care about any of this in admissions is even more ludicrous.

I'm kind of agreeing with all the comments that think it's much less clear than LW thinks that Hazel won't get into med school (I mean she probably won't, and Sarah probably won't, because most people won't, but they're probably not uniquely unqualified per admissions standards).

I do kinda want to push back on the idea that med school is automatically going to give a sheltered and possibly incurious or passively curious person a robust and compassionate view of current issues around contested topics like substance use and trans rights.

I do kinda want to push back on the idea that med school is automatically going to give a sheltered and possibly incurious or passively curious person a robust and compassionate view of current issues around contested topics like substance use and trans rights.

Never been to med school, so I wouldn't know, but I *will* say that doctors overwhelmingly fail to impress me with their communication skills. I've been in the ER as recently as six months ago, explaining to some parents that when the doctors hand you the paperwork, that's it, now your child is discharged and they'd like you to go home. Because they'd never been to the ER before, and they just... were handed a bundle of papers with no explanation.

And come to think of it, I've never gotten an explanation that "Okay, that's it, you're discharged and should go home" any time I've been in the ER. Heck, I've had multiple regular visits where the doctor ends the visit by wandering off and I've had no idea if they left to get paperwork or a test or something or if that was my cue to leave.

And it's... something as basic as "how to let your patient know that the visit is over" really ought to be covered on day one of their residencies.

A few years ago, a doctor and I had this exchange:

"I see from your file that you're on the pill, which means you're sexually active."

"No, it means I'm treating my dysmenorrhea."

"Okay, if you're not sexually active, you're not married."

"Actually, I'm in a sexless marriage."

"Okay, so what's your husband's name?"

"My WIFE'S name is..."

In Boston!

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