As a rising second-year medical student I hit the scientific jackpot.
Carving up DNA with restriction endonucleases to elucidate the control sequence of oncogene c-myc. That was my job.
Each day, I’d arise from my humble home-stay in Bethesda, Maryland, gulp some coffee and pedal through the glorious park system that surrounds DC. Once at the NIH I’d lock my bike and trot up 8 flights of stairs to the hospital floor where I worked. I’d find an unoccupied patient room and shower there, then go to Dr. Fauci’s lab to begin my workday. No matter how early I got there, scientists and post-doctoral scholars of various types would already be hard at work. I gave up trying to be first to work, because I never was, would be, or could be.
This all occurred in the summer of 1984 during my break between the first and second years of medical school. I forget the name of the program that allowed it, but essentially we could do whatever scholarly project we desired so long as Yale signed off. I applied to the NIH, and got the gig. So did a host of my classmates.
Day one we assembled in the lobby of the Institute of Allergy and Infectious Diseases for orientation and placement. At the end of orientation, my name was called. “Burg, you’re assigned to Dr. Fauci’s lab.” And off I went.
A tired-looking, rail-thin, prematurely-balding post-doc scientist from an Eastern European country (Lithuania perhaps) greeted me in the lab.
“You’ll be working here,” he said, pointing to a lab bench space crammed with exotic machines, test tubes, pipettes, and other scientific equipment.
Now, I can barely remember the details of the work but I do recall learning how to cleave DNA in specific ways, running the cleaved fragments on a “gel” and entered the data gained from these experiments into elaborate spreadsheets.
What I remember far better was meeting with Dr. Fauci during weekly lab updates and rounding (seeing patients) with him on his HIV/AIDS ward. There, dozens of wasted young men resided, wrestling with hideous opportunistic infections and other conditions resulting from the decimation of their immune systems. Most were marred with the malignant purple polygonal patches of Kaposi’s Sarcoma. Many had one or more cerebral infections like cryptococcal meningitis or toxoplasmosis. Others struggled to breathe, either because of bacterial pneumonia or the then-named pneumocystis carini pneumonia. Some were blind or partially sighted, also an HIV/AIDS consequence. All were skeletal and had chronic diarrhea.
Treatments of various types were attempted but I can’t recall that a single individual improved and was discharged home. HIV/AIDS in those days was a death sentence. The patients I saw on Dr. Fauci’s ward checked in for a chance at a novel therapy with promise, and died. I rounded with Dr. Fauci and his team of medical scientists on these patients.
What I came to know:
Bench research — not for me.
Learning the techniques and performing the procedures I had to was great. And I never want to do it again. I ended up learning an enormous amount of basic science material that was interesting and somewhat helpful to me as I progressed through medical school’s pre-clinical years. But caring for patients, not machines and glassware in the lab, is where my passions lie. I envied the NIH “lab rats” with their incredible work ethic and profound knowledge bases but realized their world could never be mine. Explore, but find what you love and do that. That was my takeaway.
No matter how much you know it is always eclipsed by what you don’t.
True, always, and forever. When I had my tangential brush with scientific fame and interacted with Dr. Fauci he had already published hundreds of scientific articles. His name was on the spine of the most august text in all of Internal Medicine, and he had come within a hairsbreadth of isolating the virus that causes HIV/AIDS. In spite of all this, he and his team had virtually nothing to offer the dying young men on their service. That all came later. That knowledge was unknown and unknowable in 1984.
Be humble no matter what your level of accomplishment.
George Palade was our cell biology professor at Yale Med. The students joked that he had “invented” ribosomes (a critical intra-cellular component responsible for protein synthesis). In fact, he had “merely” discovered them and had won the Nobel Prize for his efforts. He took our naive questions and led class, not like the visiting scientific demigod that he was, but as a slightly older version of us, our older, more experienced, and wiser colleague. Dr. Fauci behaved the same way. He led us, in the lab, and on rounds visiting patients, but more importantly, he was with us. A super-smart, engaging, and funny superb medical scientist who I remember for those qualities to this day.
Honest humility always triumphs.