Medical school and the lessons learned from football [PODCAST]

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“In the Spring semester of my final year as a football player, my college team faced necessary coaching, staff, and player position changes. At this point in my college career, we had yet to have a winning season. These changes were made to shift our program’s culture and give us new life going into the upcoming Fall season. My new position coach, our team’s former linebacker coach, greeted us all in the defensive line room during our very first Spring position meeting with a stark message that, to this day, has changed my way of thinking about the hardships, especially now as a medical student during the COVID-19 pandemic.

During his message, he put up the Japanese symbol kiki (危機) on the overhead screen and questioned if any of us in the meeting room knew its meaning. As my teammates and I looked at each other thinking, what the heck is this guy up to … our coach informed us the symbol is written in kanji and translates to ‘crisis.’ (We thought he was only foreshadowing the imminent torture we were about to face that Spring as we prepared to change the trajectory of our program.)”

Casey Paul Schukow is a medical student.

He shares his story and discusses his KevinMD article, “In crisis, danger and opportunity are present.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Casey Schukow. He’s a medical student, and he wrote the KevinMD article “In crisis, danger and opportunity are present.” Casey, welcome to the show.

Casey Paul Schukow: Thank you so much, Kevin.

Kevin Pho: So we’ll get into the article in a little bit, but first off, can you share your story and journey to where you are today?

Casey Paul Schukow: Yeah, absolutely. So I’m in my fourth year of medical school at Michigan State University College of Osteopathic Medicine. Before then, I went to school at Hillsdale College, which is a small liberal arts school in the middle of Michigan, where I got my degree in biochemistry and actually played varsity football for them as a defensive lineman for five seasons.

Kevin Pho: Excellent. For those who aren’t familiar with the osteopathic path, can you contrast that with the allopathic path during medical education?

Casey Paul Schukow: Yeah, absolutely. Allopathic and osteopathic education, there are a lot of similarities between the two. For example, I just took my Step 2 exam and my COMLEX 2 exam earlier this past year. The Step 2 exam is the MD kind of national board exam, whereas the COMLEX exam is the osteopathic DO board exam. But there’s a lot of overlap between the two. One of the smallest differences is that we learned about osteopathic medicine, where we’re really focused on, you know, learning about the structure and function of the body. You know, the body can heal itself, the body is in units, and really trying to emphasize that throughout our training during these past years.

Kevin Pho: Was there anything that surprised you during your medical education journey, anything that you weren’t expecting when you first went in?

Casey Paul Schukow: Yeah, absolutely. I think the biggest thing that’s really surprised me, so now, after being done with my Step 2 and COMLEX 2 exams, I think I’ve been able to spend a lot more time with my family. And I think that’s one thing that really surprised me, especially with my first couple years of medical school. It’s probably how much time you have to take away, you know, from your family, from your loved ones, from your friends, and really put to, you know, your education and trying to get the basics down as you prepare for your courses, as you take neurology, cardiology, biochemistry, stuff that you see on your first round of board exams. So it definitely is a dedication. And I mean, I knew it was going to be a dedication going into it, but again, how much time, looking back, that I really had to kind of separate from my family so I can pursue my studies, it really did surprise me.

Kevin Pho: All right, so let’s transition into your KevinMD article that you wrote. It’s titled “In crisis, danger and opportunity are present.” Now, for those who didn’t get a chance to read that article, can you just walk my audience through it and share the story of why you decided to write it?

Casey Paul Schukow: Yeah, absolutely. So as I said, I was a football player, and I used to be a defensive lineman. And for people who don’t know much about football and the different positions, you have the offensive line and the defensive line. They’re the two sides of the field, and we’re both really big guys. The offensive line, if anyone knows Tom Brady, he’s a really famous quarterback. He wants to say “hike,” he gets the ball, he throws it, or he hands it off to a guy who’s going to run the ball. The offensive line protects Tom Brady. I’m the guy on the opposite side. I’m trying to sack or tackle Tom Brady.

So my first couple seasons at Hillsdale, where I played, we weren’t doing too hot. And going into my last season, that spring, we had some coaching changes. And my position coach, the person who became my position coach, used to be our team’s linebacker coach. And he greeted us at our very first spring football practice slash meeting with this message about crisis. He threw up the Japanese symbol for crisis, which is kiki. And we were thinking to ourselves, “Is he saying that? Oh my gosh, this spring is going to be a crisis. It’s going to be chaos. He’s going to put us through, you know, some hectic times,” because we weren’t doing too hot, and we had to really change the trajectory of our program.

But what he was really trying to get after is that if you look at the symbol kiki, it’s actually composed of two other symbols: one symbol that represents danger, or dangerous, and another symbol that actually represents opportunity. His message for us, given this, is that, “Hey, in crisis, danger and opportunity are present.” And I think that’s in football, and all around in life, you know, especially the past 16 or so months of this pandemic. There’s been crisis all around medical school, medical education, and you can feel these moments of crisis because you’re trying to have all this information: how you organize it, how you prepare.

And I think he was just trying to tell us that, “Hey, there’s danger here, and we could be scared when we travel away from the danger, or we can embrace the opportunities that are within. We can run towards the crisis and try to take advantage and try to be with each other and see if we can go through this together.” I think that was really his biggest message for us. And we ended up having a big turnaround season, my last season there. We had one of Division II football’s best defensive lines in the nation, and it really changed the trajectory of that program.

Kevin Pho: So what were just some of the specific things the coaching staff did during that particular year that turned that program around?

Casey Paul Schukow: I think one of them was definitely focusing on, “Hey, this is going to be tough. We’re going to work hard.” And we, I mean, we worked hard. I mean, that spring, it was competition after competition, and I think competition is really good, getting a chance to really push each other, because, you know, it’s like the whole phrase, iron sharpens iron, right? And there’s definitely a lot of that too. You know, I think it’s immense as well. There were some very tough times, and there were certain times where there is tough love, you know, because there’s a lot riding on the decisions that we make and the lessons that we learned.

But on the flip side of that, there was also a lot of this softer love of, “Hey,” putting your arm around somebody’s shoulder: Your teammate has a bad practice, or he’s running, “Man, am I going to play this year?” Or a guy gets an injury and he goes down for the season. You know, I think a lot of it, so much, is trying to really support each other, build each other up, love each other, and really bring everyone together as a team and really just try to compete and be there for each other. That was just a big cultural shift. And I think we were trying to do that for the first couple years, but I think that fifth year, we were able to step it up, try to take charge, you know, as seniors and juniors and everyone throughout the team. And it was such a cool experience to finally get to be part of a winning season and help, I think, turn Hillsdale into a winning program again.

Kevin Pho: Now, you mentioned in the past 16 months or so, during the pandemic, there’s been a proverbial crisis in medical education as well. And as medical students, I’m sure that you guys have gone through tremendous amounts of turmoil, disruption, and change. Now, what were some of the opportunities that you noticed during this crisis that you can apply going forward?

Casey Paul Schukow: Yeah, absolutely. I think one of the biggest changes that we’ve seen is that we had to shift from this in-person platform to more of an online or virtual platform. And, you know, students, I think students, staff, faculty, you know, community members, people had to be separated. And I think that was definitely extremely tough early on, and trying to learn all this information early on. But I think one of the greatest things that we can try to take away with this is that, OK, so if we have to go virtual, then let’s try to embrace going virtual, but still continue to reach out to each other.

I think, you know, one of the biggest opportunities here is to pick up the phone, or get your computer, utilize the Zoom, utilize phone calls, especially, you know, not just to your classmates, but to your family and to your loved ones. You know, I think one of those is continuing to reassure that, “Hey, you are not alone.” People might be isolated, but to ensure that even though, for isolation, physically, “You know, I’m still with you here.” And I think that was probably one of the biggest things, and especially for incoming medical students.

You know, my girlfriend, who’s actually here behind me, at Michigan State, she did a bunch of tutoring stuff for, you know, the first-years and second-years. And they were able to just tremendously turn, you know, what would be physical, in-person tutoring sessions into an online platform that was still able to reach out to incoming students who are stressed, who face worries, who face anxieties. So I think that was one of the biggest things, this emphasis on just reaching out, picking up the phone, giving, you know, your loved ones a call, and letting others know that, “Hey, I’m here with you, and we’re in this together.”

Kevin Pho: Now, you had your football background to lean upon during these difficult times. Tell me about some of the stories of your other fellow medical students. How do they manage to cope with the situation?

Casey Paul Schukow: One of the biggest things that I know, talking with a lot of my, you know, medical student classmates, was, I think, regardless, like, sports, being physically active, trying to exercise, I know that’s a great stress reliever. And I think there were a lot of students who really did struggle, especially early on, because, you know, I think gyms were shut down. I think that’s, you know, you get a chance to lift weights or run on the treadmill. I think that was very difficult.

You know, talking with especially some of my classmates, you know, I think they just took the opportunity then to try to maybe run outside or try to establish a workout routine at home. I know there became so many more, just kind of at-home, like, YouTube videos and online series of, “OK, let’s make this transition at home if we need to.” So I think that’s probably one of the biggest things, to get to move. So I know myself personally, and it was tough. Yeah, you know, I think, who could have prepared for this type of isolation and this type of pandemic? But I know students responded. I know my classmates responded, and I think medical students around the country responded. Now, as we see this last match season, it’s the largest that the NRMP has ever had, and I think we’re definitely going to see, and I hope to be a part of that again this upcoming year, with the new match.

Kevin Pho: We’re talking to Casey Schukow. He is a medical student, and he wrote the KevinMD article “In crisis, danger and opportunity are present.” Casey, not everyone has a sports background before they go into medical school. Now, are there any lessons that you could share with, say, the incoming medical school class that you’ve learned over the years, or from your background in sports, that you want to share with them to make their journey a little bit easier?

Casey Paul Schukow: Yeah, absolutely. I think regardless of, you know, if you played varsity sports, if you didn’t play varsity sports in college, you know, your time in college, really work hard and find a way to be a part of some sort of team thing, whether it be, you know, it could be drama, it could be music. You know, if you’re working multiple jobs, you still have yourself be part of a team in those jobs. You’ll learn how to effectively time manage, or at least start to develop those time management skills. And you have a sense, you know, of toughness, I think, of being able to overcome adversity and overcome challenges.

You know, I think, reflecting on my time as an athlete, those are probably three of the biggest things that I remember, lesson-wise, taken away from my time as a football player: being able to be a part of a team and learn how to work in a team. I think in medicine, there is so much teamwork, from the educational standpoints to the out-there, actually practicing standpoints, within hospitals, clinics, you name it. And again, to be able to manage your time appropriately, I think, especially in medical school, because you’re going to have, you know, depending on how COVID goes here, a transition back to more in-person, you know, labs or sessions. Or if not, there’s still virtual labs and sessions. So you still have your virtual labs and sessions, and you still have to study, you know, on top of that. You have to prepare. So, “When do I have this quiz? When do I have this test? I have to prepare for the boards at this time.”

And I think, finally, just again, having a sense of toughness, having that sense of grit. You know, I think we have to continue to be there with each other and be able to reach out for each other and try to love each other, I think especially as medical students, as staff, as faculty, and try to do everything we can to support each other and bring each other up. I think that’s definitely so important, especially again, still dealing with this pandemic. A lot of people still are mentally drained, are tired. You know, there’s anxiety, there’s worry. But, you know, I think to continue to say, “Hey, I’m here with you, we’re in this together.” Those are probably three of the biggest things, whether you’re an athlete in college or not an athlete in college. You know, try to take away those lessons from whatever you do in your time in college as you prepare to go into medical school, and likewise as we go from medical school and prepare to get into residency, and so on.

Kevin Pho: Now, you’ve mentioned grit several times during this interview. So tell me, what does grit mean to you, and what are some specific ways medical students can demonstrate grit during their education journey?

Casey Paul Schukow: Yeah, absolutely. So I think to me, grit is a sense of, I’m not going to stop. I’m going to keep going. I’m going to keep pushing forward. I’m not going to let challenges overcome me. I’m not going to let the crisis overcome me. I’m not going to let the dangers overcome me. I’m going to try to embrace the opportunities. You know, like I said in the article, I’m going to try to, you know, run towards the crisis. I’m going to try to, you know, stand up, stick up for myself, to continue to fight forward, so I can pursue my goals, pursue my dreams, pursue a chance to, you know, finally help out my community in the way I want to. And I have a family who I want to be, you know, another husband or a wife, you know, sibling, etc., to, you know. I’m not going to let challenging times, you know, turn me into a ball, which can be very, very hard.

And I think, again, this is where, I think, really needing to rely on others is very, very important. I think especially in medical school, there’s a lot of medical students who, you know, might have struggled on the MCATs. You know, they might have the best MCAT scores, or they maybe don’t have the best scores going throughout medical school, but they’re still getting through medical school, and they’re still fighting, and they’re still trying. You know, sometimes we have serious events, like we lose loved ones. And I think a lot of people have lost a loved one, you know, over this past, overall since this pandemic has begun.

But I think it gets to continuing to push forward, to continue to say, “Hey, if my dream is to become a doctor, I’m not going to stop.” You know, if you do fail a class, take a second, refresh, lean back on your family and friends, and when the opportunity comes back to retake that class, if you get the opportunity to retake it, give it your best shot and go for it. Continue to reach out to communities, continue to, as you know, I think, on and on, try to continue to push forward, so you can get your degrees, you can pass your exams, and so we can become doctors and try to continue to make, you know, communities better, this world better, and hopefully continue to make life, as COVID goes on, and hopefully as COVID ends at some point here, you know, better.

Kevin Pho: And my final question: What’s your take-home message that you want to leave with the KevinMD audience?

Casey Paul Schukow: Yeah, I think the biggest take-home message that I have, especially for anyone who is trying to get into medical school, who, you know, you might play sports and think to yourself, “Oh gosh, you know, sports, there’s a lot of time here. You know, can I go through the sciences? Can I get into medical school? Can I do both? You know, I might be scared. I don’t know if I can do that.” You can do it. And if you’ve never played sports, if you’re scared at any moment, thinking, “God, I can’t be a doctor. This is too hard. This is too much. I can’t do it,” you can do it.

You know, I’ve been scared a number of times. I think the transition for me, from leaving football, from graduating, and then deciding how I’m going to go into medicine, it was very scary. You know, I’ll be very honest, I was scared, because there was a lot of uncertainty there. But I felt I had to open up to my family. I had to rely on my family, to rely on loved ones. You have to rely on the support of others, because you can never do it alone, and also, to never do it alone.

So if anything, that you can do it, that these times are tough, they really are. There is a crisis, there is crisis around us still. But you know what? There’s opportunities all around, and we have to look for them, and we have to hold on to them. And if we’re scared, it’s OK. Be there with each other, continue to push each other through, and let’s continue to get into the medical schools, get into the residencies, and go out there and become doctors, so we can try to help others and continue to make this a little bit of a better place.

Kevin Pho: Casey, thank you so much for sharing your time and insight, and thanks again for being on the show.

Casey Paul Schukow: Thank you so much for having me, Kevin.

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