What I learned about medicine in the House of Pain [PODCAST]

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“Guiding kindly illustrates mentorship, whether it be in the dojo or in an academic medical setting. Regardless of one’s stage in medical training, certain errors in patient management will be made … this is part of the learning process. It is the role of the mentor (i.e., attending physician to resident, resident to medical student, attending physician to medical student) to help identify these errors, determine their causes, and work through solutions, while being cognizant of the educational level of the learner.

Through all the chaos of the House of Pain, Doc would remind us to find calmness, controlling our breathing and minds. Above all, he encouraged us to pursue good health as good health precedes good life. If the House of Pain was a blacksmith, then its teachings are the forged, intangible swords I have gained to become a better man and future physician.”

Casey Paul Schukow is a medical student.

He shares his story and discusses his KevinMD article, “What I learned about medicine in the House of Pain.”

Reflect and earn 1.0 AMA PRA Category 1 CME for this episode.

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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, 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 welcome back Casey Schukow. He is a medical student, and he wrote the KevinMD article “What I learned about medicine in the House of Pain.” Casey, welcome back to the show.

Casey Paul Schukow: Kevin, thank you so much for having me. Glad to be back.

Kevin Pho: Now, for those who do get a chance to listen to our first episode together, can you just briefly share your story and journey to where you are today?

Casey Paul Schukow: Absolutely. So I’m a fourth-year medical student at Michigan State University College of Osteopathic Medicine. I’m living here in Southeast Michigan and pursuing dermatology. Before I joined medicine, I played football for a number of years, and I think it was a big hallmark of my life and my identity. Initially, early on, the transition from football into medicine was definitely a struggle at first. But now that I’m a couple of years away from football and a couple of years in, I’ve definitely been able to rely on the help and support of friends, family, faculty, other physicians, students, you name it. I’ve definitely been able to embrace everything I’ve learned from the lessons of my past, from football, and try to apply them to medicine and my life moving forward.

Kevin Pho: So I know that you’re nearing the end of the interview season. How’s that going?

Casey Paul Schukow: It’s got ups and downs and everything in between. It’s been a roller coaster of emotions. But I’ve been, I think, incredibly blessed. I’ve gotten to meet some incredible program directors, faculty, and co-residents, and I’ve had tremendous support. I think overall it’s been a very, very positive interview season. I can’t ask for anything more.

Kevin Pho: Now, the topic of osteopathic medicine has sometimes come up on my site. Has that come up on the interview trail, osteopathic versus allopathic education?

Casey Paul Schukow: You know, actually, not too much. I think the only thing I can think of, especially with dermatology, you know, for a long time it was predominantly allopathic physicians, or MD physicians. I feel like dermatology is a very, very specialized field, kind of like how ophthalmology is another one, off the top of my head. I’ve had a couple of physicians who will come talk with me if I’ve faced anything, especially as an osteopathic student. On the whole, I’ve had, I think, tremendous support from MD and DO doctors alike. I think that there’s a much better understanding of, “Hey, well, you’re an MD or DO, you take the same exams, you go through the same schooling.” If you’re a good doctor, if you’re a hard worker, sincere, everything up above, that’s what’s recognized more, and I think not the title at the end of your name.

Kevin Pho: All right, well, good luck with the rest of your interviews, and good luck with the Match.

Casey Paul Schukow: Thank you so much.

Kevin Pho: All right, so let’s talk about your KevinMD article. It’s titled “What I learned about medicine in the House of Pain.” Now, for those who didn’t get a chance to read your 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 the story’s about Dr. D.S. Ping, or Doc. He’s basically my second father. I’ve known him for a very long time, ever since I was 12 or 13 years old, going through my football journey. Doc is what we call a Shihan in jujitsu. He studies Jishukan Ryu jujitsu, which is something that I got the wonderful opportunity to get to know, learn from, and meet some of his students who were black belts, who were my teachers, and I also got a chance to train with NFL guys who were getting ready to go into their summer camps, since I was 13, 14, 15 years old. So I really got immersed into, I think, the world of Doc Ping. Doc is someone who, when I look back on my life, is one of the most, I think, monumental influences on who I am.

He’s definitely an intimidating man physically. He’s the only person who’s put the quote-unquote “fear of God” into me. But he’s also someone who has such a tremendous heart of gold, and I think that’s something that we cannot forget to look on. So he’s definitely taught me a lot about both hard work, sacrifice, and dedication, but love and compassion, and, I think, overall, how to be a good person, and whatever our faults are, to just continue to work on them and get better.

Kevin Pho: You wrote in your article, “While medical school is difficult, it does not compare to the arduousness and tenacity of Doc’s House of Pain.” So take us into some of those sessions. Tell us some of the stories that prepped you and made these sessions so much more difficult than medical school.

Casey Paul Schukow: Absolutely. As tough as medical school has been, I have not woken up the day after a long day of medical school or board studying and not been able to get off of the toilet, so to speak, because my legs were cramping from the incredible hard physical work that I had done from a jujitsu session the night before.

To preface that, my very first day in the dojo with some of Doc’s guys getting ready for the NFL, it was in the summertime, so it was already hot outside. It was hot in the dojo as well, back in my hometown, Saline. We had to warm up, or start the class, with a workout called squat kicks. For everyone who doesn’t know what a squat kick is, you’re doing a full body-weight squat in the air, legs shoulder-length apart, and you get down as low as you can. Then you pop back up as fast as you can, as hard as you can, and you deliver a front kick as fast as you can. It’s all about perfect form. It’s all about doing it as hard as you can. We do that with my right leg, now do it with my left leg, and then right leg, left leg, a thousand times altogether, and that was our warm-up.

That was the first time I’d ever been to the dojo, ever done squat kicks, and we had also done hundreds of other kicks and punches and forms at the end of that hour-and-a-half session. So yeah, the next day my body was killing me. The whole lactic acid thing, that’s a real thing. But as much as it was physically tough, something that they teach about in the dojo is that it’s not just the bone, it’s not just the body, it’s the mind, it’s the spirit. That’s something that I learned, or at least started to learn, very early on in my training with Doc and in the dojo.

So medical school is very, very hard. It’s a very tough, demanding journey, but I felt very well prepared, I think, through my schooling, through the rotations right now, through the application process, because I’ve had experiences like that with Doc and with the students and the NFL guys in the dojo.

Kevin Pho: So you mentioned that the training wasn’t just physical, but it also strengthened your spirit and your mind. Give us an example of how that strength translated to perhaps a specific incident or story during medical school where you thought to yourself, “I’m so happy I had this training.”

Casey Paul Schukow: Yeah, absolutely. I think, to be honest, it’s this process that I’m going through right now, the application season and the interviews, and wondering, “Gosh, am I going to have a job in a few months?” That’s a very difficult thing to go through, and for anyone who’s gone through the Match, it’s a scary process. It’s something where you’re auditioning, you’re getting to meet and getting to know so many programs and program directors and residents over the past few months. And I think, for the most part, COVID, although we have another surge right now, back in the fall we’ve had the opportunity to do things that other students didn’t have a chance to get to do a year ago. I’m very blessed and thankful for all those opportunities.

But it’s rigorous. It’s a demanding process. You’re presenting your very best, because you’re trying to find, “Geez, where am I going to fit? Can I see myself working here, having a career here, establishing relationships here, supporting a team?” It’s a rigorous process. It takes a lot of patience. It takes trying to keep a very, very level head. But I know my experiences with that, with having those very tough sessions and learning how to stick with the grind and to keep a positive attitude, go such a long way. So this is definitely, I think, a moment where all that training with Doc, I know it’s coming full circle. Hopefully, once St. Patty’s Day comes this year, a circle will be complete, at least for this stage, and then we kind of start things back up. But we’ll worry about that when that time comes.

Kevin Pho: Now, for those medical students who maybe listen to this podcast and obviously don’t have the benefit of Doc Ping’s training, what are some lessons you could perhaps pass down to them?

Casey Paul Schukow: Absolutely. I think there are three big lessons that I learned from Doc that I think any student in any walk of life, and I think especially in medicine, can really take away. They’re kind of the three pillars of the dojo. They’re pretty much kind of our rules, or the best way to describe them, and we would recite them at the beginning and end of every class as a group, so we’ll never forget them.

The first thing is to be courteous. Whatever you’re doing, just be a good person, be kind, warmhearted, and all of that. Especially in the dojo, we would always bow to each other before doing a form, before doing a technique or a drill, and afterwards, because that was just the polite thing to do. Whoever you are with, other students, teachers, or if you’re on rotations, nurses, MAs, pharmacy, just be a courteous person, be a good person. Wherever it is, it carries you such a long way. And then you want to be in an environment where everyone’s helping each other out that way, as well as being nice to each other. I think especially with these past few years of COVID, negativity, we can’t have it. It’s continuing to be positive, to have a positive attitude, and to be a positive force.

I think the next one is to be sincere. Give it your very best, work hard, and that just cannot be understated enough. Medical school requires a lot of hard work, and people’s lives are in our hands. We make decisions that impact others and families and communities, and that can be a scary thing we think of sometimes, but it’s a great responsibility to have. It’s something that I am looking forward to continuing to be able to do, to try to have that positive impact. But I think we don’t have the privilege of having that without working hard and staying dedicated and keeping your nose to the ground, so to speak. So be very, very sincere. In the dojo, if you’re not giving it your best, your classmates know, your instructors know, and this is not the reputation you want to have, as someone who is cutting corners, who, you know, X, Y, and Z.

The last thing, maybe the biggest one, I think, at least to me personally, is called guiding kindly. It’s knowing when you need to put your arm around your teammate’s shoulder, around your classmate’s shoulder, and say, “Hey, is this going to be all right? I’m here with you,” as well as knowing when to put your foot in somebody’s backside, so to speak, and say, “Hey, you’ve got to get your stuff, you know, get yourself together. We need you right now. You’ve got to work, do a little bit more.”

I think it’s definitely rooted in mentorship and trying to be there for others and help those, like, for me, helping the younger American students, trying to bring them up to my level, where I am right now. And when I get into residency, it’s students trying to apply for residency, and when you get into that and then become a doctor, and so on and so forth, you can’t repeat that whole cycle. I think that part is so important: again, knowing when to put your arm around somebody’s shoulder, and knowing when to put your foot in somebody’s backside and say, “Hey, we’ve got to pick things up a little bit.”

Kevin Pho: We’re talking to Casey Schukow. He is a medical student, and he wrote the KevinMD article “What I learned about medicine in the House of Pain.” Casey, now that you’re nearing the end of your fourth year, can you reflect back on your medical journey and think, is there anything that surprised you during medical school that you didn’t anticipate?

Casey Paul Schukow: One thing that I think actually surprised me, that now I look back on and think, “Man, this is one of the best surprises in the world,” is that I made some lifelong friends. I was a person myself who, I think, for a very long time had struggled making friends. I had struggled being a vulnerable person. I had really struggled, I think, putting my heart into somebody else’s shoulders, or really putting myself out there, letting somebody else help me out when I needed the help. I think especially with sports and football, there’s so much dog-eat-dog in there, and you learn sometimes it’s me versus everyone else. I just don’t have that feeling here in medicine. I haven’t had that feeling at Michigan State especially.

I met a wonderful person who, hopefully in the next few months, will be my fiancée. She’s a year beneath me at MSUCOM, and I couldn’t be more thankful. I’ve also got some friends in my class, in her class, and residents that I’ve gotten to know that I still stay in touch with. Having those lifelong friendships, and really being able to make more friendships and really establish great relationships with colleagues, I think that’s something. There’s so much support out there, especially in medical school, especially on this journey. You just have to allow yourself to be vulnerable and put yourself out there, and you see that you have a lot of things in common with the fellow students going through a similar process. It’s been a really cool experience.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Casey Paul Schukow: Absolutely. I think, number one, you know, I’ve got to say, go on Amazon: The Legend of Doc Ping, a bunch of short stories. Here’s a man’s life, from pretty much escaping a war-torn region in Southeast Asia, to going through foster homes, to facing really just tremendous amounts of discrimination, to where he was able to finally build himself back up and be a prominent school figure, as well as an NFL agent and trainer, and someone who is, I guess, my second father, one of the biggest influences in my life. Please check out the book on Amazon.

And I think, above all else, again, be courteous, be sincere, guide others kindly, and just hang in there, and show thanks where thanks is due. We can’t get through this journey alone. I have not been able to get through this journey alone by any means. It does take a village, and allow yourself to be vulnerable and put your heart in your hands to everyone else in the village, and be very, very receptive, I think, to criticism as well. You’re going to learn a lot, and you can help a lot of people, and community, family, everything above. So it’s been a tremendous blessing, and I’m very thankful to be in the position I am. I know the future seems a little scary right now, but you know what, I know by the big man’s grace above, or whoever’s grace we pray to and think of, it’s going to work out in the end, and that’s something I do feel reassured of.

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

Casey Paul Schukow: Thank you so much, Kevin. I appreciate it.

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