Jooeun Kang ’14, Dominion Fertility

Jooeun-KangEntering Dominion Fertility was like entering an entirely different universe. With pictures of radiating couples with their child and the beaming doctor visible at nearly every turn, the office environment made it very clear that this is a place where baby dreams come true.

Each day in Dominion Fertility began with the busy bustling of patient’s getting their ultrasounds or intrauterine insemination procedures done before heading back to their workplaces. As a pre-MD/PhD student, I was excited to see how research and medicine is synthesized in the context of infertility. Entering the embryology lab made me feel at home with its incubators and large microscopes. Whether it was an embryo implantation procedure or an egg collection procedure, it was very clear that the small size of the laboratory belies its importance in the fertility clinic; it is where the ‘magic’ of conception happens. The main procedure done inside the lab is the Intracytoplasmic sperm injection (ICSI), where the sperm is physically injected inside the mature egg with a fine needle. Dr. John Gordon ’85 explained how amazing it is that this procedure works, since it is quite different from nature’s way of having the sperm head penetrate through the egg’s outer ‘shell’ and fuse with the egg. When I heard that nobody knew why it works, the researcher inside me immediately wanted to find out. I asked the embryologists whether they conducted any research, and it seemed that they were more focused with figuring out the best conditions for the egg and embryo maturation process that would yield the best results. These precious seeds of life that are taken care of in the lab are surprisingly tiny—its vulnerability and beauty reminded me of the reason I was drawn to medicine in the first place: the intricate machinery of life that somehow makes us who we are.

Another unique aspect of this experience was the amount of administrative power that Dr. Gordon has since Dominion Fertility is a private clinic, while all my other research experiences were in large academic centers, such as the NIH. Dominion Fertility had another office in Fair Oaks, so a fair amount of time was spent on the road. During those times, Dr. Gordon and I were able to talk about a variety of topics from the problems of health insurance to the ethical problems that arise as doctors try to cater to patients’ needs. But the most informative conversation I had with him was about medical malpractice. I used to believe that medical malpractice is there to protect the patients from incompetent or greedy doctors who seek to profit from the vulnerable patients who know no better, and if I practice medicine with the kindest intentions, focusing on the patient’s needs before my own, I would not have to be concerned. It turns out, I couldn’t have been more wrong. Dr. Gordon told me of cases where the patient was aware of the risks involved in a procedure through both the doctor and the consent form, yet had sued claiming that their consent had been coerced and that they were being manipulated by the doctor. In another case, a patient deliberately sued the doctor even when he did nothing wrong as a way to gain quick money. Dr. Gordon himself was not able to evade these ‘med mal’ suits, and showed me the medical news journal where the majority of the content was discussing different med mal cases. It was clear that malpractice suits are a painful yet ubiquitous experience for all doctors, some specialties more often than others, regardless of the quality of medicine they practice. This was the reality of physician’s life that I wouldn’t have perceived otherwise, and contrasting the doctor’s side of story with our own family’s experience as patients who at times felt injustice in our treatments gave me some food for thought.

And of course, I loved observing Dr. Gordon’s interactions with the patients, whether it was a new consultation, a returning couple expecting their second baby through IVF after a successful childbirth, a frustratedKang 2 couple rejected by other fertility clinics, or a couple that are nearing the end of their options. By the third day, I could recite Dr. Gordon’s consultations verbatim. The repetitive lifestyle of a specialty used to be what made me uncertain about committing to medicine. The actual number of procedures that are done in a fertility clinic may be limited, but each day is far from monotonic. Shadowing Dr. Gordon made me realize that no two cases are ever identical, simply because we are all human. Every patient comes with a different history, a different background, and in the case of IVF, different sets of life philosophies. Being a doctor is not about just diagnosing the condition of the patient, it is about helping them through the journey of recovery. This is especially important for infertility because sometimes even the doctor cannot pinpoint the exact cause of a certain couple’s infertility problems, because there is a myriad of variables that all need to line up perfectly to result in a healthy baby.  For some, the journey may be convoluted, physically and emotionally draining, and end up in a redefinition of a family, but Dr. Gordon with his humor and easy-going character, made the patient sure that he was going to be there with them through it all.

I am very thankful to Dr. Gordon for these enlightening three days in Dominion Fertility. It made me realize how much I love the human-to-human interactions, whether that is between colleagues or doctor and a patient. Even during my short stay there, I felt the strong sense of community, as exemplified by Dr. DiMattina’s surprise birthday party thrown by the entire staff member on my last day of Princeternship. It reaffirmed my growing realization that good science/medicine is done through teamwork. Such lessons of human interactions, of decision-making, of comfort and of guidance are those that I would not have gotten anywhere else. I cautiously dream of being in his position one day, at the frontier of a new technology or knowledge so radical that it redefines how we have been thinking of life and death, and show some future Tiger the mysterious beauty of it all.