Sarah Stein, Being a Good Human

Before she even graduates as a doctor, final-year medical student Sarah Stein is already asking questions many doctors avoid.

Her widely published article, What They Don’t Teach in Medical School, in which she wrote candidly about moral distress, emotional isolation, and the realities of becoming a doctor in South Africa’s resource-constrained public health system, travelled far enough beyond the lecture halls that it was quoted in the 2025 national budget speech.

In this episode of Awakening Doctor, Sarah, raised in a family of medical academics, grapples openly with legacy, expectation, and the question of whether medicine is truly her chosen path, or one shaped by forces larger than herself. With rare vulnerability, she reflects on both the brutality and privilege of clinical training; the disillusionment, self-doubt, and life-and-death responsibility carried by young trainees; and the challenge of defining what it is to be a good human.

The conversation turns deeply personal when Sarah shares her experience of losing her father, renowned academic Professor Dan Stein, and what it has meant to grieve this devastating personal loss within the very public spaces he once occupied. Her reflections on mourning, ritual, and community reveal how loss reshapes identity, and how essential kindness, compassion, and presence truly are.

At once thoughtful, questioning, passionate, and self-aware, Sarah represents a new generation of young graduates who are asking not only how to practice medicine, but who they are becoming in the process. Join us for a tender and vulnerable conversation about legacy, responsibility, and the evolving heart of medicine. 

Read Sarah's article here: https://bhekisisa.org/opinion/2025-05-07-what-they-dont-teach-in-medical-school/

Transcript

Welcome & Sarah’s Origins

Dr Maria Christodoulou 0:00

Welcome. I'm Dr. Maria Christodoulou, and this is the Awakening Doctor Podcast, a space where we discover the personal stories of those who work in the medical and health professions. Join me as I explore the hopes, the fears, the aspirations, and the real life challenges of those who carry the title, responsibility, and privilege of being a doctor. With me today is Sarah Stein, a sixth-year medical student at the University of Cape Town and already a thoughtful observer of medicine's emotional and moral terrain. Sarah's reflections on life as a medical student in South Africa, published by the Bhekisisa Centre for Health Journalism, the Daily Maverick, Mail & Guardian, and News 24, struck such a deep chord that her words were quoted by the finance minister in last year's national budget speech. Sarah describes herself as a deeply passionate romantic dreamer who mostly wants to be a good human and is still figuring out what that means. Welcome, Sarah. I'm really glad to have you with me here today. It's taken us some time to make this happen.

Sarah Stein 1:09

Thank you for having me. That was such a kind introduction.

Dr Maria Christodoulou 1:14

Well, it's all true, right?

Sarah Stein 1:16

I hope so.

Dr Maria Christodoulou 1:17

Where should we begin to tell your story?

Sarah Stein 1:20

Well, I'm not really sure. I liked what you well, I suppose that they were my words, but I like that you spoke about me just being a human and just being a bit of a confused human and still trying to figure everything out. I don't know when that really started. I think maybe I've always been a confused human. Maybe a better way to say it is an inquisitive human. I don't know where that story starts.

Dr Maria Christodoulou 1:47

Is it okay to be a confused inquisitive human?

Sarah Stein 1:51

Of course. It's very important. I think that I was raised to be an inquisitive and confused human. I'm Jewish and it's very fundamental to Judaism to ask questions and to interrogate everything. And so I think I was raised in a home where we were. Oh, you know, the story, who was it? Einstein or someone. I don't know, when he came home from school, his parents didn't ask him, What did you learn today? They said, What did you ask today? I think that I've always been interested and kind of fascinated with philosophy and bigger questions and moral distress and humanity at large. And then I was also raised in a completely medical household. So that's always been at play too.

Dr Maria Christodoulou 2:40

Well, I guess there's a deep intersection between those things, right?

Curiosity, Judaism & Philosophy

Sarah Stein 2:44

Yeah. Philosophy affects medicine, health. I'd like to think so. I was actually telling my friends this recently that medical jargon is just second nature. It has always been second nature. It's what we spoke about around the dinner table, and I can't really remember where that began, but I distinctly remember when I learned about philosophy. There were two instances. One where my dad was working at home in the study, and I asked him what he was doing, and he told me he was emailing someone about philosophy. And I didn't know what that meant. So I asked him what are you emailing about? And he said, Well, someone had written to him to ask him what is beautiful. I was a child when this was happening, really a little person. I immediately responded by saying, I thought... I was very proud of my answer. Anything not man-made is beautiful, obviously, dad. And then he replied by saying, Yeah, that's a good answer. But now, how do you decide what makes a painting beautiful? Or, you know, what makes a particular thing more beautiful than another? And that really stumped me. And then I remember from then kind of always thinking about these difficult questions. And then the other instance was I was driving back home from the College of Magic. I can't remember exactly what I said, but my dad said, That's very meta of you. And I said, What's meta? And he said, Well, it's kind of like you know, thinking about thinking or writing about writing. And I must have been, I don't know, younger than 10. And that was also one of the first times I remember thinking, Whoa, that's really like, you know, your brain is really thinking hard, abstract thinking.

Dr Maria Christodoulou 4:30

Right. Tell me about the College of Magic.

Sarah Stein 4:33

Oh, it's a wonderful place. Do you know the College of Magic?

Dr Maria Christodoulou 4:37

I don't.

Sarah Stein 4:38

It's an amazing place, and they basically just teach a lot of actually underprivileged kids and a lot of kids who come from privileged backgrounds as well, about magic and illusion and mystery, and you start off with a lot of trinkets and little like play baby kind of illusions. And then as you get older, they teach you proper sleight of hand and everything. But it's really a great place, and they have amazing like social programs and everything.

Dr Maria Christodoulou 5:04

What took you to the school of magic?

Sarah Stein 5:06

I think I wanted to be like my brother. He was super involved in the College of Magic. He was even a teacher there. He just had such a nice community of magicians. I think I just really modeled myself on my siblings, my parents, a lot. So I wanted to be just like him.

Dr Maria Christodoulou 5:25

So often one of the questions I ask is why medical school? I think you've given us some clues already. But tell me about how you found yourself in medical school.

Sarah Stein 5:35

I think it's a number of things. I like to think that I made my own decision of my own free will. But I think that in reality, I was, as I said, raised in a house where medicine was just a part of the conversation, it was just a part of life. Um, I think some part of me kind of didn't really see an alternative. It was already so comfortable and not even comfortable, just it was how I viewed the world and how I viewed a future for myself. Another part of it is that I really did think that it was an important profession, an impactful profession, and something where you have the opportunity to really make a difference in the world and to the people around you, which is very important for me. Again, like when I was growing up, my mom instilled this sense of social responsibility as really, really a critical value to have. I kind of thought, I'm very interested. I really enjoyed biology in high school. I'm really interested in the body and the systems and how everything works, and it's so interesting. And I remember learning about the heart and the chambers and just thinking that's magical. I would love to learn more. And then thinking, well, medicine's not a bad place to start. And if I really hate it, I can change. And I think that that's mostly why I chose medicine.

Dr Maria Christodoulou 7:03

So the article that you wrote last year, five years into being at medical school, was titled, What They Don't Teach in Medical School. How has it been to be a medical student?

Sarah Stein 7:14

I kind of have a funny relationship with medicine now. It's the first time... your introduction is the first time I've been referred to as a final year, which kind of gives me the heebie- jeebies a little bit.

Dr Maria Christodoulou 7:27

Do you want to say more about that, why does it give you the heebie-jeebies?

Why Medicine Chose Her

Sarah Stein 7:31

Every year it's just... I just can't, I just can't believe that it's sixth year, and next year is the real world, and there's actually, you know, like there's all this talk about, oh it's such a long degree, and there's so much work, and the path is so arduous, but actually there's something quite comforting about knowing, you know, next year I'll come back to the same campus and I'll have the same friends and the same lecturers, and everything will be sorted for me. I just have to register, it'll be fine. I feel like I'm catching up to my friends who are in the working world now to have stress about that. But I have a bit of a funny relationship with medicine now because what led me to write the article, and at the time of writing the article, I had just done a few very challenging blocks and rotations that had left me feeling a little bit desperate, a little bit disillusioned, kind of not sure where to go, where to turn, just feeling very disappointed in the healthcare system, in South Africa, in you know, the world and the path that I'd chosen. That's why I wrote the article. Since writing the article, my relationship with medicine has changed a little bit. And fifth year, I found, was a lot more manageable than fourth year. We did all these sub-specialties, which didn't really take the same emotional toll on me as the really tough ones, like internal medicine of fourth year. And also, I've been in the position this year or last year, 2025, where I actually really valued having the medical knowledge that I did and just dealing with some very close personal interactions where I actually found that knowing what I knew, even as a student, was very powerful. And it gave me a level of understanding that I could see people around me just didn't understand. And I was very grateful for that.

Dr Maria Christodoulou 9:42

I remember when I read your article, I guess I'm partly relieved to hear you say that since the article, some of your perspective has changed. Because one of the things you wrote about was that... You said, I hate medicine more often than not, and I cannot fathom spending more of my life doing this.

Sarah Stein 10:00

I think that is... I think that is still true. It's a very difficult space to be in. The content is very interesting, you know. Theoretically, on paper, to be a healer, that sounds beautiful. It sounds wonderful. In practice, it's not like that. Just as I imagine being a lawyer in court is not like Suits. The reality of living as a doctor, which I can't actually speak to because I've obviously never been a doctor, but the reality of living as a medical student, which is as close as I've gotten, is not one that I would choose. I wouldn't choose the lifestyle, the stress, the pressure, the burden of dealing with such charged situations every single day where the level of responsibility really is life and death. And maybe that's cowardly. I don't know. Maybe some people will say that's, you know, what a privilege to be able to help someone choose life and have life every day. But I find it a bit terrifying. I was talking about this again with friends the other day, where I think that being chastised by a consultant or in a wardround, you know, you get the answer wrong, you feel this deep embarrassment and shame. It's so powerful. It's far more than being criticized for another thing. You know, you may you made an ugly piece of art or you baked a bad cake and someone criticizes you. It feels a lot worse. I think partly because you know that if you had been a doctor with responsibility and not a student, and if you hadn't known the answer to that question and you were ridiculed for it, that might have actually been the difference between helping someone and inflicting suffering on someone. And that is just incredibly heavy to deal with at every moment.

Dr Maria Christodoulou 12:02

That's a big responsibility to take on your shoulders.

Disillusionment, Burnout Fears & Responsibility

Sarah Stein 12:05

Yeah. And I have huge respect for doctors. Really, I have huge respect. They work so hard, they deal with emotional turmoil so often. I have huge respect. I don't know if I'm strong enough to live that life.

Dr Maria Christodoulou 12:21

It's a great question, a great reflection. How do we answer that? How do you know if you're strong enough to live that life?

Sarah Stein 12:28

Gosh, I don't know.

Dr Maria Christodoulou 12:30

I mean, you've made it this far. You're almost a doctor.

Sarah Stein 12:34

I know. Gosh, yeah. Every year, every year it's a little bit, you know. I remember being in second year and calling my brother and telling him, I really hate this. Like, I really hate this. And everyone is telling me to stick it out because second year is anatomy and second year is the worst. And I really don't want to. And he was the only one who said to me, Okay, you know, then quit. Then change. What are you gonna do? Change. And that was the closest I came, I think. But everyone else around me was telling me, you know, just put your head down. It's just second year, and then it's put your head down, it's third year, you haven't gone to clinical, and then fourth year, put your head down. It's just the first year plan. I've met junior doctors and I I've met registrars and I've met consultants who, in their words, have told me they're not really quite sure how they landed up where they are. You know, they just took the next step and this is where they are. And I don't want that. I want to intentionally pick my next step and be happy with my next step. I'm not a fool. I know that in every junior position in every industry, there'll be bad work and the circumstances won't be good, and you'll probably be underpaid and overworked and all these. I know that that happens in every industry, but I at least want to choose this is where I want to be. I'm willing to endure this for however long because I see a future for myself here. I guess it's also hard because as you learn more about something, at least for me, it just becomes more interesting. It doesn't matter what it is. I feel if I applied myself to geology, you know, nothing against geologists. But uh, I can think of a few more interesting subjects. But hypothetically, if I applied myself to geology, I'm sure that after six years of studying it, it would be incredibly interesting. The deeper that you go, the more fascinating everything becomes. So it is just such that I'm six years into this field and I know enough that it's interesting. Obviously, the beginning is hardest. But in the beginning, there were many, many moments where I felt this is not interesting. This is not what I signed up for. I don't care.

Dr Maria Christodoulou 14:53

So, what did you sign up for? What was your idea of what you were getting into?

Sarah Stein 14:58

I thought that it was going to be, it sounds silly, but I really did think it was gonna be like Grey's Anatomy. I really wanted to be like Callie. The emergency doctor. I thought she was so cool.

Dr Maria Christodoulou 15:09

I can't tell you how many people I have interviewed who say that they thought going to medical school was going to be like Grey's Anatomy. I don't know if that show realise what an impact it's had, or how big an impact it's had on whether people choose medicine or not. So you thought it was going to be like Grey's Anatomy. You were gonna be like Callie.

Sarah Stein 15:27

Yeah, I thought it was gonna be like Grey's Anatomy. The thing with medicine, I find, is that you have to know a lot of content that forms your foundation, and that must just become implicit, must become passive. So that when you are being a detective about a patient and trying to figure out what's wrong and what to do, that knowledge informs you. And the detective work is what's interesting, not the knowledge, but you can't do the one without the other. So it's very impressive to watch someone be a detective. And I have huge respect for doctors that are like detectives and really figure it out, but to get there.

Dr Maria Christodoulou 16:06

Yeah. So when did you realize that this is not Grey's Anatomy?

Sarah Stein 16:11

Oh gosh, day one. No, it would never be like Grey's Anatomy. It's just not like that. I don't think even in America it would be like that. Grey's Anatomy is largely more about people's personal lives and the drama. And I do love drama, like acting kind of drama. I love performance, and I think that's what I was also drawn to.

Dr Maria Christodoulou 16:35

So you spoke about growing up in a medical household, and I know both your parents were doctors. How much of an influence... Even as I say that, it feels like it's a silly question. Of course it had an influence, but how does it shape the choices you're still making today, do you think?

Sarah Stein 16:51

Immeasurably. I don't know about, you know, nature and nurture, but my parents were very, very important. My siblings too. And my grandparents, we are a very close family, and the way I was raised has a huge impact on how I see the world and how I interact with other people and the types of things that I perceive as valuable. You know, on the one hand, my parents raised me to value social responsibility and healing and human connection and philosophy and all these very important... I still perceive them as important and large parts of life. And then on the other hand, I don't really think that they showed me what medicine truly was, because both of them are academics. So I had this completely skewed perception of what it was like to be a doctor. And I guess they were also done with the difficult parts of being a junior doctor. So I never really saw that and I never spoke to them about it.

Dr Maria Christodoulou 18:00

I think what I'm reflecting on a lot lately is how the idea of what it's like to be a doctor is so different at different stages of the journey, even for different generations. What it was like for your parents or for my generation to study medicine, what it's like for your generation to study medicine, what you guys are having to deal with and carry in terms of where our health system is at. It's never an easy journey, that much I can say. But it also feels like even if you had tried to have those conversations with your parents, they would not really be able to give you insight into what it's like to be a junior doctor in today's South Africa.

Redefining “Good Doctor” Through Kindness

Sarah Stein 18:36

Yes, I agree. But in every profession, I think you have to experience it properly for yourself to know what you're getting into.

Dr Maria Christodoulou 18:43

Yeah. On the weekend, actually, I visited my own family, and my niece had some friends over, and they're in grade 12 now. And one of the friends wants to do medicine. And her mom was also there, and they were talking with great excitement about her passion to be a doctor and how well she's doing at school, and how you know it's quite likely that she's going to get a place. And I noticed my own sort of almost anxiety on her behalf because it was this big, wide-eyed, naive excitement about being a doctor and becoming a doctor. And I wouldn't settle for just being a GP. I'm definitely going to specialize. And my stomach almost turned at the like, oh, this child has no idea what she is in for and what lies ahead. And I did refer her to your article and I did also tell her that she should listen to some of the other podcast conversations. But I guess based on the fact that you wrote an article about what they don't teach in medical school, what do you wish you had known when you were in high school thinking about doing medicine?

Sarah Stein 19:49

It ties to what you were saying about the experience being different at every stage. I think that it completely changed as I started medical school, you know, in first and second year. I really felt like there was a huge amount of sacrifice that I didn't know that I would have to make. And just ordinary, mundane sacrifice. I didn't get to sit with my friends on the stairs at lunch, and I didn't get to make friends from other departments, and I didn't get to craft a degree as you go through it, taking majors and minors, and exploring across topics widely, you know, having freedom to change disciplines and really extend yourself. And then those kind of sacrifices were really difficult for me. Or just having, you know, having your holiday at a different time to all your friends' holiday and being so isolated in a way that I didn't think medicine would make you. But it only makes sense, you know, to get hands-on teaching, you have to have small groups. So you land up having groups of two, seven, ten people for most things. I found that was really isolating for me because I love people and I love connecting to lots of people and meeting new people. And then a little bit further on, I wish that I had known just how much of my life would be devoted to medicine. It kind of felt like I didn't know who I was without medicine. Even though I didn't like medicine, I couldn't quit because then what would I have left? And like , I couldn't do the hobbies that I did in high school, and I had different friends, and it just felt so all-consuming. And then a little bit further on, I wish that I had known what it really meant to be working in a clinic or you know, working with patients, and that it's not a job where you're working with people. I didn't perceive it to be a job where you're working with people in a team. It's you and your clinical partner and the patient. There's very little camaraderie, there's very little network and the brutality of medicine. And the pressure and the loss. And I, gosh, all these issues with clinical medicine as a very, very young student. I didn't know that it would be like that at all. Now I'm kind of at this stage of the journey, I'm kind of wishing that someone would have told me that there was actually job insecurity with this degree, which I never imagined.

Dr Maria Christodoulou 22:27

Yeah, something that wasn't a reality before.

Sarah Stein 22:30

The one reliable thing is that you will have a job with medicine. It's always been that way.

Dr Maria Christodoulou 22:34

I mentioned in my introduction that you were trying to figure out what it means to be human, and you said that you were glad that I had described you as human. And you've just spoken about the brutality and the pressure and the loss that you encounter as a medical student. What came up for me is, isn't that part of being human? Yes, you're exposed to it at a very young age, but I don't know about you. The world we're living in right now feels quite brutal, and there is a lot of pressure, and there is enormous loss on so many different levels.

Training In A Resource-Limited System

Sarah Stein 23:10

That is an interesting thing to think about. I guess it's the same as being raised in South Africa. Oh, I'm contradicting myself because... I have thought about my family that live in different parts of the world, or maybe friends that are in different parts of the world, and thought, how naive are they? They don't see suffering like South Africans see suffering. They don't see beggars at robots, they don't see homeless people under bridges, they are just living in peace. And I've kind of always felt a little bit sorry for them. Like they don't really see the world for how it truly is and all the goodness that is yet to come and that we have opportunity to build. This is obviously in the context of people talking about South Africa being an unsafe place and an impoverished place, and the question: do you want your kids to be raised in South Africa and risk of crime and this and that? And I've kind of always chosen to look at that with the lens of, but that's so real. You know, this is going on, and we have to make it better. So now you've stumped me because I don't think that way about medicine.

Dr Maria Christodoulou 24:24

So maybe there's a reason for that though. As someone who was always interested in medical education, I find myself wondering if that isn't the dilemma, more so than the reality of the experience itself. In your article, you wrote... I mean, you began the article talking about the first time you experienced a patient's death and how clinical it all was and how unemotional it was, and how there was no space to figure out how to process your own emotions about all of that. And I'm wondering if there was a way to do that, maybe it would be different. If there was a way to process the brutality and the pressure and the loss and the chaos.

Sarah Stein 25:02

Maybe that's a good suggestion. Because I guess you do process the suffering that you see on the street or whatever, because you talk about it with people. You talk about it with your family and your friends. I don't know. I've, at times, have felt that the brutality of medicine is just too much for me. Me, Sarah. Not necessarily for a person, because I can see my peers all handle it in different ways. For example, my clinical partner is much better than me. He does something wrong, and someone ridicules him for it, it's just water off a duck's back. Nothing can faze him. He knows that he made a mistake, and that's that. For me, I'm deeply affected. I don't know what that's got to do with. A little bit of personality, a little bit of upbringing. I'm not entirely sure. As you say, it's difficult to describe until you've actually experienced it yourself. I don't want this to sound all negative though. There's many times where I felt incredibly grateful for being a medical student and a medical student in South Africa.

Dr Maria Christodoulou 26:10

Well, let's talk about some of those times. Tell me about some of the things that have made this good, positive.

Sarah Stein 26:16

Yeah, so in the same way, I think it changes with different phases. In the beginning, I was very grateful because all the people in my class were from all around South Africa, and they had different upbringings to me, and they had different perspectives on what medicine would be like. And I was just grateful to be in university and to be living at res. That was very, very exciting for me. And then I was very grateful because we had some great teaching and we had some great experiences and some great stories. And I've always come home and told my friends who don't do medicine about these crazy things that we do. Which to me, I'm just like, I'm just telling them about my day. We just did 10 pap smears today. You know, that's just what we did. And my friends are always like, What do you mean? You did the pap smear. How could you do the pap smear? And then it catches you, and you're like, Oh yeah, shit, I did do the pap smear. That is pretty cool. So I'm grateful for these kinds of opportunities. I'm grateful to have an inside access to these kinds of places, de livery rooms and to procedure rooms, and to surgical theaters for all the exposure and all the teaching. I'm very grateful. And then obviously, more recently, as I mentioned, I'm very grateful for the knowledge that medicine has equipped me with. You really learn to understand, and I'm really quite stupid as far as it goes in terms of my class and my peers and everyone else in the medical world. But sometimes I do understand what a decimal point means, and that is really, really impactful.

Dr Maria Christodoulou 28:04

Are there any patient encounters that stand out for you? Any stories of things that have happened that stay with you?

Writing That Reached The Finance Minister

Sarah Stein 28:12

Many. I kind of try to keep a little log of patients that made me feel strong emotions. But the one that I wrote about in the article is really one that sticks with me very strongly. And it was this old man who had come in to the emergency center, and shame, he was not doing well, he was quite delirious, but it was a very quiet night on call, so I just kept going to check on him, giving him a blanket, chatting to him, and he was very delirious. I didn't imagine that he would remember who I was. And then the next morning on the ward round, he was in the ward, and he said on the ward round to the consultant, he said, This doctor, she's the best. And I was mortified. I was like, I've done absolutely nothing for this patient. I was so embarrassed. He doesn't even know that I'm a student. He couldn't remember that I'd introduced myself as a student, and everyone turned to look at me. And they obviously knew that I had nothing to do with the management of this patient, and I was so embarrassed, but it really was quite impactful for me because it was just my presence that made him feel like he was being taken care of.

Dr Maria Christodoulou 29:27

Absolutely. Why were you mortified that he thought you were like the best doctor?

Sarah Stein 29:33

Oh, I just remember being so embarrassed. I think I turned red like a tomato. I just... because it wasn't true. I thought it was truthful for him, but it wasn't the truth because I wasn't a doctor, and I'm not the best doctor in the world. I'm not a doctor at all, and I had nothing to do with his care. Oh, it was just such a... It was....

Dr Maria Christodoulou 29:54

Whoa... I find myself kind of like you had nothing to do with his care? You spent a whole night coming and going, taking care of this man and giving him a blanket and listening to his stories.

Sarah Stein 30:04

I know, but it just didn't feel that... it wasn't the correct... I wouldn't have overstepped, it felt like an overstepping of the hierarchy.

Dr Maria Christodoulou 30:12

For him to say that you're the best doctor.

Sarah Stein 30:15

Yes, of course.

Dr Maria Christodoulou 30:17

But maybe that's the dilemma. Two things come up for me. The one is the perception of what it means to be a good doctor, what components of care fall under that banner? And two, the overstepping of the hierarchy. Your being human, your presence, made such a difference in a patient's life that he spoke about it to a whole group of your colleagues, and something in you shrank. It wasn't what you thought you should be praised for.

Sarah Stein 30:50

It's complicated. I don't know. I don't know.

Dr Maria Christodoulou 30:54

What did that patient teach you about what really matters?

Forensics, Impact & Ambition

Sarah Stein 30:58

Yeah, that patient taught me that it was just important to be kind, even if you're not capable medically. Obviously, it's important to be capable medically, but it really is just important to be kind. There were many patients. My internal medicine rotation was very challenging for me, but also very impactful for me. I kind of have this cognitive dissonance about it because I think it was absolutely traumatizing, but I also learned a huge amount more than I've ever learned in a block before. Kind of I remember on a ward round, I didn't say that the patient was in heart failure. That wasn't how I led my presentation. And the consultant was really stern with me about missing heart failure and about saying that the patient is in heart failure if you've picked up the signs. And again, I felt absolutely mort... I was just, it was such a difficult ward round. But I know that I will never miss heart failure now. I will never, never, never miss it. You know what I mean? It's just like it really sticks with you. Or there was a patient that... I can't remember the exact situation, but I remember it was a patient with COPD and he was on oxygen. They didn't want to increase the flow rates of oxygen, and I just didn't really understand why he wasn't getting more oxygen. And how do I say this? His work of breathing was very difficult for him. And I just didn't understand what was going on and why he wasn't being given more nebs, and maybe I just didn't understand the condition or the management plan. But it was just so difficult for me to watch. And then the next day when we walked in, he was dead, and I was just so upset and I didn't understand. He wasn't my patient, he was my clinical partner's patient, but that just it just was really difficult to watch. I mean, all these things I remember the first time we did CPR in the wards, and we stopped CPR, and the consultant was really nice, and she explained why we had stopped afterwards. That there's something really unsettling, even if it's warranted. There's something really unsettling about that omission.

Dr Maria Christodoulou 33:13

What do you think it is that makes it unsettling?

Sarah Stein 33:16

People think that doctors are like gods and they know everything, they know all the answers, they're these people that you know they've got it all under control, but they're really not. They're just people, they've just read some books. I think I'm just a bit disillusioned. I think like psychologists, they're just people, they've just read some books. There's nothing magical about them, and they make mistakes and they they don't know what to do all the time, and they're kind of playing a little bit of a guessing game as well, and just doing the best possible thing that they can at that time. It's not to say that that's you know the absolute cure. That is very unsettling to see behind that curtain.

Dr Maria Christodoulou 33:54

So to see the humanity is unsettling.

Sarah Stein 33:58

Yeah, I guess you could say that, yeah.

Dr Maria Christodoulou 34:01

Because it struck me that what you shared about that patient and him feeling that you were the best doctor, it was like in acknowledging that he spoke to your humanity, he spoke to the part of you that was just human and cared, and that there was something quite mortifying about that being made visible to these doctors that you were with.

Sarah Stein 34:23

Yeah. Shame, what a sweet man. There were some really great patients as well, some really hilarious patients, made us laugh a lot. Some very kind patients, and you know, patients are always kind when they let students help, but some really kind patients, and I'll never forget those ones either. Yeah.

Dr Maria Christodoulou 34:46

You wrote a lot about the reality of being in our public health system and some of the shortages and limitations and the lack of resources and how that impacts on your experience as a medical student. Is there anything about that you want to share?

Grief, Public Mourning & Ritual

Sarah Stein 35:02

I think that the article actually spoke about that quite a lot. You always speak about it, even growing up. Oh, we're in a resource- short setting, we're in a third world country developing this, you know, blah, blah, blah, blah, blah. It becomes white noise in the back of your head. But until medical school, I had never really... and obviously I grew up very privileged. I went to a private school, I live in a house with my family. So medical school is really the first time where it was just heavy. It was, this is real. We don't have the resources that we need that other countries do. And, you know, if South Africa had more money, more staff, more this, more that, more people would have their lives saved, or more people would have a better quality of life, or whatever the good outcome would be. And I really felt that. I especially felt that when we were doing obstetrics and we would be in a maternity outpatient unit, and there were just no measuring tapes, no towels, no gloves, no alcohol swabs. And I was just so confused. How can this be the state of a clinic, a hospital? I don't understand. How can there only be one registrar between three hospitals? How can that be? It just doesn't... How can the... it's really difficult. And I think that this also was a lot of the time that this patient who wasn't getting oxygen or someone whose CPR was stopped because there wasn't a bed in ICU or something like that. It's just so difficult for the boundary to be concrete like that. The limiting factor is so... it's actually fixable, but it's out of your control. And that was very difficult for me. And on the other hand, and at the same time, I do feel very privileged to be a student learning in South Africa. Because of the limitations, there are adaptations. And we're taught by incredible clinicians and tutors, lecturers, and we're taught all these methods and little hacks and things, you know, like no problem. We don't have alcohol swabs, it's fine, just put the cleaning solution on the cottonwool swab. It's the same thing. And people adapt and people are resilient, and that's very impressive and inspiring to see. And there's lots of international students, and they come to learn from what we've got. And so I don't take it for granted that we have all this exposure.

Dr Maria Christodoulou 37:42

Yeah, I guess it's more about the impact and the moral distress that many of those things evoke.

Sarah Stein 37:49

Yeah, I agree.

Dr Maria Christodoulou 37:51

You spoke about the fact that it's out of your control. And as you said that, I was struck by how you wrote an article. I imagine you had no idea that that article would get published so widely, or that it would reach the ears of our finance minister and influence his budget speech. So, to some degree, you have had influence.

Sarah Stein 38:14

Yeah, I had no idea. I had no idea. I wrote it because I had stuff to say. I just had to write it. And Heidi Mattison, who's a bioethicist at Groote Schuur, who's become somewhat of a mentor for me, kind of pushed me to write it. And I love working with her, and I really value her opinion. She just told me to write it, and I was like, Yeah, you're right. I'm just gonna write it. I had no idea that it would have as far a reach as it did. I didn't even know. I wasn't watching the budget speech. My politically, you know, engaged friends who are studying law and whatever started sending it to me, and I was just, What? Yeah. It's funny too. So I'm doing my forensics block. That's my first block of the year, which is just a crazy block to be doing, but it's also full of such... I feel there's so much dichotomy, cognitive dissonance. On the one hand, it's absolutely revolting, it's horrible. I feel almost like an animal instinct to be repelled by it. I can tell it's just not natural, it's not the way that things are supposed to happen, and it's so disturbing at every point. But then on the other hand, it's so impactful. These people are really making change. They really are, and I think for the better. And this morning I was reading my notes, which were actually about legislature and criminal law and civil law, and I was thinking, geez, these people are these people, the people that are dealing with law, they are really making a difference. This is real. This isn't snotty kids coming into your rooms, nothing against snotty kids coming into rooms. That's also making a difference. But this is impactful. Is that the kind of impact you would like to make? Forensics?

Dr Maria Christodoulou 40:14

That level of impact, maybe forensics, who knows? Is it?

Sarah Stein 40:18

Oh, I don't. I just... I cry, I don't think forensics is for me, I must be honest. But that level of impact, yeah, I would like to have an impact and a large impact. I've got huge shoes to fill. I'm really grateful for my parents, and I'm really proud of them. I think that they've both achieved huge impact in a way that I'm not sure that I ever will. But I want my kids to be proud of me in the same way that I am of my parents.

Dr Maria Christodoulou 40:53

Do you want to acknowledge your parents by naming them? You don't have to.

Sarah Stein 40:58

My dad is Dan Stein, or he said Stein. He recently passed away, and that was very difficult for me and my family. And my mom is Heather Zar. And they're both professors and A-rated scientists, and their list of achievements is absolutely endless.

Dr Maria Christodoulou 41:19

Those are big shoes to fill.

Sarah Stein 41:22

Yeah, among a number of other titles. They're just both very, very impressive. Academics and doctors and humans. Very big shoes to fill. Yeah.

Surf, Play, And Finding Balance

Dr Maria Christodoulou 41:35

I wasn't sure you would mention your dad today, and I wasn't sure how to broach the topic of your dad, because on the one hand, he's been such a legend in the medical world, but his death was quite recent. But I was struck by the article you wrote and the focus on not being taught how to process death as a medical student, and then losing your own father quite suddenly and unexpectedly. What's that been like for you?

Sarah Stein 42:07

Yeah, it was very difficult. It's been very difficult, it still is very difficult. I think it will be difficult for a long time to come. My dad taught me how to write, and I remember showing him. I'd always send him my essays and things in school just for him, you know, after they'd been submitted. I wanted him to say well done. Yeah, he taught me how to write and I stopped doing that in university. And then I showed him the article before it was published, and I really wanted him to say well done. And I remember he turned around and there were tears in his eyes, and he told me he was proud of me, and I was just so... It was, yeah, I'll never forget that that feeling and I'm thinking a lot about that moment and about how my dad might not he won't see where I land up going, but he'll be there, yeah. It's been very difficult.

Dr Maria Christodoulou 43:13

Yeah, I can't even begin to imagine.

Sarah Stein 43:16

Yeah, there's a picture of my sister graduating, and she's being capped by my mom and my dad, and they're both in their red gowns on the UCT stage, and I remember like... my sister's a lot older than I am, and for the longest time, my whole like... I always kind of knew I would do medicine. So even in high school, I remember I saw this picture and I was like, Yeah, that's going to be me. I'm going to have that same picture, and I'm not going to have that same picture, and that's very sad.

Dr Maria Christodoulou 43:51

I can feel the emotional toll of that. I'm really sorry, Sarah.

Sarah Stein 43:55

Thank you. But we have had amazing support. Friends and family and people have really been amazing. I'm very grateful.

Dr Maria Christodoulou 44:07

I'm pleased to hear that. I did wonder what it's like to have your father be, you know, to have the loss and to be processing that loss quite publicly in the sense that your father is a very well-known man, and so there's been a lot of sort of - both in the academic world and beyond - ritual around his passing. How's that been for you that your loss is quite a public one?

Sarah Stein 44:30

It's very confusing. I was saying to my aunt, on the one hand, it's really nice that I don't have to tell anyone anything, they all kind of just know because it's quite hard just to say the words about what's happened. So it is a little bit comforting just to feel held by the space that I'm in. And on the other hand, it's very hard. Every space that I walk into, everyone knows. Someone will invariably mention it, and I'll say it's okay, thank you, whatever. And to walk into the same places. Everything is just very close. It's all UCT, it's all the same, the same spaces, physically, the same people, the same worlds. So that is very difficult.

Advice To Future Doctors

Dr Maria Christodoulou 45:24

Gosh, yeah, you're giving me a different perspective. So my father died nine years ago this week, and he died in Cyprus, and I got there a day too late to be present when he died, which brought up a whole lot of stuff for me. But traditionally in Cyprus, especially in the Greek Orthodox community, when somebody dies, people wear black for at least 40 days, and then sometimes people wear black for a lot longer. And historically, it was also a way not only for the individuals to acknowledge their grief, but for people in the community to know that they were grieving. It was a sign that you'd lost someone. And I came back from Cyprus and I made the decision to wear black for 40 days, just out of respect for my parents and their tradition. And I thought it would be a challenge. I have a fair amount of black in my wardrobe, but to wear it every day for 40 days felt quite like a big thing. And in my case, not many people here knew. And I remember being quite comforted by the fact that I was wearing black because everybody else was carrying on as normal. And it felt really weird that this big thing had happened in my life, but that life just carried on and that everybody was just being normal and expecting me to be normal and having this major mind dilemma, like a disorienting dilemma around how can it be that someone you love so much is gone forever and everything carries on as normal. Like surely there should be something to mark this as different. Yeah, and I and now I'm listening to you talk about how it is to go into every space and everybody knows. That there's no privacy and that there's no...

Why She Stays & Closing Reflections

Sarah Stein 47:12

Yeah. I hear you. Right in the very beginning, and even now, I 100% felt my world's completely shattered. I don't understand how people can just go on. I don't understand how your worlds aren't shattered as well. And it was very painful for me to see like friends keep doing the things that you know their lives go on. And it's really hard. And then I thought about a poem that we read in high school called... I think it's called Funeral Blues by W. H. Auden. It's like, we've got blues, stop all the clocks from going and give the dog a bone, and it speaks about the world coming to a standstill. And I just kept thinking about that poem, and then I decided that I was going to try to read my dad's book again because the first time that I read it, I felt absolutely stupid, and you know, it's just... it's really... very talented person to understand what that book is saying, but I decided that I would try to read it again, and the first page is one of W. H. Auden's poems, yeah. So I found that quite comforting. It was just a really weird, I don't know what you would call it, a sign, a coincidence. It was something for me. So I felt that quite comforting. I've already spoken a little bit about Judaism, but I just want to mention it again. I think that Judaism deals with mourning very, very well. It gets it right. I really do think it gets it right. For the first week, your house is called the Shiva House, and it basically just means that your house is open. It's an open house. Anyone can come in, the people are encouraged to come in, the community and family and friends, and you don't have to tell the family that you're coming, you don't have to... you don't liaise, you don't organize a time, you just come in and you can sit in silence or you can talk or whatever. There's obviously many other things that you do during the week of Shiva, but I really think that it makes you feel very, very held. And then we, the children, say a prayer called Kaddish for a year, every day for a year. And I find that really comforting as well. I myself am not a particularly religious person, but you wake up, you feel that the world is shattered, and then the first thing you do is you go to shul and you say Kaddish, and you just, you know, it's just a public declaration that this day is different and this day is hard, and this day will continue. And you're saying it surrounded by community and support, and it's not long, it's just an hour in the morning, and then you just continue with your day as you would any other day but you have taken the time to just feel it.

Dr Maria Christodoulou 50:09

Yeah, that's beautiful. You're reminding me of the work of.. and now, will I remember his name? He's a shamanic healer who talks a lot about grief. He's written books about it, and one of the things he spoke about was how ritual is critical in grief, and also that grief is communal, that you can't process grief in isolation. It's meant to be processed in community, and it's meant to be processed through ritual, and that we actually create a lot of dis-ease and ill health in the way that we typically mourn or approach grief and loss in the Western world, and that we've lost that sense of community and that sense of ritual around it, and that there's enormous comfort to be derived from that ritual space and the community space. And my small little scale of just wearing black every day was my little symbol for 40 days, and it was so profoundly meaningful, it surprised me, and it actually even challenged my arrogant thing of oh, wearing black is so depressing. Why would you choose to wear black for so long? Now I think I have a very different understanding of simple, small rituals and the way that they can hold you through difficult times. The other thing that Martin Prechtel spoke about in this talk that he gave about grief was how the word shaman means weeper or singer, and that the healing happens through our tears and our grief and the songs that we sing through the process of ritual. I'm not being very articulate as I talk about it, but I remember what I took from it was this idea that our tears help the souls of our loved ones cross over to the other side.

Sarah Stein 51:57

That is beautiful. Yeah.

Dr Maria Christodoulou 51:59

If your father was listening to us today, what would he want you to make sure you shared with the people who are listening?

Sarah Stein 52:07

I think he would tell me I must make sure that I don't come across as completely one-sided. I must make sure that it's a balanced perspective and that I'm acknowledging all the parts, the good parts and the bad parts.

Dr Maria Christodoulou 52:29

Right. So do you think you've done that? Is there anything you want to say to make sure that it sounds or feels balanced?

Sarah Stein 52:35

I think I've done that. I hope that I've done that. One of the first times I spoke about, we had a panel to speak about the article, and I told my dad, and I was so excited, and I really hoped he would say he was proud of me and all this and all this. And he kind of just he was just like, okay, but just you know, don't say anything too bad. You know, you're still a student, you just, you know, like just careful. And I was so angry, I wanted him to be feisty and passionate because that's how I am. But I got that from my mom, and my dad was much more diplomatic, much more eloquent. He just saw everything, every single thing, as a gray issue, and everything was something to be discussed and questioned, and I got really upset with him for not kind of backing me. But I very quickly realized that that was silly. I think that a very, very big part of who my dad was is absolute humility and this ability to decipher some kind of truth, some kind of middle ground between two seemingly impossibly different opposite views. And that's actually a lot of what he does in his book, and a lot of what he did, you know, every day. So I've got him in my head telling me.

Dr Maria Christodoulou 54:04

What of him is carried forward in you?

Sarah Stein 54:08

I don't know. I'm very grateful for everything he taught me. I wish that there was time for him to have taught me more. I think he had so much to teach and so much to give. And then just I'm very grateful for all the small things that he did. My dad and I were like we were friends.

Dr Maria Christodoulou 54:27

I can see how painful it is to talk about. Thank you for your courage, Sarah.

Sarah Stein 54:32

Thanks. Yeah, we... we like... we... it... it took me a while to realize, because I obviously also had a rebellious teenage phase and a hating your parents phase and all the natural progressions of life. But once I did realize it, we were just great friends, we had very similar interests and very similar, I think, ways of looking at the world. We had really thought-provoking and stimulating conversation, and then we also had a huge amount of laughter together, and a huge amount of just joy, shared joy. And I remember in June, July, I was away with my dad and my friends, and we all went out for dinner, and we spent the whole dinner, I felt, laughing. We were having beers and it was chilled and it was beautiful and the sunset, and it was very relaxed. And when we left, my friends said to me, Is that always how your dinners are? And I was like, Yeah, what do you mean? And they were like, We were talking about such intellectual topics, like we really got into it. We were talking about this and that, and I was like, What do you mean, guys? We spent the whole time like just bantering. So my dad and I did a lot of both, and I'm very grateful.

Dr Maria Christodoulou 56:01

Sounds like you loved him or love him very much.

Sarah Stein 56:04

I do, yeah. I think we all did. He was very lovable. It's very hard to... yeah, he made it very hard to not love.

Dr Maria Christodoulou 56:15

Yeah, I'm glad you also described some challenging teenage years and rebellion and all of that. That's also an important part of a healthy relationship with one's parents. And I guess his ability to see the gray zones between all these complex matters, may be something that evolves with time. And I love how passionate you are, and I love how deeply you feel things and how intensely you feel things. And I think that that is part of what helps a new generation drive change. I was actually at a workshop this weekend where the facilitator spoke about how at any time in life there is an evolutionary force that is moving through the world. It's moving through each of us as individuals, but it's also impacting on an organizational level and on a societal level. And that one of the questions that he asked was if you allowed that evolutionary force to move you in the direction of your full potential, where would it take you? And so often when evolutionary forces are taking us, we feel helpless and we feel like we're at the mercy of, you know, in some of the bigger events in the world, like COVID or even now the rise of AI and technology, and we have no idea where it's taking us. It's almost like a tsunami. But it is always an opportunity for change, an opportunity for something new. So it feels like you've been at the mercy of a very powerful evolutionary force that almost precedes your existence. You were born into this medical family with these two really powerful people in the medical world, and it's moved through you in a way that somewhat unwillingly you found yourself in medical school, and you're still going, why am I here? Why is it bringing me here? Like, really, I'd rather be on a stage performing or doing something else. And I can so resonate with that feeling. But for some reason, that's where this evolutionary force has carried you. And I guess I'm curious, as I'm sure are you, about where it may take you next.

Sarah Stein 58:27

Oh, yeah. Thank you. I think that's a nice way to put it. Quite beautiful. I don't know where to next. I would like to explore adjacent paths to medicine. I've kind of explored a little bit of the humanities, adjacent bioethics and philosophy and this, which I find very, very interesting. But I'm not sure that's, on a practical level, what I want to be doing every single day. And I think I know what the academic world looks like, though I can't be certain. I don't really know what my parents do when they're working. Not sure about that either. Maybe this year there'll be some space for me to explore kind of a business adjacent, an entrepreneurial adjacent, finance. 2026 is the year that I'm going to launch my own yogurt brand.

Dr Maria Christodoulou 59:24

Okay. Say more about that. Let's talk about these adjacent interests in your life.

Sarah Stein 59:30

It does sound ridiculous, but I really am passionate about yoghurt. That sounds ridiculous too. Just watch the space.

Dr Maria Christodoulou 59:39

Well, what makes you say that it's ridiculous?

Sarah Stein 59:42

Oh, it's just it sounds very silly to say. But anyways, I hope that this year will be... there'll be space to grow and to experience the adjacent. I think as we've kind of discussed, you don't know what it is until you yourself have been there. I hope that I have time to be there. The yoghurt thing is a bit of a joke, but it also isn't a joke. I love movement, I love being outside, I love dancing, I love running, I love going for walks and being on the beach and being in the mountain and swimming. And I just... I love all that stuff. It's a huge part of who I am. And then I also love food, because who doesn't? This yoghurt thing does sound ridiculous, but it's so nutritious and delicious, and it will target the protein carers and wellness junkies of Cape Town, I hope.

Dr Maria Christodoulou 1:00:37

Great. Well, good luck with that venture. It sounds really exciting. Your whole face sort of lights up, and then you keep saying it sounds ridiculous, but there's this huge grin on your face as you talk about it. So I'm loving that you're allowing yourself the playfulness of that.

Sarah Stein 1:00:53

Thank you.

Dr Maria Christodoulou 1:00:53

In the bio that you sent me, there were a couple of things I was smiling about when I read it again today. I ask every guest to send me a little bio just so that I have some guidance around how they like to be described, so that I can incorporate that in my intro. But you said that you were a 6th-year, or at the time a 5th-year medical student, and then you said, although I rarely act like it, being a medical student, and I thought, so what does acting like you are a medical student look like?

Sarah Stein 1:01:22

So my uncle always used to say to my granny when he was in university, any percentage over 50 is wasted time. And I echo that with every morsel in my body. Seriously, any percentage over 50 is wasted time, you could have been on the beach, you could have been with your friends, you could have been just somewhere better. And so that's what I try to embody, and that's what I've tried to embody my whole medical school career.

Dr Maria Christodoulou 1:01:49

So you think if you were being a true medical student, that wouldn't be the case?

Sarah Stein 1:01:54

Of course not. To be a true medical student, I would care far more about academics and academic validation and academic success. I think. I know I have a little bit of A-type in me because I got into medicine, so I have to be somewhat A-type, but I try my hardest to push that away.

Dr Maria Christodoulou 1:02:18

Maybe what needs to change is an outmoded idea of what a doctor is supposed to be like or what a medical student is supposed to be like, because yes, of course, the academics is important and mastering the knowledge is critical. But the thing about the knowledge is that it's rapidly changing. Some of the knowledge that you're learning today will be obsolete six months from now, maybe even less. I don't know what the current data or stats is on that. So, what's maybe more important is knowing how to access that knowledge and how to make sense of that knowledge and how to interpret that knowledge in the context of the patient that is sitting in front of you. And for that, you need those detective skills, but you also need some humanity and you do need to be human so that you can apply the knowledge in ways that are meaningful. Maybe we all need to rethink what it means because we do have a stereotype of the typical medical student and the ideal medical student. And what if it's okay to be like more than 50% is a waste of time that you could have been doing something more meaningful?

Sarah Stein 1:03:22

Yeah, I'm with you 100%. When I started medicine, I made a promise to myself. I mean, I'd seen people that were older than me be medical students, and I promised myself that I wouldn't let the degree take away my 20s. And I'm fortunate enough that I don't think it has, and that I have still had lots of opportunity to be young and to enjoy my life and to really feel like I have laughter every day, and I'm very grateful for that. Oh, I wanted to say something else. You made me think of something else. Oh, that's what I was gonna say. On the other hand, I was struck when I first started clinical, being in the wards, I got very scared because I had had this mentality anything more than 50% is a waste of time, and my peers hadn't. And then suddenly I was thinking, oh no, if I only know 50% of the content, 50% of the people are gonna have poor outcomes. And that was a very scary thought. So I think it's got to get a little bit more serious at some point.

Dr Maria Christodoulou 1:04:32

Yeah, and I mean, sure. If we had a lot of time, it feels like we could really unpack that with a broader perspective of like, where does healing lie? Who holds the responsibility for healing? What responsibility do we have? And how much of whether a patient lives or dies is actually in our hands? And isn't it arrogant for us to think that it is in our power ultimately? Because that's kind of a little bit of the God complex. And yes, we can do things, we can intervene in ways that prolong life or that help people to get better and that help people to heal, in as much as we can be agents of hastening people's death. There's no doubt about that. When you're human, you have to acknowledge that birth and death are part of a cycle.

Sarah Stein 1:05:16

And how lucky we are that we can play a part.

Dr Maria Christodoulou 1:05:20

Exactly. You also said in your bio, coming back to what you shared with me, you said, I love living life to the fullest. And for me, that means spending as much time as possible laughing with the people that I love. I love romanticising Cape Town, going to beaches, hiking mountains, and having sundowners in beautiful lookout spots. And I'm deeply passionate about movement, which you shared a moment ago. I run, dance, and surf, and I have big dreams about building something of my own in that space. Tell me more about that side of you.

Sarah Stein 1:05:52

The playful side of me or...

Dr Maria Christodoulou 1:05:54

All of those things. The romantic, passionate, yeah, dreamer.

Sarah Stein 1:06:00

Yeah, I think that's of my essence. That's yeah, that's not what I do, that's who I am. I think that's the way that I conduct myself and I live every day. What I fill my time with, what I surround myself with. I really do just love being outside. I don't know if it's nature or nurture, but there is something about the waves that are coming over your face. The sun on your back, it really does feel completely magical to me. It's just something bigger than yourself, I think. It's so much fun.

Dr Maria Christodoulou 1:06:37

Well, as you spoke about that, the waves sort of coming over you. I wondered about whether there was something we could learn from surfing because being able to stand up on a board and ride the waves and surf the waves and not get knocked over by them all the time. What if there's something in that, almost like a metaphor for these waves that keep coming at you like tsunamis in the medical world and in your training? What lessons have you learned from surfing that might help you to navigate this medical space?

Sarah Stein 1:07:05

We must be like Big Z from Surf's Up. Long, smooth strokes. Surfing is so much fun. I actually haven't been able to surf for a while because I had a knee operation not so long ago. So I'm missing my... a little bit of summer in Cape Town, but it's okay. My best friend's mom shared a poem with me the other day. I don't have it on me, but it was basically about going to the sea and sitting by the sea. No matter what you feel, the sea will be watching you and it will be watching over you and it will engulf you. It's bigger than you and it can hold you. And that's very, what's the word. It feels... it feels like a revival. I can't think of the word I'm looking for.

Dr Maria Christodoulou 1:07:59

Revival sounds good.

Sarah Stein 1:08:00

Yeah. I love play. I love laughter. I think that that's very, very important to me.

Dr Maria Christodoulou 1:08:07

So if someone were to say, so who is Sarah Stein? What would you answer?

Sarah Stein 1:08:12

I would read them my blurb that I sent you.

Dr Maria Christodoulou 1:08:16

Okay. And let me ask it this way: a decade from now, if someone were to ask, who is Sarah Stein, what do you hope your answer will be?

Sarah Stein 1:08:28

Oh that one's quite deep. I hope that they will speak to attributes of a noble person, of a kind, warm, humble person. Yeah, not necessarily what I do, but how I do it. I hope that they would speak to me as a person who listens well and is able to connect to other people and who's just a good person in their soul. A good person. That's the goal. That's what we're working towards.

Dr Maria Christodoulou 1:09:05

Love that. It's beautiful.

Sarah Stein 1:09:07

Thank you.

Dr Maria Christodoulou 1:09:07

It reminds me of the patient that thought you were the best doctor because you did all of those things.

Sarah Stein 1:09:14

Oh gosh.

Dr Maria Christodoulou 1:09:17

Is there anything I haven't asked you that you want to share?

Sarah Stein 1:09:20

No, I quite like the story that we told today. Thank you for your questions.

Dr Maria Christodoulou 1:09:26

You're welcome. We've touched on what you wish you'd known about medical school and some of your experiences there. Perhaps there'll be a young person who's at school now who listens to this conversation and is thinking about going to medical school. What would you say to them? What advice would you give them?

Sarah Stein 1:09:45

I would say don't go job shadow a consultant in private, or even a consultant in public. Go job shadow an intern. Get stuck in for a few days, not just half a day or whatever, and speak to people and find out what it actually is to be a doctor on a day-to-day basis. What does that mean? Yeah, that's what I would say. I wish I had done that.

Dr Maria Christodoulou 1:10:11

What did you do? Or did you just apply and got in? Did you do any job shadowing or...

Sarah Stein 1:10:17

I did do my job shadowing. I actually job shadowed Dr. Stuart Dix-Peek, who is a paediatric orthopaedic surgeon, and he works at Red Cross, and he also works a little bit in private, and he was incredibly inspiring. And I also... I loved Callie from Grey's Anatomy, and I just thought the work that he was doing was amazing. We did a club foot clinic and he let me help with the plaster, and we went to go see his patients, and you know, it's orthopaedics. Something's broken, and then something's fixed, and it's just unbelievably impactful to see that. And he is an amazing doctor. He was actually recently my consultant as a medical student, though he didn't remember me, but it felt very full circle to see him do his work for real. But I wish that I had done it for a few more days and shadowed more junior doctors and asked people more, had the courage to ask people what is it really like, you know?

Dr Maria Christodoulou 1:11:18

Yeah. The podcast listenership is fairly small at this stage, but I am aware that we often have people at very different levels of the medical hierarchy who are listening, from medical educators to senior consultants to junior doctors to people out there in the world who are not in the medical profession but have an interest in these stories. What's the message you'd like to share with them?

Sarah Stein 1:11:42

I can't say that I have one kind of motto that would do it for everyone. I really can't. I think a little bit of everything that we've spoken about, a little bit of kindness, a little bit of laughter, maybe a little bit of diligence, seeing the gray areas, a little bit of hard work, a little bit of everything.

Dr Maria Christodoulou 1:12:06

I do find myself wanting to ask you what keeps you there. Because you said, second year already, you were phoning your brother and saying, This is not for me. What stops you from leaving?

Sarah Stein 1:12:19

Largely because I'm quite stubborn. I'm the kind of person that will finish what they start. If it's a movie or a book or a packet of biscuits or a medical degree.

Dr Maria Christodoulou 1:12:31

Yikes.

Sarah Stein 1:12:34

I consider myself as being quite resilient. Partly my clinical partner. I really love him and he's been very supportive for me. And I also feel really bad to leave him alone in a class of A-type people when I'm you know, we can just go to the beach together. I'm joking, but yeah, he has really pushed me to push on, and partly because I do really believe that you have such opportunity to make the world a better place with a medical degree. Even if it's not in clinical medicine, I just feel that the degree is innately a good one, and I'm quite proud to be doing it.

Dr Maria Christodoulou 1:13:19

Well, you're almost at the finish line, so kind of want to say hang in there. And I do have such a sense of this notion of an evolutionary force, and of course it's uppermost in my mind because I did this workshop recently, but it does feel like sometimes our idea of where it should take us conflicts with where it's actually taking us. And I've been reflecting on my own life and how struggling against where it's taking me creates a lot more chaos than surrendering to where it's taking me. And maybe trusting that impulse that took you to medical school and that has kept you there throughout all of this.

Sarah Stein 1:14:01

Definitely.

Dr Maria Christodoulou 1:14:02

And what I do also see with more and more of your generation is that different career options are becoming available, and I think some of them haven't even been conceived of yet. And I think your unique blend of heart and passion and playfulness and creativity and philosophy and ideas and ideation and compassion could result in something quite amazing, Sarah.

Sarah Stein 1:14:31

Thank you. Those are very kind words, thank you.

Dr Maria Christodoulou 1:14:34

You're welcome. Anything else before we close?

Sarah Stein 1:14:38

No, thank you so much for having me. I'm honored to be on your startup podcast. I hope you get famous.

Dr Maria Christodoulou 1:14:46

Thank you. I hope the stories get famous. That's what I'm really after. And I'm really grateful that you were willing to share your story and that you were willing to do it so soon after losing your dad. I was not sure how that would be for you. And so thank you for sharing. Thank you for sharing your grief with me today, with us, really, because people will listen to this and I hope that they will take heart from it. I have such a sense of do not lose that playful, passionate dreamer self, because we need people like you in the medical profession.

Sarah Stein 1:15:23

Thank you.

Outro & Calls To Action

Dr Maria Christodoulou 1:15:24

And I don't want you to hear that as a you must stay. If the force is taking you elsewhere, may the force be with you.

Sarah Stein 1:15:37

Thank you.

Dr Maria Christodoulou 1:15:39

You're so welcome. I'm Dr. Maria Christodoulou, and you've been listening to the Awakening Doctor Podcast. If you enjoyed this conversation, please share it with your friends, follow Awakening Doctor on Instagram, Facebook, and Spotify, and go to Apple Podcasts to subscribe, rate, and give us a good review. Thank you so much for listening.