In this week’s episode both our storytellers give us a glimpse into how they make a living in science.

Part 1: After a gruelling residency shift, Natalia Khosla starts questioning how medical students are trained.

Natalia Khosla, who also goes by Neha, is an artist, dancer, medical student, and radical intersectional feminist whose activism, research, and art is focused on the legacies of colonialism-capitalism and the mental and physical effects of chronic discrimination. In her effort to break down the silos between scientific research and art-entertainment, storyteller feels like the best umbrella unifier. She is passionate about art for radical change telling the stories of the groups whose experiences have been historically portrayed as monolithic and unworthy of exploration. She is interested in stories as spaces and moments that welcome validated rage, platonic intimacy, community building, and radical joy.

Part 2: Mateus F. Carneiro doesn’t know what to do when his paycheck still hasn’t show up three months into his new research job.

Dr Mateus F. Carneiro is a particle physicist and science communicator. Currently working as a Postdoctoral Researcher with neutrino experimental detection, at the Brookhaven National laboratory. Neutrinos are the tiniest and most elusive of fundamental particles, around 500 trillion neutrinos from the Sun just passed through your body while you read this sentence. They are everywhere but almost impossible to catch, the work is worth as neutrinos may hold some of the most well kept secrets of nature. When not using neutrinos to understand atomic nuclear structures, Mateus have a passion for science education and communication. Their work is heavily focused on inclusion of underrepresented communities and the use of unorthodox methods of communication. As a queer immigrant scientist in the US, Mateus fights to shed light in the structural problems of academia and to question the stereotypes around who is and who get to be a scientist.

Episode Transcript

Part 1

I'm in medical school, right? When I was on my surgery rotation during third year, we do rotations through all these different specialties, I was there on one of these marathon nights. I was there from 5:00 a.m. until 8:00 p.m. with back-to-back surgeries on my feet. The most I had eaten was two peanut butter and jelly sandwiches I had stuffed into my white coat because there wasn't time to go get lunch. It was one of those kind of days.

I was in the operating room and I sighed with relief at that moment when my resident gave me that line we're all waiting for. She was like, “There's nothing left for you to do. Go home.” 

And I was like, “You don't have to tell me twice.” 

So I ran out of there. I changed all my scrubs. I went home.

The next day, I was talking to my fellow med school friend and I was telling her about my day and she was like, “Oh, so you just left after they told you to leave?”

And I was like, “Yeah.”

She was like, “Oh, because I like to go and check on all my patients after, even no matter how late it is. You know, just to like check in on them and hang out with them.”

I was like, “You're crazy.” I was like, “Are you kidding me?” She was asking that after a 5:00 a.m. to 8:00 p.m. day at not a paid internship, not even an unpaid internship, but an internship where you pay to work, you literally pay to work. To be clear, I think medicine is the only field where this happens. She was asking that I should go chill with the patient in the room, something that is not going to help them.

So I was baffled but, to be honest, I wasn't that shocked. Because I would say that this lines up with the general feeling I'd had throughout med school that we're supposed to be like martyrs. Like doctors are these self-sacrificing, god-like martyrs who just roam the halls and save lives and throw their own health and sanity out the window and judge everyone else who wants to sleep and eat. And so I had this whole feeling all along. 

You hear residents all the time brag about how few hours they had slept, how many meals they skipped. I had this one resident tell me one time when I was saying something that was ridiculous in med school, he was like, “Oh, if you think that's bad, you wouldn't have survived a day back in my day.”

I was like, “Bruh, I don't doubt that's true. Yeah, that's probably true and I don't want to test that theory. Like, thank you.”

But you can't really blame them too. These are people who came to med school wanting to apply science, to better lives. They get here and they're swarmed with these messages saying like, “The way that you show you are committed to your patience and to this field is by forgetting that there was even ever a life you had before this. Forgetting you had any interests. Forgetting that you need food or sleep.”

Honestly, that's ridiculous and it feels like we're teaching how to perform good doctor, not actually be a good doctor, and forget about all your needs.

But the funny thing is, though, if you ask a patient what they think they need, probably they would agree that they need you to be awake, like conscious. So I think we're actually on the same page as patients with that.

The great irony of this field where they're like, “We made this whole field and it's committed to human well-being and health, but the entry criteria for entering is abandon your well-being and your health.” Like what is going on?

But on a serious note, how can we expect people who've been taught for so long that self‑care and self-compassion is selfish, is shameful, is weak? How can we expect them to show that kind of kindness to patients?

So I started asking some questions. One of my rotations I was on, my resident was on a 36‑hour shift. You heard me right. It's called a 36-hour shift not by a coincidence. It is 36 hours of resident come in at night. They don't leave the next night. They leave the morning after that. The person that's doing your care, 36 hours of awakeness.

So I mentioned to one of my attendings, I was like, “Hey, what if we made a cap at 24 hours? I feel like people perform optimally when they're not awake for 36 hours. What if we tried that?”

You know, very well-meaning attending of mine was like, “You know, but that's just not really how things are done here. That's not how we do it here in medicine.”

I was like, “Okay.”

Another time, I was with one of my residents and we were up at the crack of dawn rounding on patients, and you each go and see your own patient and then you come together and talk about it at like 4:45 in the morning. I was like, “Bro, what do you think if we…” I didn't really call him ‘bro’. I wish it was that casual, but I would have liked to.

I was like, “What do you think if we each just did our own patient and then we talked about it with the attending instead of each of us, half asleep, rounding on ten people that you only know one of them, right? What if we did that?”

He was like— honestly, poor dude. He was on his 35th hour of his 36 hours. He's barely awake. In a haze, with a to-do list down to like his knees of things to do for his 12 patients on his service. And he's like, “I don't know. That's just how it's done here. It must be based on something if that's why we do it here, right?”

And some people when I'd bring up these complaints would agree with me. They'd be like, “Yeah, it would probably be better,” but they'd pretty much keep it to themselves because they didn't want to offend their superiors by suggesting that they didn't respect the way things are done.

I think herein kind of made me realize the problem. Equating respect to blind obedience, I don't think that's how we create the best doctors. I don't think that obedience should be treated as a sign of respect and that teaching people to blindly follow orders without checking if the orders they're following make any sense to them is a way to make a good world.

At the same time, this recurring theme I kept hearing is probably happening for a reason. There's probably some reason we're doing this. That's also a really great way to pin ideas before they even can come out. The way we do things is the best way because it's the way we do things, because it's the best way, because it's the… A little circular.

But whatever. I was like, “Let me give them the benefit of the doubt.” So I went home that day.

Other people were like, “I'm going to study science.” And I was like, “I'm going to look up when medicine was created in this way.” I looked it up.

My friends, it turns out not only is the way we do things not recent-evidence based, it is not even recent history. Can you guess when the current medical system, the way it's designed now was established? We have 1960. Further. Okay, that's quite far. 1889. 1889. Squarely in the 1800s is when the current system was put in place. 1889. 

You know what we didn't have in 1889? Antibiotics. Electronic medical records. Women in medicine. People of color in medicine. Period. Right? A lot of stuff has changed since 1889, but not how we train doctors because this is the way it is done.

Another day I was with one of my med school friends. I was talking to her. Because the day before, I had been on a rotation again, long day. I was doing this classic thing that medical students, if you're in med school you will recognize this. If you have a partner or spouse in med school, they will recognize this. I was doing this thing. I was done with my work and so I did the classic flipping pages of the book back and forth, sighing, looking over at my resident hoping he would notice that I'm sitting there doing absolutely nothing. And it's a classic thing you do because there's this unspoken but agreed upon rule we've all decided that you are not allowed to say, “Hey, I'm finished with all my stuff. Can I go home?” Because that is disrespectful to the honorable field. So I couldn't ask that.

He wasn't noticing me, though, so I was like, “Shoot.” So I went to my next launch of attack, which is the classic question that we all know. It is, “Is there anything else I can help with?”

When you ask this question, you are putting yourself in a very solid prisoner's dilemma, because two things can happen. One, you drew attention to yourself. They saw that you're doing nothing. They send you home.

But, two, you drew attention to yourself and now they know you're doing nothing. And so then they give you more to do. And you can be there anywhere from the next five hours to the next five minutes. There's no guarantees.

So I was like, okay. Roll my dice. Let's go. And he let me go. Score.

I was talking to my friend about it the next day, my med school friend, and I was like, “What if we trialed something where…” instead of this crazy system where I just spent 45 minutes literally debating in my mind whether or not I should ask him that question, like 45 minutes of our health care dollars. That is not the best way for us to spend it, right? Me being like should I ask.

And I was like, “What if instead we made it so every student has to say like, ‘Oh, I'm done,’ and that way the one student who says that they are isn't seen as like uncommitted.”

She suddenly looked baffled, like flustered. And she was like, “I mean, well, because like, I don't know. Well, that's just how we do it here. If there was a better way to do it, we'd already be doing it that way, right? I mean it must be based on something.” 

it must be based on something. And I was like, “Girl, it's not based on anything. I looked into it. It's 1889. I swear.” And I was like, “No, it's not based on anything.”

But I realized that that's the problem also is that we have this idea that science is objective. That there's this evidence somewhere that scientists have some magic arrow to sling. That scientists aren't humans. That scientists don't have biases. That they didn't make things up, like we made up all of the rest of human knowledge is an agreed upon story. And stories are subject to change. 

But as long as we keep having this idea that scientists are like all-knowing gods, we fall into dangerous patterns. Like seeing, questioning science as disrespect instead of as progress.

So in med school I'm definitely known as a contrarian. No one would disagree with that in my class. Probably some people even take my behavior as like, “Oh, she's just trying to get out of obligations.” 

But I would say that if that is how I'm seen, let it be. Because the only way that we can progress is if we have people changing the definition of respect, not making it equal, blind obedience. And I think that's how we're going to have human-centric medicine in the future. 

Thank you.

Part 2

Hi, everyone. So let's jump into it. 

The thing a lot of airports and academics today— so imagine this with me. It's February. I'm at the Rio International Airport a couple of days before Carnival, which means just a lot of people, a really, really scorching hot day and that AC is just not really getting through. It's 45 Celsius, like 120 Fahrenheit out and I'm just sitting there trying to read a book, waiting for my flight. Just low-key sweaty, but trying to get through this. 

I'm anxious. I'm nervous. Right now, at that moment, all I have is a backpack and a contract I'll be in the US doing research completely funded by the Brazilian government for the next three years. This is sort of a moment of a conclusion of a couple of years of me having to go through different PhD programs and moving cities a couple of times and going into bureaucracy, get a visa, project approved. All of that to that moment, because I really got the opportunity of going to work in one of the top laboratories of my field for my lab.

I'm in Rio. That has been my house for a year now and I'm leaving all my friends, all my family in Brazil and exchanging it all for Batavia, Illinois.

Twelve hours later at the airport in Chicago as I wait for my ride, I take a step out and I instantaneously understand what being cold means. This is 2014, the polar vortex winter year. So not just I understand what cold is, because it's minus five Fahrenheit outside, I actually go from never seen any snow in my life to seeing all the snow in my life right there. 

My advisor picks me up. We drive towards the lab. I immediately also understand how far from the city the lab is where I would be staying. Also, how flat a landscape can be. 

But the lab itself is very interesting. Fermilab is the most open of all the national labs. Anyone can actually come in. They have herd of bison that people love to go and see and the architecture is actually thoughtful and very interesting. 

But in general, all of this was a lot. All the research that I had done up until that point was just a theory so it was like me working with one, two other people in a project and here I am working with like tens of people that I had never seen before and the single experiment. 

It's also my first time in the US ever. My first time speaking English all the time. I have no former learning of English. All of this is movies and video games. So it is that, but at the same time it's a bunch of people that are welcoming 

I stayed in the lab. So Fermilab has the Fermilab village, which is a part of the laboratory, which is just a combination of dorms and little houses, big houses, all sort of like a ‘70s military style. It is as creepy as you're picturing. They have a lot of wildlife.

But it's also a combination of people from everywhere. I think I literally lived with people from every single continent and people that worked on Antarctica. And you have all of these people. We are there in the middle of nowhere and some staying for years, some staying for months, some come and go in for like days. 

So you have these people all in the situation that I usually call ‘alone together’, because you are there and you look around and you don't know anyone. None of your support system is there. But everyone else is in that same situation, so there's a bonding that happens because everyone kind of needs each other. You make friends really easy. And it is a very interesting situation to me. 

It took a time but eventually I started to find my crowd. I do remember being in the pub. We have one pub/chilling area in the village. I overheard this group of people that I hadn't talked to or haven't seen before saying something like, “Oh we have all these beers and games but they are closing. We don't have a place to go.”

My answer is just stand by and say hi, introduce myself and offer my house. Next thing I remember, there's a mix of people playing drinking-card games and someone trying to hook up a Nintendo 64 on the TV. I just found some people and, in the end, it was a good spring.

Fast forward to the end of April. In the end of, April I'm supposed to get paid. As I mentioned, all of this is being funded, my side it's being funded by Brazil. They have a system that I do. They set up to me like a bank account. I have a card and they're supposed to pay me every three months. They paid the first part of it before I left Brazil. 

So it's the end of May… sorry, it's the end of April. I'm supposed to get that first check. Okay. I don't know when it's going to happen so I start checking it every day. it's the end of the month, the money don't come. Suddenly, May starts and that money never came so, okay, there's something wrong. 

I get into a bit of a crisis mode and I start spending a lot of my time making these international calls to Brazil and going through monolithic Brazilian bureaucracy, which is the US bureaucracy only gets close to it when you need a visa but Brazil's pretty good at that.

Eventually, I get some information. It's like, “No, it was just a mismatch of dates. In the end of the next month, so in the end of May you will get your money.”

Okay. I wasn't saving any money. Also, I'm kind of lucky that there was not much to spend with around there. But at the same time, I had some costs. Like I had to buy winter gear. That was a big one. And I did have to buy a computer, otherwise I couldn't even work. So there were things that I had to spend that money on.

But, sure. It's a month. I get it. It's fine. I'll be fine.

The end of May comes and my brain is already alerting that something's coming. Pay attention. I start checking that bank account all the time and that money don't really come. It's the beginning of June and that money is not there. Now, this is really serious, right? It's the second month without pay. Whatever they told me that was wrong before and was fixed, apparently was not. 

And here I am, back at square one. I'm the only one losing something with it. Okay. Let me get back on crisis mode and figure this out. 

So I get back into spending all of my days on international calls and sending all the emails that I could. Well, let me go a couple of steps back. This is June. And if you ever heard anything about Brazil, you probably know that we sort of love soccer as a culture. 

So if Brazil is playing in the World Cup, so every four years, if Brazil's playing that's a holiday. It's not like a ‘holiday’ holiday but you don't go to work because your boss is not going to work because whoever is supposed to be there opening the door is not going there too. I mean I never care for sports. I never care for soccer. But since ‘94 when I was six, I watched every single game even if it was just to skip class.

So back to 2014. June 2014, Brazil was not just in the World Cup. Brazil was hosting the World Cup. So if Brazil was playing, that was actually a holiday. If Brazil is playing, there is no one that I can talk to and it's a day lost on that quest of trying to figure out my own payment.

On top of that, the funding agencies are in Brasilia, the capital that was hosting games. So if there were other games in Brasilia, that was also a holiday and I couldn't talk with anyone. So beside everything else, I was competing with the World Cup to get through. 

Eventually, I do. Eventually, we figure what’s wrong. There were two project numbers, whatever. I go through a whole bunch of hoops and I get to everything being said, to which I get the final information that was, “Okay. You're all set. Everything is fine. Next month you'll get your paycheck.”

Next month, the end of July. How can I work with that? How can I work and not being paid? How can you choose between some analysis system if you need to think about having lunch later or not? It was really hard. It was like you're angry, like you’re pissed, but you don't even have who to be angry with. I talked with every single person somehow responsible for that and they figured it out. But did they? Am I actually getting paid? It was a lot.

But a lot of hotdogs, homemade vegetable soup and tons of things that I truly believe it wasn't butter, I get to the end of the month and it's the end of July. My birthday is around the corner. We actually even have a party organized in the village, not just for me but some other people having birthdays too. 

But I'm not really in that celebrating mood. Actually, what is going through my mind is like, “Should I be trying to figure out my stuff to go back to Brazil? I can't. I can't stay for another month here without getting paid.”

And if I'm going back to Brazil, like what happens? Does someone pick up my project? What do I do? I don't even have a place to live or something to do back there.

Should I be concerned about this? Should I be concerned about here? It was very complicated.

Eventually, and this is July 27 and I remember the date, I wake up. And usually waking up and checking that bank account was the first thing I would do in the morning, because Brazil has a couple of hours difference. Just enough to give me that little hope.

I checked that account and there you go. It's not a zero. I actually got paid. And actually, it is the largest amount of money that I have seen up until that point in my life. Because it took them so long that they paid me the three months that I was supposed to be paid and the next three months. So I just got this huge chunk of money.

The relief is it's hard to explain. That relief of just knowing that I had something to be provided. And even like remembering that it's kind of sad. It's not like I was happy because I was rich. I was happy because lunch was okay. That was guaranteed. 

In the end, what I did then is that like I just got all that money and went to a liquor store. I think I bought a bottle of every single different alcohol that I found, including cachaca, and that was the fuel to that party. I don't fully remember that party. I mean, it's a good thing on my books, already was back in my 20s. That was fine.

But the point is that, through all of that, there was no safety net. There was nothing. There was no structure. That was my struggle. Other people and other students and everyone had their own problem ongoing. Like even no one had a proper health insurance. So even a little problem could really go really far. 

So it's not uncommon that grad students are just somehow like exploited, even being highly educated and skillful they are exploited. And if you are international and you don't have that structure there for you, it can be very complicated.

But when I remember that summer, I remember more about actually cooking every Saturday to like 20‑something people. I remember skipping lunch. But I do remember having drinks and dinner with different people all the time. I remember breaking into conference rooms on days off so we could watch Star Wars on the full HD projectors or spending time in the lab testing photo multipliers, like underground checking and taking care of our giant neutrino detector thing. 

In the end, that summer, even under all of this, I learned a lot. I did science. I met amazing people that I still call friends. The project that I did there is still very much related to what I'm being paid to do right now, almost ten years later. 

The point is that that community made to me something that was actually supposed to be impossible. It's still really hard but feasible. We need community to do anything and science is not, never was and never will be something different from that. 

Thank you very much.