Karen Law, MD
Undergrad Institution; Degree and Major:
Brown University, BS in Human Biology, Minor in Art History
Brown Medical School
In practice since:
Where and for how many years did you train AFTER medical school:
How did you choose your specialty?
It's a long story, but one I share with every student who comes to me for career advice. I tell them that I "backed into" my specialty, but have no regrets. I knew I wanted to specialize, but wanted to maintain a foundation in Internal Medicine – to me that meant a specialty that was still multi-system (ie: not cardiology). Initially I was interested in BMT and malignant hematology, and did research and lots of electives in the field. I loved the intense continuous relationship with patients, I loved looking at blood smears, I loved thinking about immunology. However, as I neared the end of residency I began to see myself burning out from the intensity – the sudden deaths and complications were taking a toll, as was the unpredictability of the schedule – people always seemed to decompensate right as we were finishing work rounds for the day. I began to see myself getting more and more frustrated, and perhaps even resentful, when patients fell ill. It was an unpleasant and unsettling feeling as it's not the kind of doctor I wanted to be. I was lucky to have the chief year to take a step back and re-evaluate things, and that was when I started to look at Rheumatology. Rheum patients always seemed so fascinating to me- complicated, with multisystem manifestations, and I liked the continuity of care, multisystem approach, and immunology, and that rheum was entering a new era with lots of new medications and paradigms of treatment. I did a few extra electives, applied in Rheum, and never looked back. I like that I still have the opportunity to take care of sick and well patients, but that the balance is more towards well than sick, and makes things more manageable for me, both psychologically and schedule-wise. That having been said, what I also tell all my students is that as long as they maintain 1) their love of patients and 2) their intellectual curiosity, almost any specialty will be meaningful and fulfilling. Meaning, I could be here extolling the virtues of nephrology, and how much I love spinning urine, and teaching young patients how to do PD, and would probably be as fulfilled.
What do you like MOST, and like LEAST, about your specialty?
In your opinion, what attributes are important in anyone choosing this specialty?
Need to be comfortable with broad differentials, as in rheum you are dealing with common diagnoses as well as the zebras, and need to be comfortable "living in the gray" --- it's the antithesis of surgery or cardiology – sometimes there are conditions that elude specific diagnoses, and yet we treat them anyway. It's very different than specialties where a problem is diagnosed and solved or well-established treatment protocols are used in daily practice.
Cooking great meals and traveling, though with 2 little kids our travel options are limited. Yoga and making quilts for friends are my quiet/meditative activities.