Student: Singyi Yen
Interviewee: Dr. Chiu-Bin Hsiao
Dr. Hsiao is the medical director of the Positive Health Clinic of Allegheny General Hospital. The Positive Health Clinic is the designated AIDS center in North Allegheny, Pittsburgh, PA, where Dr. Hsiao cares for several hundred HIV+ individuals; the clinic offers both primary care and comprehensive HIV care for its patients. In addition, Dr. Hsiao is also an infectious diseases physician and offers in-patient consultations on various related cases.
Q: May I ask you to go more in-depth into what a typical workday looks like for you? What do you like about it, what do you not like?
Dr. Hsiao: The workday looks like that because I am a more senior person; I’m not a junior anymore. So, what people want me to do falls more in an advising mode rather than an action mode. Basically, I have five clinics and I help one clinic a week. And sometimes, once a month, I have weekend calls; on Saturday and Sunday, I have to go in and see patients and people that need an infectious disease consultation. They have questions about infectious diseases so we go to see the patient and give advice. And then, we do have many administrative things. Also, I have a couple clinical studies, clinical trials to run. [laughs] So, it’s quite busy. I also teach medical students.
Q: Wow, you are a really busy person, it’s very impressive! So now, did you always know that you wanted to be this kind of doctor, or to pursue this career?
Dr. Hsiao: Umm, no I haven’t always known. But I guess it depends on how long ago you’re talking about. I graduated in 1984 from medical school and at that time, I had no idea. But then, when I was in Toledo, Ohio, I studied microbiology and I ended up really liking it. I did my residency at the University of Buffalo, where I official “joined” medicine and decided to go for infectious diseases.
Q: So what do you find interesting about infectious diseases, what drew you in?
Dr. Hsiao: People say that if you are in infectious diseases either you are super smart or super dumb. The reason is that people often don’t get paid well in infectious diseases. The reason, however, that you do it is because of a passion. Being a physician, there’s a lot of different things you need to know and that’s really hard, and sometimes – oftentimes – frustrating. How can you know all of it? So basically, [your success] is based on your knowledge and experience. Not only that, you have to know how to dissect the cause, the reason, and then you try to find a resolution. Then, you finally take care of [the patient]. Most of the fields, like cardiology and radiology, are all like that. However, infectious disease is very special. In infectious diseases, you are like an inspector, or the police, or a CIA agent, and you are trying to solve a crime. There is a pathogen causing somebody to get sick and there is a pathogenesis. How do you know the cause, how do you know what type of pathogen is involved? So you need to gather all of the information, no matter whether the information is good information or bad information. Whatever the information is, you need to put it into consideration; you analyze it all together, just like you are trying to solve a crime. Only after you go through that are you able to find the criminal, or, if you do not find the criminal, you are able to prevent the crime from going further, getting worse. So that’s why infectious disease is, I think, a very, very good field.
Q: Wow, that’s really awesome! [Dr. Hsiao laughs] Because I have definitely met other people who are just in the career for the money or something like that, but hearing somebody talk about their field in that way is really inspiring.
Dr. Hsiao: [laughs] I mean, that’s why I am in infectious disease, but why do I designate in HIV? Well, actually, I know infectious diseases much better than HIV, but my HIV is very good too. The problem is, nobody wants to take care of this group of people, so if I don’t take care of them, who will? So I decided to take care of them. And you can learn a lot from this group of people. Since they have immunodeficiency, there are lots of new things happening. In the normal population, you may not even see it; I mean, occasionally you might see it, but from the HIV population, you can learn more than from the regular patient population.
Q: So you had mentioned before that you studied microbiology. Did you feel that the major adequately prepared you for going into this field, or into medical school?
Dr. Hsiao: Actually, I learned microbiology after medical school. I graduated from medical school in Taipei, so when I came to the US, I had to try and adapt to the system and that was my first step. I went to graduate school and focused in something that I was the worst at when I was in medical school. So I chose microbiology and it turned out well. The thing is, whether that was truly helpful, I don’t know. Obviously, I was more prepared for infectious disease because I had focused in microbiology for a couple of years. My focus became more on infectious disease only during my residency. So that’s how I prepared myself. And also, my fellowship was very crucial because my mentors were very good, very supportive and they let me do whatever I wanted [laughs]. I did microbiology, molecular biology, sequencing of bacteria. Sometimes, in the middle of the night, I had to come in and collect the sputum sample and isolate the haemophilus influenza mollica tyrase, something like that. It takes a lot of hard work.
Q: So then, can you describe the mindset or the work ethic of a successful physician?
Dr. Hsiao: As a physician, the work ethic is simple, patient first and do no harm. Do not play god. There is no absolute in medicine, you just have to do your best. Because I am older, I am the professor now. As a professor, something I say that people find interesting is that the pathogen you see may not be causing the illness and the thing that you don’t see is not necessarily not the one causing the illness. Even if you do everything right, things can go wrong. And even if you do everything wrong, things can still end up fine, so don’t give yourself the credit. You just have to keep going and do your best. That’s it.
Q: Last question, what advice do you have for someone who is interested in pursuing a medical career?
Dr. Hsiao: Obviously, the number one thing is don’t count on the fact that you are going to earn a lot of money. And number two, medicine is a hard career, it takes a long time before it is finished. So you have to love it to choose it. You should like to be with people; if you cannot stand people, their attitudes, you might struggle and you might not be outstanding. The thing is, people might be underserved. They might smell really bad, they might have poor hygiene, they are ill, they are sick, they may not be loveable. As a physician, if you cannot stand that, you cannot be a physician because those people are the ones that really need the help. Unfortunately, I see many physicians that don’t address those who are sick, those who are in need; they only take care of the people who are already healthy. That is not a true physician. I think the most important characteristic of a physician is passion. Every field, it doesn’t matter whether you want to be a physician or a musician or an engineer, it has to be your passion. So if you think your character is suitable to be a physician and you have the passion to help people, go for it. It’s just the passion. It doesn’t matter how smart, or not smart, you are, in the end, the most important thing is still passion.
Dr. Hsiao is one of my father’s long ago classmates. When the opportunity presented itself to interview him, I couldn’t pass it up. Dr. Hsiao is such an encouraging professional and he is very grounded and passionate in what he does. I chose to interview Dr. Hsiao because I felt that he would provide valuable insight into a type of medical career that I am very interested in. Initially, I had wanted to delve deeper into a certain undergraduate major, but having a discussion with someone who has overcome many of the steps in a medical career and has come out very successful, I now feel, was much more beneficial. By better understanding my end career goal, I believe that I am now better equipped to choose an appropriate and helpful major.
This interview served to strengthen my resolve and certainty in pursuing a medical career. It also presented me with a new field, infectious diseases, that I had previously known little about, but, surprisingly, aligned well with my imagined career. Talking with Dr. Hsiao has definitely relieved some concerns and worries about choosing a “correct” undergraduate major, instead, supporting the idea that as long as I am willing to work hard and spend time in a certain field, any major I end up declaring can start me down the right path. The focus of my major exploration has since shifted from trying to find one that will help me be successful in medicine to looking for a major that greatly interests and inspires me.
Most of the information that Dr. Hsiao shared seemed, at least to me, typical of a profession in the medical field. First off, a career in medicine requires a lot of time and effort (and money), so it would be extremely valuable to find a specialty that inspires passion. Secondly, what it looks like to be a physician can vary between specialties, but the main focus of medicine is to help the patient in any way possible. While most of the overall information was what I expected from a doctor, several other things that Dr. Hsiao mentioned definitely took me by surprise. Looking at Dr. Hsiao’s own story, he hadn’t had a perfectly set plan that he followed, instead, he explored different options until he found a niche that he enjoyed; from this, I’ve learned that I don’t have to have the next ten years of life strictly planned out. Additionally, Dr. Hsiao eventually entered a field of study, microbiology, that he originally struggled with, showing that difficulties can be overcome and even defeated. The last piece of material that was unexpected was that not all medical careers result in a high salary, at least not as high as generally believed. While this does not deter me from the career, it is an interesting piece of data to archive for later.
I am fairly certain in my decision to enter into a medical profession; more courses and focus areas need to be studied, however, before a specialty can be chosen. I would like to compile some information about different medical fields and careers and their representative courses/majors. As I continue to explore the different sciences, I can not only better choose an undergraduate major that interests me, but also take a step in determining a medical specialty. Furthermore, the (hopefully) future medical school education also needs to be taken into consideration. In terms of career, I am pretty set on medicine, disregarding the specialty area. As for declaring an undergraduate major, I feel that the next semester of courses actually spent in the different sciences will help to solidify a choice before the school year is over.
Several resources were available and used throughout the year to explore different majors. One that I found extremely helpful was the Exploration Office’s “What Can I Do with a Major in…?” resource. I appreciated the long term mindset that the information sheets provided. For most students, the end goal of receiving a college degree is usually to enter into a good career. The sheets for the different majors provided an easily understandable and accessible overview of the different career fields the specific major could lead to; the information was definitely helpful in picking out potential majors. Another activity that I found extremely beneficial was this one, the informational interview. I can sort and read through piles and piles of information about a certain major or career, but actually being able to have a conversation with an individual applying all the information in a very real way was most helpful.
Overall, the discussion with Dr. Hsiao was a very interesting and pleasing experience that inspired thoughts of hard work, passion, and kindness that will accompany me as I continue into the unknowns of the future.