Code of Ethics: Stories about doing the right thing

This week we present two stories of people struggling with what the “right” thing to do is.

Part 1: Catherine Macdonald always wanted to study sharks, but her first time tagging them in the field doesn't go as planned.

Dr. Catherine Macdonald is co-founder and Director of Field School (www.getintothefield.com), a marine science training and education company dedicated to constantly improving field research practices while teaching students to perform hands-on research with sharks. She is also a part-time Lecturer in Marine Conservation Biology at the University of Miami’s Rosenstiel School of Marine and Atmospheric Science.
Company website: www.getintothefield.com
Personal website: www.drcatherinemacdonald.com

Part 2: When Michelle Tong visits home after her first semester of medical school, a stranger presents an ethical dilemma.

Michelle Tong is a second-year medical student from Milwaukee, Wisconsin. She has been published in the Margins and Glass, among other literary journals, and reads for the Bellevue Literary Review. This past summer, she won first prize in the Michael E. DeBakey Medical Student Poetry Awards and received a fellowship from Brooklyn Poets. She teaches poetry at the Icahn School of Medicine at Mount Sinai and lives in East Harlem.

Episode Transcript

Part 1: Catherine Macdonald

There are a lot of really cool shark facts that I could tell you and I want to. But the truest thing I can tell you about sharks is that, from the first time I saw them, I loved them. And love isn’t really that vulnerable to logic or explanation. I just did. I just do.

The first time I ever tagged a shark, I was 21 and I had no idea what I was doing. I was being trained. We caught a nurse shark and somebody just thrust a tagger at me and said, “Right there.”

So I hit the shark with the tagger. Nothing happened. Nurse sharks have super thick skin.

They said, “No, no, no. Harder.”

I tried harder, a couple of times. I totally failed.

They said, “Hit it with your palm.”

I hit it with my palm. I definitely hurt my palm. And I looked at the shark and I was hurting the shark. I mean not the way that I'd be hurting a person. Shark nociception doesn’t work that way. But I could see that under the skin the tissue was starting to get a little mushy. I was bruising it. I was doing it harm.

And I finally said, “No, no. Somebody take this away from me. Somebody who knows how to do it.”

They did and they did like it was nothing. We finished the rest of the night and we went back to the lab. And I went off and I found a quiet corner and I cried. Nobody becomes a shark scientist because they want to hurt sharks. And I said to myself that there has to be a better way to do this.

Catherine Macdonald shares her story with the Story Collider audience at Open Stage Club in Miami, FL in December 2019. Photo by Jim Rassol.

I am a born rule follower so I decided I was going to figure out the rules. I spent about the next ten years working out the best way to teach this kind of stuff and to do this kind of stuff. And I know now, although I didn’t then, that when you're trying to tag a nurse shark there are some places that the skin is a little bit thinner, like just behind the dorsal fin. That sometimes you want to take a scalpel and cut a tiny hole so that that tag slides in smoothly. Or that some people like to use a rubber mallet to just give that tagger a tap to get it through. But, you know, live and learn.

So now, I teach students to do that and have a progressive approach that allows them to gradually challenge themselves, learn new skills, but also feel like they have some idea what they're doing, hopefully, all the time. I applied that approach for five years as a graduate student at the University of Miami teaching undergraduate interns and master’s students to work with coastal sharks.

So we were out fishing with drum lines. And if you don’t know, a drum line is about a 40-pound weight attached to rope and floats and then attached at the drum, to a long line of monofilament with a hook and bait on the end. You set ten of them at a time and the rules for this are you set them for one hour. The reason for an hour is that it balances stress to the shark with the likelihood that you're going to catch something. If you put one out for 15 minutes what are your odds and you're going to have a hard time getting to all that gear in that shorter period of time.

So we’re out. We’re setting. We've got ten drum lines out. And we’re checking them. We pull one up and the hook timer is popped. The hook timer is just a stopwatch that tells you if you have something on the line and how long it’s been there. As soon as the animal takes the bait, it pops and it starts counting up. So it says 30 minutes, a great amount of time. We’re well within our one-hour soak time.

So I’m bringing it in. I use a plastic circle called a yoyo that the monofilament goes around. You just wrap it like that. And the line feels really heavy. That means you've hooked the bottom or it means you've hooked a big animal. Heavy but not fighting. It’s not dragging me around. It’s not trying to yank me off the back of the boat.

And I start to get this cold feeling in the pit of my stomach. So I reel and I reel and this giant dorsal fin breaks the surface. It’s a great hammerhead. In the shark world, great hammerheads are known to be very vulnerable to capture stress. They joke that they like to die like that. And they're also known as rock stars, so my students go nuts.

“It’s a great hammerhead. Oh, my God,” jumping up and down, losing their minds. And that pit of my stomach just gets a little bit colder.

And so I bring him in and up alongside the boat and we work him up. Everything goes the way it should. It takes about three minutes to get four measurements and three biological samples and he's ready to go. But he would not swim.

So I grab my fins and I grab my mask and I go into the water fully clothed to try to swim him off. That’s something that we do sometimes when we’re worried about the condition of an animal, to keep an eye on it, to give it a little encouragement, to swim off as it moves away from the boat.

I’m in the water. I’m holding him. I’m kicking away and nothing. And there's this moment where I realized that I’m not in the water with an eight-foot shark. I’m in the water with a 200-pound sack of meat that I’m dragging.

And I swim him for probably about ten minutes and his dorsal fin kept slipping through my fingers as I tried to keep him at the surface. He just wanted to sink. But I had to be up there to breathe so I’m dragging him up, dragging him along.

And I look back at the boat and I can see that the students have caught up and that that excitement, that elation, that adrenaline is becoming something else. So I finally lose my grip and that dorsal fin slips through my fingers and he arcs downward.

They’re so perfectly balanced, they're so hydrodynamic that for a second you could almost believe that he was swimming. And I come up to the surface and I’m panting and the photographer who was on the boat comes up to the surface next to me because she got in the water when I did with a camera.

She looks at me and she says, “It happens.”

Part of me said, “Yeah. I know it happens. That’s true.” And part of me said, “No. No. It shouldn’t happen. It shouldn’t happen to anyone. IT definitely shouldn’t happen to me. I followed the rules. I did what I was supposed to do. Nothing went wrong. No. this isn’t fair.” But it was.

So I swam back to the boat, got on board, told the students that it was not their fault. That I was the trip leader. That if someone was responsible it was me.

I labeled those samples. I put them on ice. And I sometimes think, although it was a few more years before I got my PhD, that I went into that water as Catherine but I came out as Dr. Macdonald, because, for the first time, I think I really got the fact that science has a cost and that being good isn’t a way of opting out. That no matter how hard you try to do things right, they’ll sometimes just go wrong.

So I have a picture of that hammerhead on my desk. To be more exact, I have a picture of me swimming that hammerhead on my desk. And every time somebody comes into my office and sees it they say, “That’s so cool.”

And I say, “Hmm,” because I don't have anything else to say.

And I think about the work I do as keeping a ledger. I hope that the net good that I do for the species that I work with balances out the harm that I know that I do to individual animals, no matter how hard I work, no matter how hard my students train, no matter what we do.

This year, my team and I found what I think is the first known great hammerhead nursery on the east coast of Florida. It’s only a few miles from where I caught that hammerhead. And the data that we’re collecting, I hope is going to help push forward protections for that nursery so that those little guys can grow up safe.

I’m still in the red on hammerheads but I’m trying. And I hope someday I’m going to get back into the black. Thank you.

Part 2: Michelle Tong

I moved to New York last August. Actually, last July. And when I tell people where I’m from, I usually say North of Chicago because no one knows where Glendale, Wisconsin is.

So, let me tell you about Glendale. It’s a suburb that boarders the City of Milwaukee. In my neighborhood, people like to garden and gossip about their kids. If you drive just minutes from my house west and cross Teutonia Avenue, you're in the city of Milwaukee.

I used to go there as a kid with my friends because that’s where the McDonald’s was and we liked to get soft-serve, and then my mom found out. When she did, she sat me down that day and whispered, “People get shot there. You’re probably going to die.” And I didn’t want to get shot so I stopped going.

Oh, Glendale also has a mall with the Cheesecake Factory. We have some nursing homes and a gas station. Actually, three gas stations. Yeah, that’s pretty much all about Glendale.

Michelle Tong shares her story with the Story Collider audience at Hatch Auditorium at Mt. Sinai Icahn School of Medicine in New York City in November 2019. Photo by Zhen Qin.

So I was in Glendale last December after finishing my first semester of med school here, and my sister, who loves to bake, wants to make sugar cookies. We don’t have butter so I graciously offer to drive to the grocery store. So I went right by my old high school.

On my drive back, I have the butter in the passenger seat. It’s going great. This is a road I know super well so I’m going like ten-ish, above the speed limit. Then I see this awful Stop sign that has plagued my existence since I was 14, so I pause before turning right.

And then I hear police sirens and think, “Oh, my God. There's no way I didn’t see that.”

So when the officer comes over, I look up and say, “Hi. I’m so, so sorry. I’m home for the holidays. I just don’t know this road really well. I really didn’t see the Stop sign or the Speed Limit sign. Really, just all the signs, I didn’t see them. I’m really sorry.”

He looks at me, doesn’t respond and asks for my license. I give it to him and then I start talking about this cold weather, how I live in New York now and there are too many pigeons and how my sister wants to make sugar cookies and he doesn’t care. And he cuts me off and asks me for my insurance card.

I have no idea where this is. This is my family’s car so I start digging around in the glove box and under my seat and I look back at him and I say, “I’m sorry. I don’t know where that is.”

And then he looks at me and says, “Let me see what I can do,” and walks back to his car. When he comes back, he says, “The Speed Limit is 25. There's a Stop sign on the corner and Happy Holidays.”

So now, I’m on my way back home but something else happens before I get to my neighborhood. I’m on the last intersection before my house and I see this middle-aged black woman on the side of the road. She's wearing a ripped gray sweat suit, matching fuzzy boots and, over her left shoulder, she has a hot pink tote bag.

And when I get closer, I notice that her eyes are puffy like she's been crying and she's waving her arms in the air like this and she's trying to get cars to stop.

This is not ordinary for Glendale at all. We don’t have side blocks so no one just walks around. But no one is stopping. And, to be honest, I think about not stopping either because I want to go home and I want to make sugar cookies with my sister.

But I’m not sure what comes over me and when I get closer to her, I roll down my window and she leans down and our faces are aligned and she says, “I’m not safe. Can you take me home?”

In this moment, I’m thinking about that thing they taught us in elementary school where you're not supposed to talk to strangers and you're definitely not supposed to let them in your car. I’m also thinking about her hot pink tote bag and how it’s probably filled with gum wrappers and tissues but how it could also have a knife or a gun. And I’m also thinking about how she's at least 100 pounds heavier than me and how easy it would be for her to knock me out and steal my car.

I’m thinking about all of this when I unlock the door and I move the butter from the passenger seat to my lap and she gets in. And I’m still thinking about this when she starts talking to me and she tells me her name is Misty. She's come here from Atlanta to visit a man she met on the internet. The situation got violent and she got out of the house as soon as she could.

She asks me to take her to her friend’s house and points towards Teutonia Avenue. I say, “Sure, no problem.” But that’s a completely lie, because my hands are clenched on the steering wheel and I’m probably tachycardic and definitely hyperventilating.

Then she starts asking me for money. She says she needs $300 for a bus ticket back to Atlanta. And then I’m not sure what to do but all I can feel is my face flushing and I say, “I’m sorry but I don’t have that kind of money,” which is another lie because I know I do. It’s in my bank account. But I say I need it for school even though I really don’t need it for school.

And I ask her if she's heard of shelters in the area and that I could get her connected and make sure she's safe. Then Misty tells me about she's had bad experiences in the shelters and that the lights are too bright and the people are too loud and that she really just needs the $300.

I think about this and I say, “Let’s go to the bank and I'll see what I can do.”

Misty thanks me over and over for my kindness but this is really just a decision I make for my own safety.

The bank I go to is at the mall, the one with the Cheesecake Factory, and it’s a place I’m familiar with. There are lots of people and it’s away from Teutonia Avenue.

After this compromise, Misty and I both relax. There's no more negotiating and we start talking like people in the Midwest do, standing in line at a grocery store except we’re not at a grocery store. We’re in my family’s Honda Accord.

I learn that she used to be a nurse but had to stop when her mom got sick. She really hates the humid weather in Atlanta but really misses her kids. When she learns that I’m a medical student, she gives me some advice. She says, “Study hard. Don’t let anyone tell you you're not smart enough. And remember to be good to your nurses.”

When we get to the mall, I pull up in a busy lot and we walk to the bank together. When we get inside, Misty sits in the waiting area next to one of those old tables with the old magazines that no one reads and I go up to the teller, give him my ID and ask for $50 cash.

The teller looks at me, looks at Misty and then looks at the security guard and opens his mouth like he's going to say something but he doesn’t and just gives me the money. When I ask him for an envelope and a pen, he raises his eyebrows but just gives it to me anyways.

I scribble my name and my number on the back of this envelope, shove the $50 inside and then when we walk outside of the bank. I give the envelope to Misty and tell her to call me if she ever needs anything. We walk in opposite directions and I haven't heard from her since.

When I finally get home, my parents are waiting for me in the kitchen, because even though I’m 24 I still have a curfew when I go home. They're Chinese immigrants. Bless their hearts. But yeah, they're waiting for me. And I tell them of this really odd series of events that happened.

When I finish my story, my mom immediately fixates on how gullible I am. She says, “How could you trust this woman. Like you don’t even know her. She probably lied to you.”

I think about this and I agree that it could be true. I may or may not have been used or lied to. But my mom doesn’t point out that I also lied to that police officer that day and used his trust in me to get myself out of a $50-ticket. But his trust in me never faltered, or at least it never showed. And unfortunately, I can’t say the same about my interaction with Misty.

To this day, I think about how hard it was for me to trust Misty and how I’m still not sure if I do. I think about how easy it would be for me to trust her if it were an older Asian woman in her place that looked like my mom or my grandma. I’m still thinking about this when we have to judge the reliability of a patient’s narration and put it in the formal writeup in my Clinical Skills class. And I’m thinking about it again when I’m shadowing in the ER with the doctor who immediately questions a black male patient’s motivation for coming in despite the wheezing we both heard on physical exam. In that moment, I’m not sure who to trust but I don’t give it freely to the patient or the doctor. Thanks.