Evolution/Devolution

Sitting in my office, I tap the last words of the progress note on the keyboard as the student shifts in his seat. He looks up at me with all the innocence and naivete of one who is at the beginning of an arduous journey. I strain to hear his words.

So, how does it feel to be a doctor?

I'm taken aback by the sincerity of the question and the rawness in his quivering voice. I ponder carefully how to respond. A million cliches pop into my head, and I fight them off one by one.

This time will be different.

This time, I'll tell the truth.

*

I can't remember a time when I didn't want to be a doctor. In fact, my identity and profession have intermixed to such an extent that I often can't tell them apart. My internal image includes a lab coat and a stethoscope. It always did. Even as a child.

My voyage through medical education was powerful. Like a flower, the seeds of identity blossomed and became external reality. But I couldn't help feel a certain sense of unease. It was as if the more I learned, the less the burning embers of humanity would glow.

When you encounter death and destruction at every turn, such things lose their profundity. And patience and tolerance become the exception and nary the rule. Such a treacherous path for a wandering soul.

Once, while sitting in the exam room, I found myself staring at the clock while I talked to a patient about her recent cancer diagnosis. I listened to the barrage of questions, but secretly I was calculating how to end the appointment early to run errands.

As the patient left the office, I realized how far I had fallen. I promised myself that that would never happen again. But now my eyes were wide open.

After all these years in medicine, it wasn't the difficulty of diagnosis nor the desperation of disease. What I find myself continously struggling with is maintaining the beauty and humility that were present when I started this process. Because somewhere amongst the paperwork, fears of malpractice, sleepless nights, and unexpected outcomes, something broke.

How does one build armour strong enough to repel the demons of sickness and despair yet allow the skin to bask in the piercing barbs of humanity? How do I evolve as a physician without devolving as a person.

*

How does it feel to be a doctor?

Well, how does it feel to be a human being?

Mired in the morass of moral frailty, I struggle with my own imperfection.

The difference is, as a physician,

the affect is greatly magnified.