Friday, December 30, 2011

I Know This Much Is True

I walked out the door and down the steps on a clear St. Louis morning. The air had a slight chill as the sun began to rise in preparation for the new morning. Spring had not yet transitioned into summer and the humidity was minimal.

As I had done on so many other days, I walked with my lab coat slung across my arm. My stethoscope would occasionally pop out of the pocket and dangle from a thread before I scooped it back up and placed it awkwardly into its temporary resting place. If the temperature dropped, I may slip the coat over my shoulders and wear the stethoscope around my neck.

When I arrived at the hospital, I walked through a side entrance and took the elevator to the medical wards. The resident's office was busier then usual. The interns awoke and left their adjacent call rooms to find that they were no longer on the bottom rung. The new interns, donning neatly pressed and clean white jackets, had arrived for their first day of work.

My fellow residents and I basked in the glow of our final day of training. We would stay for a few hours and hand off patients, help with rounds, and generally enjoy the absence of true responsibility.

We walked the floors as if we were kings. We strutted back and forth and chatted with the nurses.

A few hours later it was time to go.

We left the sheltered and protected existence of training and launched ourselves into the vast unknown.

And we never looked back.


There is a sense upon leaving residency that you know just about everything. That you've seen and done all that is important. You've cared for the sickest of the sick, and dealt with the poorest of the poor.

A list of dieases and procedures has been appropriately checked and checked off. An air of confidence lingers.

But I have to admit that the majority of doctoring, I learned after training. The ivory towers provided a good working knowledge of the arcane, but the day to day, bone on bone grinding of patient care was learned on the fly. Each encounter provided a new skill, a new fount of knowledge from which to draw from.

And I was often surprised at my own prior misconceptions. I would have never imagined that as an attending, I would sleep less and work harder then in residency. I couldn't comprehend the crushing responsibility of being the bottom line. No one prepared me for the three am call from the nurse when there was no one higher up on the food chain to call for advice.

Yet the hardest skill to achieve was not the science but the art. How to become a "healer" and not just a doctor. How to know when to place your hand gently on the shoulder of a mourning patient or to raise your voice to an unyielding family member.

I still struggle with how to remain humane and kind, as well as stay effective. Medical knowledge comes and go. Diseases are discovered and cured. But in the purest sense, the job of the physician is to be a beacon, a lighthouse, to guide each ship safely to land in the harshest of conditions.

This is what it is to be a doctor. After all these years of training and practice,

I know this much is true.


prancingpaws said...

Beautifully expressed. You will continue to be a doctor forever.....

Jackie Fox said...

I find it hard to believe you have to struggle to remain humane and kind. Everything you write says otherwise. But it's to your credit that you worry about it, and I think part of the reason you won't lose your compassion. Great post.