Tuesday, September 25, 2012

Would You Do It All Again?

I suspect I would have changed anyway.  It's not just medicine, but life itself that distributes it's share of blows.  Battered and bruised, the body adapts. Unfortunately the mind also adjusts. The softer, more sensitive parts, are often the first victims.  We become hardened to the difficulties of reality.

There is no doubt that medical education is particularly aggressive.  The ego, like a scab picked over and over, maintains a solid exterior .  The skin becomes leathery and tough.  Our behavior subtlety changes.  A patient is quietly castigated or a child is allowed to whimper without the benefit of our empathic touch.  There is an attempt to assault the victim.  Instead of facing the difficulties and harsh realities of dumb luck, it's easier to cogitate blame. 

If they had just exercised more and eaten better!

There is an urge to cower and protect oneself.  In residency, many imagine that they are under siege.  They devise a plot where the world is out to get them.  The poor CHF'er in the emergency room on thanksgiving morning no longer becomes the wounded soul in need of healing, he becomes an agent of torture.

Those who read my writing will scoff.  They will say that I exaggerate, and point to the ideas expressed on this blog as proof. But I will counter.  Words on a page are much easier than real life. They are more safe and require less action.  I have known the coldness and bitterness that goes along with doctoring.  Accusations find their target on my chest from time to time.  And often they are deserved.

So it comes as little surprise that I paused when asked by the exuberant young college student if I would do it all again.  Her eyes scrunched together and her lips pursed in anticipation as she waited impatiently for my response.

Ultimately, the answer is yes.  But it's a calculated and often unsteady answer.  I would do it differently.

I would hold on to my idealism more tightly.

I would try not to protect myself so much.


Diane said...

This past year, as we have found diet one of the few tools we have to fight Mito, MAST, allergies it has dawned on me, No Dr. has suggested this path, and with the exception of one specialist, all have scorned it.

Many of your peers side with the American patient- why bother with clean eating, if it is easier to add a tube,a pill, a line? Surely a can of medical food is more effective then the patient learning how to eat clean and to learn which foods might help them feel better

Too many Drs. side with the "take a pill" theory- we the patients follow your lead- remember, Dr. knows best. A Dr. I know said they don't recommend diet changes anymore- the patients won't follow them because mass marketing of pharm products have taught them that a pill is easier- and sadly many Drs. back up that belief. How do you explain that despite Mrs. Obama declaring pizza healthy, and the bombardment of vitamin commercials and cures in a bottle, that "food" in it's purest form is actually a better option to try first? A few sane Drs. voices swallowed by massive marketing and money making pills.

FYI- yoga and exercise are good, and in moderation can relieve some symptoms-but doesn't cure Mito, fibro,chronic fatigue, arthritis, lupus, Mast and a zillion other diseases that Drs. are unwilling to treat these days- easier to blame the patient- cheaper too.

older + wiser said...

One of my favorite books is Middlemarch (and one of the main characters is a doctor). It's about what happens when idealism collides with reality and the compromises we find ourselves making.

I think what you describe is universal. Maybe it's just part of the process of coming of age and acquiring life experiences, good and bad.

But I agree, it is hard to keep one's perspective, especially on a bad day or series of bad days. What keeps me grounded is remembering that core of humanity in all of us - that we all struggle sometimes, we all have longings, we're all vulnerable, we all want a life we can be content with. If you can hang onto that little spark within your soul, you won't ever truly succumb to burnout.