Doctors and doormen

There's a certain je ne sais quoi of a good doctor. You know, ask a hundred people about doctors, and they'll tell you a hundred different qualities, but there's something that everyone wants out of a doctor, and it's stuff that keeps people coming back for more. And really, I'd like to think that's all I've got going for me.

I went into a residency interview and I flat out said, "I'm not the smartest candidate you'll interview, not by a longshot. I'm not the sharpest or the most qualified, but I'll be just as good a doctor if not better because if all you were looking for were the smartest and the sharpest, you wouldn't be interviewing me right now." There's truth to that. I think about my med school class, and I know who I think the exceptional ones are, and they weren't the smartest. They were the ones that patients love, because medicine is more about relating to people than treating disease.

I was telling a friend of mine a truth to medicine. Even an incompetent doctor can be loved by his patients if he's willing to stand up and fight for them. And I'm living proof. I have patients all the time in the hospital, and my pitch to them to follow up with me in clinic is about as negative as possible. I'm a first year. I'm in training. There are better, more qualified doctors that abound. They're under no obligation to establish care with me. But still, I've had patients that turned down my attendings to follow with me. I'm not incompetent. I think really it's just that people want to know that their doctor is someone that cares about them. I don't talk down. I talk with.

The reason I like medicine, the reason why I wake up every morning and go to the hospital is because I like working with people. I like helping people out. I like talking to people and getting to know their problems and how I can help. Diseases, treatments, procedures, it's all a means to an end. If there were no patients to care for, I'd rather be a doorman. This is in complete opposition to one or two friends I have that don't want to care for patients at all. And I'll admit, I don't get it. If you don't want to take care of patients, why bother?

To me, being a doorman has the same luxuries and benefits of medicine. It's all about knowing someone who at the end of the day is looking out for you.

Do you really want to be a doctor?

It takes a certain level of masochism to go into medicine. Something in your mind has to actually say that yes, I do think that getting the shit beat out of me on a regular basis sounds like a way to spend my life. Never in all my life have a felt stupider than when I'm taking care of patients. What's the patient's UA show? How do you explain this uric acid level? What are we doing for her renal failure? What medications do we have him on for blood pressure? What has her white count been doing for the past week?

I think that the great advantage attendings have over us lowly interns is that they can cherry pick. They can take aim at us from high above and we really have no recourse. It's wholly their right, since they take the heat if shit starts flying, but it certainly doesn't do much for the ego when your attending shoots a string of questions at you and the only one you can answer is that yes, she has been afebrile for the past 24 hours.

But it balances in ways. My senior has a habit of saying that I did a good job with this or that, and it's unbelievable, absolutely unbelievable how much I appreciate that. It's nice to have someone say, hey, good job, I think that's the right thing to do. One of my seniors questioned an order I wrote. I told him that the on call senior told me to do it and he laughed. He said to me that he knew it wasn't me. I was too smart to do something that dumb. I'm glad that others have such confidence in me, and I'm starting to think that I need to have some confidence in myself as well.

I'd love to talk to pre-meds in college. I'd love to tell them that this glorious career of medicine, it's not what they think. It's work, tough work. It's as blue collar as you can get for six figure salary. It's not noble. It's not honorable. It's work. And if that's your flavor then more power to you, but if I wanted to get some respect, I think that there are better ways.

I think the one beautiful thing about medicine is that despite what other people do to you, no matter how much the system beats you up and down, you can feel good about yourself if you can go home and say that you helped someone. You know, it's not often that you can go home, sip a beer, eat a pizza, and think to yourself that you made the last few hours of someone's life as pleasant and pain-free as medically possible.

A patient looked at me today and asked me what I would do in her shoes. I didn't have an answer. She wanted one but I didn't have one. What would I do? I dunno. Would I fight? Would I give up? I don't know. And sometimes, just knowing that this decision that she's been fighting with is a tough one, that's comforting to know. And so I can go home and sip on a beer and think that in spite of how lousy today was, I did okay.