Why did I want to be a doctor?

My friend went through a lot of grief before settling on psychiatry for a profession. Third year of medical school is tough that way. You play around in all these various fields of medicine and while everything should be appealling and fun, it's all sucky and tiring and you wish you could just be a doorman. That's third year of medical school. And without fail, any good medical student finds himself questioning what ever possessed him to enroll in medical school, and now the $100k of debt means that the only two ways out of this sticky wicket are to die or to become a doctor.

And the true value of this exercise in self-deprication is to ask yourself the question: So, why did I want to do this? When you can answer that question, you're home free. You can look someone in the eye and say with a straight face that you really want to be a doctor.

For me, it's working with patients, educating them. I am their user's guide to the human body. I get to work with people and help them to understand themselves. I'm the guy that says you're going to be fine or you have 6 months to live. I'm the guy that people come to and ask if it's normal to have burning chest pain after eating pasta with 3 cups of coffee. People have switched from their long time family doctor to me because I answer their questions and I want to know who they are. It interests me that she's a molecular biologist or he's a janitor or that she loves meatloaf or that he runs 3 miles a day. That's what gets me up in the morning.

The problem is that the decisions we make about what we want to do with our lives, other people read shit into that. And no field is more fraught with this than psychiatry. Psychiatry is very cart before the horse. This lady is depressed, and she's depressed because she's a widow and she just retired from her job which was her only connection to other people. Now she spends all day at home with her needlepoint, waiting to die. She is fucking depressed. I say she needs a life. The psychiatrist says she has a chemical imbalance.

It's one thing to say someone has a blocked coronary artery and needs angioplasty. It's another thing to say that a person's grip on reality is all fucked up by a couple chemicals and proteins that are not doing what they're supposed to. But are the chemicals causing the depression or is the depression causing the chemicals to be all nuts?

Granted, people with psychosis need treatment, and a lot of it. But it's quite a big thing to say that I need to alter someone's perception of reality. That's why psychiatry is frowned upon. No other field of medicine questions reality, and supplies such a shitty answer as an imbalance of neurotransmitters.

But here's the deal. In any field of medicine, there are people who are in it to pay the bills, people looking to pay off their 6 digit educational debt, and there are people that honest to God love what they're doing. You'll meet them. You'll meet a radiologist that spends 30 minutes talking about Houndsfield units on CT. You'll find the internist that sits you down for an hour and is in love with hypertension. You'll stumble across the hematologist that is sad that you don't care about factor VII nearly as much as he does.

And happiness in medicine is as simple as realizing that something completely geeks you out, and for example, the idea of spending an hour talking about immunosuppresants for HIV sounds like something fun. When you find something like that in medicine, screw what other people think. You've answered your big question.


Dr. Luke Van Tessel said...

Thanks, man. I needed that. I was thinking about surgery again today. Then I pulled up the OR schedule. And I thought, "What if I had a couple of laproscopic cholecystectomies today? How would I feel?" Then I realized it would totally suck. I am happy to say I never thought about the doorman thing. My alternate gig would have been trucking.

Jennifer said...

I watched Donnie Darko for the first time a couple of weeks ago and have watched it twice since. And even though Patrick Swayze is the ultimate in cheeseball, I thought what he had to say about fear and love was something truly amazing.

Sure, Donnie's right, too, when he says it takes a while to figure out what to do with the rest of your life. But I also liked what Patrick Swayze said, "I think you should look deep within yourself, deep within your heart, and find what it is in the world that makes you feel LOVE. And then go to that."

I know that it's meant to be total BS. But I like it. And it's the one thing that makes me think I should be doing nursing, instead of going back for my masters in education. Why teach literature...because I love the material? For me, I can't do that. For me love is being a patient's calm in the middle of the storm. And my love for writing and reading feels only selfish to me. And where's the love in that?

incidental findings said...
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Nita said...

This is exactly what I needed. Thanks for sharing your thoughts, you answered a few questions that were lingering in my mind.