Don't become a doctor #1 - the very worst in people

Recently, the Cheerful Oncologist had this to say about wanting to be a doctor. I have indulged myself similarly, numerous times in fact (1 2 3). But reading through the Cheerful Oncologist's list, I was struck by the fact that we spend so much time talking about the qualities required to be a doctor, and it's always cast in such a noble light. Rather than rehash a trite list of admirable qualities, I thought I might point to the blemishes instead.

So for your benefit and amusement, I will start a continuing series of essays on why NOT to become a doctor, starting with this one. I think it goes without saying that if you can read through these and still be gung ho for medicine, then feel free to proceed. Currently, I'm planning on at least 16 of them. Yah. I'm surprised too.

If you wish to be a doctor, there are things that you should know. The first thing is that you cannot ever understand what it means to be a doctor until you actually are one. Life truly is a little different once you've put on the long coat. You can't talk to someone who's dying and not be changed. And so, all I can hope for is that when I'm all done with this series, you can read them and piece together what it is to be a doctor, and decide for yourself if it's for you. And with that, I'll begin.

I found this comic, "Nana's Everyday Life" on the web, and I have to warn you, VERY NSFW! Briefly, it's a humorous look at the life of a little Japanese girl who's a sex slave. Believe it or not, the idea of having sex with little girls is such a prevalent fetish that it has a nickname, Roricon (Short for Lolita Complex). The comic itself starts as a satirical and ironic piece, but by the end is very somber.

And while it's designed to be jarring, I was absolutely struck by this, because it brought back flashbacks to me of child psych, the field that I was considering but chose internal medicine instead. The reason why I couldn't do child psych was because of stuff like this. It's because I would meet these little kids, the most innocent of innocents in our world, and they've lived harder lives than I could ever imagine. They've survived rape, torture, neglect, assault, abuse, starvation, and every form of physical and emotional abuse. They've been scarred for life, scars so deep that we have nothing that can fix them, nothing to make them better. There is no amount of love or caring or compassion that can heal these little children's wounds. Never. They are destined to live existences tainted by the horrors inflicted upon them.

And that first week on child psych, I wanted to buy a gun and shoot their parents for doing what they've done. I wanted to mete out justice, the kind of justice I pray exists in this world or the next. And it took me a long time to realize this truth about medicine: you see people at their worst. You see the worst people, the worst of times, the worst done to them, the worst circumstances. Medicine isn't a field that makes you feel happy. It isn't full of sunshine and songs. It's people sick, people dying, people shitting themselves, or living with a tube in every hole and some holes we've had to make.

In medicine, you only see the very worst of the world. Those are the folks that need our help. And it drains you. It eats at you at night. It can convince you that the world is full of disease and death.

I was talking with a friend, and noted that a lot of Catholics are in internal medicine. Of course, he said. What better field to suffer in? But the catharsis isn't just for the patient. The profession of doctor is cathartic. If you aren't ready or willing to face the dark side of the world every day, then please don't become a doctor.

5 comments:

Anonymous said...

It's also strangely addicting. But that could just be the Catholic speaking.

CT
http://cardiactamponade.wordpress.com

Anonymous said...

Would you choose to go into IM again? Are you sick of it?

incidental findings said...

I don't know if I had to do it over again if I'd choose IM again over child psych. It was a really tough call when I made that decision the first time. But I do enjoy IM. It helps that I'm good at it.

Crystal said...

I've read all of Fake Doctor (Ah, Yes, Medical School) and now I'm devouring your series.

You see, I was a pre-med, had a son, and said "residency can never compete with motherhood". So I quit school, and have been a Mom ever since, happily homeschooling and parenting and being a family.

I'm a cancer survivor from last summer. Stage 1A endometrial. As I like to joke, if you have to have cancer, it's the one to have. ;)

Somehow in stumbling around Mommy Blogs, I wound up on cancer blogs. And doctor blogs. And uh-oh... Medicine is calling. Worse than ever, because after 6 years of my husband working for a large and awful HMO, and cancer, and the entire comedy of errors that was our experiences with this HMO... I know I could do better. I actually give a damn. And I've been through so much in my life, that I'm pretty hard to scare. Even that distant fear of gross anatomy isn't quite so frightening. I've stared death in the face (okay, for the 6 weeks waiting for surgical staging with elevated CA-125). We all die. Period.

So I thank you for this series.

Why I'm posting here, is I have to quibble.

Kids who have been through what you listed do not have to deal with it forever. Granted, it's rare for them to heal. But I believe only because it's *hard*. But not impossible. I am one example. I've been through everything, or damn close, on your list. I pushed everyone away, acted out, loathed myself. And I met my husband. Who loved me no matter what. No matter how hard I pushed. He didn't get caught up in the drama, he just kept being a good, decent, honorabl and trustworthy person, and kept reflecting a side of me nobody had bothered to see before.

The past can not be erased, but it can be healed.

We had foster kids before we had a son with autism (and someday we'll have foster kids again, but right now, we're earning our Ph.D. in autism). We only had one kid we couldn't reach. I think she could have been reached, but she was 17 by the time she came to us. She'd had enough. She didn't want to work hard, she wanted an easy way out.... I still grieve that I couldn't reach her, but she had to meet us half way. I couldn't do it for her. I could only reach out my hand.

The rest though.... they all made progress. And they all learned there are honorable people in the world, and when you have a choice, choose honor. They learned to trust. And they learned why we thought each and every one of them hung the moon (even the one we couldn't reach).

Our society does not want to spend the time, money, or energy to do what it takes to reach these kids.

But when we have a better grip on autism, and have paid off the medical debt from last summer, I will be like the person throwing starfish back into the ocean. I can make a difference in the lives of these kids, one at a time.

And maybe, if I can find the time... finish my degree and go to med school.....

BTW.... You are an extraordinary person, and an incredible doctor. After our experiences with the HMO from hell, I get tears in my eyes reading your blog, the way I do with my new, non HMO doctor. He cares. And the buck stops with him. Amazing. I'm learning with him how to trust doctors again the way my husband taught me to trust people again.

So thank you.

incidental findings said...

Thanks. I think this is the most heartfelt thing anyone's posted on this blog.

But don't be so quick to laud me. I am simply a person who has learned how to deal with other people as people worthy of respect and compassion. That speaks nothing to my medical skill.

When I talk to my interns, my advice to them is peppered with stories of some lady whose kidneys I destroyed or some old guy who's 6 feet under because I didn't see that his belly was full of dead bowel. Or the one that haunts me: neutropenic sepsis.

If I had to choose between my ability to interact with patients and being more medically proficient, I'd choose proficiency, because even an asshole can take good care of someone.

Don't get me wrong, I love my patients. But they could have a better doctor than me.