Don't become a doctor #11 - perfection

I was in an elevator one day, and I couldn't help but overhear two neurologists talking (elevator conversations are bad! Even when it's an elevator full of doctors! Don't make me call the HIPAA police!). The only part I caught was one saying, "The PCP really dropped the ball. It was textbook HSV encephalitis."

Just as an aside, herpes simplex virus (either the cold sore or the genital herpes variety) can rarely INFECT YOUR BRAIN, and if you manage to live through that, you'll usually suffer some major neurologic damage.

I was completely stunned at the boldness of the neurologist's statement. But I'm sure that this PCP doesn't need a couple neurologists beating him up. Probably doing a good enough job himself. I know I would.

In medical school, one of my professors told me something wise. "Ifinding, I'll bet you think you should be right 100% of the time, because when you're wrong, people suffer, and maybe die. But guess what? You'll never be right 100% of the time. No one can be. We're human. In fact, you only need to be right 60% of the time. That's what the USMLE says (182 out of 300 on Step 1). I think that the most admirable goal would be 90%. If you can be right 90% of the time, then you'll probably be the best doctor you know. And when you fuck up, then you can say to yourself that you're allowed to be wrong one in ten times."

That's a really easy concept when you're a student, and the only thing at risk are your grades. It's a lot harder when you're trying to decide if it's pericarditis on EKG or an MI. And after a while, you learn painfully that you will be wrong sometimes, and the best you can do is plan for the worst.

So if you can't deal with being wrong sometimes, then stay away from medicine. I long for the days when being wrong meant losing points on my boards. Now when I am wrong, people get hurt, and people die. There aren't many things in medicine that feel worse, but the truth of the matter is that it is unavoidable. No one is 100%. No one.


Anonymous said...

It is a damn shame to see you so cynical about your profession, and about life in general, in all of the posts in this series.

While I have no practical experience in this profession, I do happen to be close to a number of physicians. They are generally happy people. They have their bad days, just like everyone else, but they also maintain a significant degree of optimism.

Everyone is different, though, and this world is full of half-cup-full people as well as half-empty people. While you do raise some useful points in your posts, I urge other Pre-Meds to also consult other physicians that have a more cheerful approach to life.

incidental findings said...

I always try to put up contrary views, so I have approved your comment. I will however take the moment to correct you that I love my job, and I think being a doctor is the most awesome and amazing profession ever.

Also, I would appreciate if comments criticizing this series in general could be posted on the main page and not on an individual post, as I feel that comments here should be directed toward disagreements with this particular issue.

Anonymous said...

Thank you for your blog! I'm reading it now, old entries, jumping from one to another, and just would like to tell you "thank you", and to oppose in a way to some other comments here. That's important things that you write. Thank you for doing so!

Kirsten said...

I don't see cynicism in these posts, I see the reality of medicine. I believe the writer is very happy in his/her career but feels the need to post about the bad as well as the good...medicine is certainly a mix of both. Have you never heard a waitress complaining about her job, or a maintenance person? Why are doctors not allowed the same opportunities?
I appreciate seeing your posts, ifinding! It's important to see the whole scope and definitely important to analyze emotions about crazy days or common misconceptions. I love this blog, thank you for writing!

Anonymous said...

I've been making my way through these today. First off, great series. Second, Kirsten said it well: I'm really glad I've read these posts, and they didn't change my outlook on med school (which I start this fall)and the profession afterwards. It's nice to get a glimpse of the other side of the coin!