Though not immune to the hassles and hardships of practice, this physician
tells why he experiences the joy of medicine.
Twenty years ago, when I was barely out of medical school, I attended a
conference and found myself seated at a table with far more experienced
physicians. As usual when seasoned doctors converge, the complaining-
managed care, malpractice, unfair reimbursement, lack of respect-quickly
began.
I kept quiet, until an older doctor turned to me and asked what I thought.
What I wanted to say was: "What a great job we have! We help people, we make
a difference, and we make a fine living." Not wanting to sound like a
Pollyanna, I simply replied, "I think the positive aspects of being a doctor
outweigh everything else." But even this response brought stares of disdain.
Okay, I thought to myself, there are real challenges. But even so, these
guys could use an attitude adjustment-and an "injection of wonder."
Much more than mundane
Since then, I've remembered that phrase. It's become an approach that's
helped me throughout my professional career.
As a doctor, I've experienced life's extremes. I've felt life enter the
world in my hands as a child was born, and felt life leave the world under
my hands while performing CPR on a patient who didn't make it. But, like
most doctors, my day-to-day routines are not so dramatic. In my pediatric
practice, most of my time is spent on mundane problems-kids' colds, worried
parents, ear infections, strep throat. Same old, same old.
But wait. Everyday routines can hide everyday wonders.
Ashley's in Room 3, with a positive rapid strep. It doesn't get more
commonplace than that. Then, with a sense of wonder, I remember: A century
ago, rheumatic fever complications from strep were the No. 1 cause of death
in school-age children. Now, we hardly see rheumatic fever in this country;
a few generations ago, Ashley may have been one of the victims. As I write
out yet another prescription for amoxicillin, I think maybe I just saved a
life.
Bobby's in Room 6. Routine immunizations, which I've already given 20 times
today. Then, a quick thought: During the first half of the 20th century,
polio killed tens of thousands of people, and crippled tens of thousands
more. Since the development of polio vaccines like the one I'm about to
administer, polio has been eradicated from this country and is close to
elimination in the rest of the world.
When I pause and really think about what our profession has accomplished,
the sense of wonder rushes in. Since the mid-1800s, life expectancy in much
of the world has doubled. It's as if modern medicine and public health have
given each of us a second lifetime. Who among us doesn't have a relative who
was saved by modern science-heart bypass surgery, perhaps, breast cancer
treatment, or a C-section? My role may be small, but it still feels good to
be a part of such a positive change.
No matter what your specialty, the same approach can be applied. Removing a
mole isn't just a minor procedure-it can be a life-saver. That
antidepressant order isn't just a simple script, it's a contribution to
human happiness. An insulin dose adjustment may seem like nothing much, but
more than 15 million people living with diabetes would have died at an
earlier age were it not for insulin.
Granted, it's not always easy to think this way, especially when results are
slow and I'm striving, as most physicians are, to run a business and deal
with a litany of practice management problems. It helps me to remember that
it's not just the success of my practice or my day-to-day efficiency, but my
patients' health that's at stake. And wonder-a sense that's reawakened by
stepping back and taking a second or two now and again to look at the big
picture-helps to balance my perspective.
At the end of that lunch so many years ago, one of the skeptics said to me,
"We'll see what you say in 20 years."
Hard to believe, but it's been almost 20 years, and I still feel the same
way. Being a doctor can be a hassle. But it's still a joy and a privilege.
[ME]
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