February 16, 2010

During this time of third-year, much of our class is embroiled the tough decision of what to do with our lives, for the rest of our lives. It's a question I've been wrestling with myself, and although my decision is postponed for a few years, I still wonder what I want to do with myself when I grow up.

I was running by some of ideas with Dr. Allan, one of my mentors, and I started to talk about some of my concerns. "I really liked surgery," I said, "but the lifestyle seems so terrible." I told him about the long hours we had, even as students, and our attendings and residents who were overworked, tired, and who seemed to constantly lived in the hospital.

Dr. Allan surprised me by suggesting that deciding a career based on lifestyle was a bit of a fallacy. "A lot of the people you see working those long shifts," he said, "have other things going on. If you want to make balancing work with other aspects of your life a priority, you'll make it work. If you want to live on the beach all day and still make tons of money, that probably won't work out-- but I think people have more control over their lives than they realize."

In many ways, this was a shocking message, and despite how awesome of an advisor Dr. Allan is, I couldn't help but approach it with some skepticism. Really?

After all, a great portion of medical school is dedicated to the idea that we have no power, and more so, work is absolutely paramount. Often, we don't know where we're going the next day, or how long we'll be there. Although we're still students, we work long hours and weekends, at least compared to many of our peers on Wall Street or in other industries, but they normally don't have to go home after a long shift to study. On some rotations, skipping meals and subsisting on granola bars is the norm. We even hand off our life decisions to the machine, the Match where a computer determines our residency placements and the next decade of our lives.

Even our student evaluations forms have a section where we are rated, on a scale of one to five, on whether or not a student "consistently places patient needs before personal needs." Our evaluation forms place a clear message that we should no longer expect our personal needs to be paramount-- doing so would detract points from your grade.


Now that I'm no longer on the wards, I find myself a few pounds lighter, out of shape, less in touch with my friends and family, and perhaps unsurprisingly, with a ton of personal issues that I've piled up over the year. And, unfortunately, I find that I can't only blame the system. The reality is that to some degree, Dr. Allan was absolutely right-- for myself, I realized that it was often easier to take care and think of others than myself.

After all, what do my petty problems compare to my patient lying on the floor, with a mystery illness that we had no idea how to treat? Or the kid in the ER who we're admitting for suspected child abuse? Or my buddy Mr. Galloway, who is likely to be dead in a few months thanks to a challenging liver cancer? Or even the simplest of cases in the hospital-- ear infections, pneumonias, broken ankles, at least these are issues that have clear, easy prescriptions. These are problems and issues that are either prioritized or concrete and easily fixable. Either way, they are problems that are worth more of my attention than my own.

These days, I find myself flooded with loose ends, personal things to ponder and think about, and relationships to restore and develop. I used to blame the hamburger machine of med school, but at the same time, I can't help but realize that I, too, share much of that blame. Sometimes, being selfish is the most difficult task of all.