March 30, 2014
A story is told of a child (for the sake of ease, we’ll name this child “Johnny”) who, when asked by his fifth grade teacher about what he wanted to be when he grew up, the child responded “I want to be a doctor.” “Why is that” asked the teacher? “Because doctor’s help people feel better, and save lives,” responded Johnny. “Do you realize that doctors work long hours, sacrifice time with family, are on call 24 hours/ day, and deal with life and death issues?,” asked the teacher? To which, Johnny responded: “I know.”
Years go by and Johnny excels in sciences and math. As a matter of fact, he excels in most things that interest him. He finds himself playing lead roles in classes, clubs and sports teams. His friends tend to go to him when they have challenges as John seems particularly adept at problem solving. John is always seen reading books or magazines and loves to share his knowledge with others. Throughout school and college, John carries on his habits of determined and focused work and a willingness to take risks, as motivated by a fierce sense of curiosity and a desire to make a difference.
As he progresses through medical school and residencies, he encounters numerous challenges such as tough teachers, competitive students, sleep deprivation, “politics,” and pain caused by hard-learned lessons from mistakes and patient errors. His days are long; his body is oftentimes weary, yet he is propelled forward by patient and family accolades and appreciation for the miracles he seems to perform. There truly are no words that can adequately express gratitude for eliminating pain and extending quality of life. Perhaps more than anything else, we take our health for granted until it is taken away. Then we realize how dependent everything else is on how we feel.
John manages to find a woman who has enough patience and love for him that she is willing to tolerate his long hours, and middle-of-the night calls, and they wed. They have two children and move out of their meager apartment into a country home. Life is good, and they are able to take exciting vacations and participate in cultural events.
Then one day, John expresses unrest. There are pressures to see more and more patients, cutting down on the time he has to listen to them as much as he’d like. There are regulatory documents and new electronic systems to learn, which all seem to take him away from what he enjoys doing the most: caring for patients. He believes there has to be a better way and starts wondering how he might play a role in creating a better system for his peers and his patients. Unfortunately, it seems like, in order for him to truly make a difference, he must give up the clinical world and move in to the world of “the suits.” Of all the risks he’s taken in his life, which include surgeries that involve going through vessels, into the heart and brain, this seems even more formidable.
His work won’t impact one patient at a time; it will impact thousands! His influence will impact access to care; who gets care, where, and when; it will impact his friends and colleagues with whom he’s worked side-by-side; with whom he’s shared fields of battle that happen to be an emergency room, delivery room, ICU, or operating suite. His usual state of confidence, bordering on arrogance, is shaken. There are no well-defined protocols, formularies, or standards of practice. His opinion isn’t the only one that matters and he knows he’ll hear more complaints than he will compliments. Family life will continue to be impacted: he may not be in the operating room but he will be in board rooms and making rounds to be visible; he’ll be spending precious time that he could be spending working out and looking after his own health, in front of an electronic device responding to email.
In a rare quiet moment, during his sporadic efforts at meditating, John hears another voice asking him: “What do you want to be when you grow up?” “What is the difference you want to make in.. and for this world?” John spends a few more moments with eyes shut, and then with a sense of clarity that has long been missing, makes his decision.
In appreciation and gratitude for what you do, and who you are,