Thursday, February 14, 2019

Precariousness

There is a yearly essay contest in Spokane with the topic of "being a physician." Insomnia is rare for me, but it struck a few weeks ago and the backbone of this essay was the result. I just submitted the essay today, so I have no idea if it's a 'winner' or not. But I thought the ideas would also fit nicely here.




Precariousness
Being a physician grapples with the extremes of life: euphoric triumphs and crushing defeats, both joy and prolonged suffering, generosity and selfishness, birth and death. Practicing medicine can soften a soul to be more human and compassionate or harden someone to be jaded and disconnected.

Frankly, being a physician sucks.
You sacrifice your youth on the altar of medicine; I missed my wife’s graduation from her Masters program for a medical student surgical rotation.
A sense of inadequacy and imposter syndrome hangs over everything; my long time patient has one visit with another physician and they make an obvious and life altering diagnosis.
Societal and social pressures are awkward and embarrassing; I routinely try to hide my profession when meeting people for the first time.
Suffering becomes routine; I had to tell a 21 year old man that the mass in his neck he was ignoring was cancer.
Taking the blame for suffering is something you volunteer for; ‘Why would I ever let you vaccinate my child? Do you just want to give them autism?’
Helplessness is a constant companion; pregnant women return to their substance abuse and the men who give them orbital fractures.
Randomness is your worst enemy; I was the one who discovered an unborn baby, dead at term, when only 3 days ago it was alive when Mom decided to delay an elective induction.
Normal life is ripped from you by a sense of professional obligation; I had to meet my next door neighbors for the first time in the ER, then watch as their mother’s mucous membranes sloughed off and she died leaving a broken and dysfunctional family.

Dude, being a doctor is awesome!
People trust you enough to share their most subtle achievements; my patient just cut back from smoking a cigarette every 30 minutes to every 45 minutes!
New life dawning on the world is something you can participate in; I have the fortune of facilitating the making of a perfect family even more whole.
Physical and emotional suffering are treatable; my palliative care patient physically relaxes once the pain is adequately treated which literally changes the trajectory of an entire family rocked by grief and loss.
The brightest minds around collaborate on the toughest problems; I am routinely both challenged and educated by my peers, on both medicine, social, and personal issues.
Watching children grow is like absolutely nothing else; delivering a child and then caring for them over years is having the honor of joining in on the molding of a new spirit.
Passing on a legacy of compassion to the future is a humbling responsibility; fostering the bright spark in a medical student’s heart and teaching them how to protect that in a broken system may be the biggest impact I ever make.
When the oppressed rise above their circumstances, you are there to give a hand; my OB patient had nothing, no support from family or the father, she was addicted to drugs, and by sheer force of will she built the best circumstances this child could hope for.
A pedestal to fight for justice is easy to find; the societal clout afforded physicians gives us the opportunity to correct injustice for both our own patients and in the systems affecting our communities.

Donning the white coat, you are exposed to and shaped by the worst in yourself and others. But implicit with the honor of caring for others is the potential to witness and share in love, sacrifice, joy, victory over impossible situations, and all the best that humanity has to offer.