Archive for November, 2010|Monthly archive page

A growing fear…

In medicine, Rants on November 8, 2010 at 4:47 pm

Hello, my internet readers!  Hope all is going well out there.  It’s been a while, but I’ve learned a lot of interesting stuff since we’ve last interacted.  All-in-all, now that everyone’s coming out of their shells, opening up, and putting false pretenses and facades aside, I ABSOLUTELY LOVE MY CLASS!!! I really do!  We had a few bumps in the road the first month or so of school, but I think people are starting to venture out of their comfort zones – all for the better.  I am all smiles.  Don’t get me wrong, at times I absolutely see how we can revert to high school (actually, middle school might be a more accurate analogy), but overall, life.is.great.! 🙂

Recently, we had to submit an introspective reflection on a major fear we have pertaining to our future careers.  Though rushed and not fully expounded, I thought I’d share one of mine…

As a tenderfoot on the path to full-fledged medical doctor status, I already find myself with drastically less free time.  And as leisure time diminishes, there is less time to devote to nonacademic activities, generating a growing fear that I will disconnect permanently from the nonmedical community – the very people I am training hard to one day serve.  Associated with this fear is the potential to transform into a physician that loses sight of her patients as unique individuals and who sees them for their condition, not for who they are, and consequently decreases the quality of care delivered to them.

My fear stems from various interactions with physicians – from personal interactions on the patient side of the medical relationship to listening to guest lecturers who had lost touch with their patients.  I have interacted with physicians that view their patients as little more than inanimate words on a page – age, gender, ethnicity, chief complaint – and have pondered as to how they came to this state-of-being.  Is coldness an inherent part of the training process?  Is it a probable fate that as I train and find myself insulated with medical professionals that my vision will narrow and I will lose sight of all that is outside of the hospital affecting my patients on a daily basis? These are the questions I ask myself, for this is the antithesis of the physician I aspire to become.

Inherent in our medical training is a certain degree of hardening.  In my opinion, we work with cadavers not only to learn the parts of the human body, but also because it is an exercise in dissociating the flesh from the being or the spirit of the individual.  Depending on what field of medicine is selected, the reality is that a certain amount of detachment is required to be able to perform specific procedures on patients.  At the moment, I am strongly considering a career as a surgeon, and therefore know that in order to take a scalpel to a living human being and perform complex procedures that are “unnatural”, I will need to master this dissociation.  That being said, I must not operate in a world where I neglect to re-associate the two – the presenting problem and the individual.

I can easily see how increased time demands can result in generating cognitive shortcuts that can become crutches on which care is executed.  How I master living in a profession that necessitates temporarily dissociation from my patients, whether to perform a procedure or to deliver bad news, as well as constricts my time to interact with the “real world” while simultaneously living in a world where deep human contact is integral to life is up to me.  It is my responsibility to ensure that over the years I remain the same core person I have always been – that I do not become the physician that transfers the distance required at work to “get the job done” to home life.

I do not believe it is necessary to surmount this fear, for this is a healthy fear to have – one that if kept in-check in the back of my mind, can serve as a positive directing force in my life.  There are two main ways I can avoid succumbing to this fear.  The first is the proactive choice of selecting training programs that emphasize patient-centered medicine.  The second way, which is more prolonged and repetitive, is remaining involved within the nonmedical community.  Not by merely financially contributing to charitable organizations, but by physically putting myself out in the community through service projects will I maintain the connections necessary to remain a physician in-touch with reality – this is what will make the difference in my life.