Gen-Y Doctors

It might still be too early to tell exactly what the character of my generation, the so-called Generation Y, might be, or if it even has a distinct character. One TV show, Wonderfalls, a one-season production that was sadly cancelled by its short-sighted network, took an interesting take on my generation in its second episode. In this episode, the main character was being stalked by a journalist who was trying to paint her picture as the quintessional Gen-Yer: unambitious, self-centered, detached, overeducated and unemployable, but also inexplicably cool. Of course, not everyone in a generation acts the same way, but I think that distinct behaviors can be pervasive: sometimes the tail can wag the dog, and the crowd can sometimes identify and try to act like the few, even if those few are on the margin rather than at the center. Thinking about where we are coming from as a group of young people, I think about what has shaped our lives:

– no major wars that have truly affected the continental U.S. in a mobilizing fashion (whether for or against the conflict), like the Vietnam War

– increasing political apathy, particularly with President Clinton’s sex scandal and the second President Bush’s façade of stubborness, indifference, and ignorance

– desensitization to extremes by an increasingly polarized media, increasingly scantily clad pop culture figures, etc.

– the advent of the Internet, the initial stage of digital isolation, and now a complex mish-mash of half-online/offline social networking and blogging-voyeurism

– the myth and the reality of terrorism, and the perceived or real threats that might end one’s life at any random, given moment

With that in mind, it’s no wonder we’re all seemingly disenchanted, detached, and disaffected. In some ways, I feel that the 1990’s were not altogether unlike the 1950’s, a peacetime boom, and the first decade of the third millenium is not so unlike the early 1960’s with some small-scale outcries against political corruption, except that the children of the 1960’s are our parents and we’re too cool and apathetic to be like them. Plus, they’d disown us if we were.

Nonetheless, getting back to the theme of this blog (i.e. medicine), today I’m suddenly concerned what this future generation of doctors is going to be like, because a generation of doctors is like a generation of anything else – there are some common traits, feelings and attitudes. I’ve obviously never been through this process before so I don’t know what sort of changes to anticipate, but I wouldn’t be surprised if many of my classmates believe that the greater part of their personal development has already happened. If that were the case, I think we’d be screwed (patients and doctors alike), because doctors aren’t supposed to be nonchalant or “cool” or apathetic. Certainly not all people of this generation are – there are many examples of outspoken individuals, but does the majority follow? I think my generation has grown up believing that the weight can be pulled by a select few hypermotivated individuals; afterall, maybe nothing has been so important as to truly require the hands of a multitude.

Looking around me, I wonder what sort of doctors these people will be. I have no doubt that they are good people, but are they good enough? Perhaps at its core, the medical education is designed (or perhaps has been adjusted) to shock and awe, because many of my classmates are probably not ready on a psychological or emotional level to handle being responsible for the life of another person, much less hundreds or thousands. Most of them probably have never seen another person when he or she is dying and in excruciating pain, or if so, that person’s illness or disability was more likely than not attributable to age. It’s incredibly shocking to see an adult, and much more so a child, suffering from a terrible disease or in great pain. I’ll share a story which I could be embarrassed by or for which some might perceive as an admittance of weakness, but thanks to J. K. Rowling and Professor Lupin, Harry and I can both understand this sort of experience as indicating the depth of our emotional experiences and the extent to which these experiences shape who we are and how we interact with and see other people. When I was shadowing a pediatric oncologist, I had the opportunity to observe a bone core biopsy performed on a young girl who was very sick from her cancer. She was under conscious sedation, so she wouldn’t retain any memories of the procedure but she would be able to talk and express pain during the procedure. As the core biopsy was being performed (in this case, poking an enormous, thick needle into the hip bone and pulling out a sample of bone tissue), the girl was crying out in pain. For me, being a premed college student with no purpose there but to observe, it was a very painful experience: all I could do was listen and feel the pain she was feeling, and even as I was slowly losing vision and starting to black out, I could hear her screaming in my head, a type of screaming and a magnitude I had heard many times before. Her pain and suffering completely enveloped me, and that’s all I could think about. Fortunately, I didn’t completely lose consciousness or collapse, but instead tightly grabbed on to my girlfriend’s arm (she was also there shadowing), and she and a nurse helped me find a chair because I was as rigid as a board. When I sat down and the screaming left my head, the doctor was pulling the needle out and her pain was starting to subside. This girl’s excruciating cries of pain literally opened up a world of pain for me: one that had been locked away in my memories of my mother’s long battle with cancer. One in which I would be lying in bed at night while just across the wall she would be grasping her abdomen and trying not to cry out in pain and wake us up. Years later, after talking to and interacting with so many other patients, I still wasn’t prepared for that one moment when it all came crashing back down on me. Perhaps it’s because of the extreme magnitude of the pain (a core biopsy needle is not trivial). Perhaps it’s because she was so young, and I hate to see a child in so much pain. Perhaps, even, it’s because I’m too soft on the inside, and I can’t handle that sort of blunt force emotional trauma. I know now, at the very least, that the third reasoning isn’t true, and that I would have reacted very differently had I been the one inserting the needle, holding the patient still, or monitoring her vital signs. Though it happened to me without warning, I can take from the experience the knowledge of how much pain can hurt and how much that pain makes me want to do something rather than run away or ignore it. But this experience posed one very important question to me: Do you shield yourself from the emotion and the pain, or do you embrace it?

I think some doctors build a wall around their inner cores so that the pain and suffering they see around them won’t affect them. Others take it in and internalize it, perhaps too much, and feel overwhelmed by the extent of the suffering they witness around them. I think that while some who are excited to be doctors and have high EQs will tend toward the latter, quite a lot of the future doctors in my generation will tend towards the former: emotionally cut themselves off from patients, because it’s less traumatic for the doctors and they can more easily maintain their performance without having to wade through the emotional quagmire presented by disease. Sympathize instead of empathize. In some ways, it’s a matter of the your own personal emotional wealth: how much have you experienced, and what will happen if you experience more? A patient’s experience, and perhaps much so your own experience or that of a loved one, can pull you to both extremes: the worst moments in life when the pain is greatest and the prognosis is dismal, and the best moments when you know she’s going to live and that you will be able to continue your life together and be happy again. Ultimately, I think the attitude of apathy and the stategy of shielding will fail and do a great disservice to medicine, to the community of doctors, and to patients. Especially in a time when the world around us seems increasingly less stable and the future seems increasingly more uncertain, people will look towards us, doctors, as though we are pillars of strength, anchors against the storm. They may have some skepticism in their minds, but we can’t let that skepticism of our mettle, our character, and our dedication to serving others grow. There’s no room for apathy or being cool or being noncommittal in this profession and in the world we’re entering: we need to be steadfast and engage ourselves as much we are willing to give, because people all around us need so much from us. And in this case, we have to be a lot more willing to give than we’ve ever been at any other time in our lives, because we’re going to become something very different from what we were.

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