There are many things I dislike about many medical blogs (and blogs in general): the term “medical blogosphere” sounds silly and full of self-aggrandizement, posts are usually too short or superficial to reveal any insight or critical thought, and many bloggers tend to be too lazy to include references where needed (including myself, but I try). Most of all, though, it disappoints me how one-sided the most popular blogs tend to be: many writers express a single viewpoint or emotion, appealing to a niche audience (however wide). Life is never so simple, though, and so the same debates repeat in an endless, 250-word cycle, across days, months, and years as new readers discover blogs and new writers emerge to express the same thoughts. I suppose this is a condensed, proliferative phenomena reflecting the slower growth cycles of popular media prior to the emergency of the Internet: with each generation comes new voices with old stories. Old wisdom with new packaging. Like the popular media, bloggers thrive on negativity: complaints and exposés provide a powerful catharsis for themselves and for their readers. Blog writers often criticize the popular media and try their best to uproot the establishment, but they themselves are prone to mimickry of that which they dislike: using sound bytes and sensationalism to prove a point. Blog writers, of course, are not unique in their approach; the same can be said about all people in the ways they express their thoughts and emotions. However, is this all there is to say and share about medicine, or about anything in life?
There certainly is much to be frustrated and angry about in health care and medicine today, and it’s no surprise that many choose to vent this through public writing. It’s also no wonder, however, that even the most negative of blog writers find themselves periodically answering to their readers who question their continued participation in the practice of medicine: why keep practicing if medicine is really that awful a field to work in?
From what I have seen so far, it’s really not as bad as many make it seem (judging from my experiences, my interactions with physicians at all levels and stages of their careers and in different work environments, and from a broader perspective of the directions toward which medicine and health care are headed). The people who really can’t find reward, personal worth, and meaning in their professional work fall by the wayside: they drop out of medical school, they don’t continue on to residency, they choose not to engage in clinical practice, and sometimes they even try to justify their choice to end it by bestowing unsolicited advice and foreboding warnings upon others. If anything, I hope that medical school admissions committees improve their screening methods to weed out these individuals before any financial and time investment is made. Yes, the financial investment belongs to the student, but the time investment belongs to the school and our society: there are limited number of spots in each medical school class, and there is no room to waste on individuals who aren’t willing to make the commitment, be team players, and be nonjudgmental and compassionate healers.
Medical school candidates can’t just be smart: they also need to have some strength of character, willingness to grow, and capacity to be humble in the face of death and disease. It is this last characteristic that I believe is in short supply among physicians and physicians-in-training who are most vocal in their disdain for patients, in their contempt for difference and change, and in their self-aggrandizement. These individuals are a minority, but a loud and obnoxious one. Yes, there are many frustrations and problems with health care and its impositions on the good intentions and practice of physicians, but these frustrations should never alter the way we treat or view our patients. I believe the words of my Chief of Medicine: that you cannot believe one thing and act in a different way, you cannot have a certain attitude in private life and hide it completely in one’s professional work.
There’s an easy test to diagnose one’s own humility (as it is hard to detect in another person): have someone you respect tell you, “It is a privilege to be a physician.” There are definitely people who clearly demonstrate that they don’t believe this at all: perhaps they have lived in privilege all their lives and have never known hardship or suffering. For them, medical school and becoming a physician is just a matter of going through the motions to assert their social and financial status in a society that emphasizes accomplishment. And then there are those of us who are quietly tempted to believe that we have worked hard to earn a right to something: we’re placing ourselves in massive debt, we are (or will be) working ridiculous hours for minimum monetary compensation, we’ve worked hard in school for years, and we’re sacrificing the best years of our lives to work and training.
And yet, there is another, less tangible force pulling us in the opposite direction. For those of us who have seen or experienced true suffering and pain, whether just recently or early in life, there is something incredibly humbling in the exchange of glances, the hearing of cries, the feel of a painful twitch, the smell of death. There you are, in a room with someone who is sick or dying, and some part of you feels another presence, something wrong. Would you really stand around and do nothing, or even leave, if you had the capacity to do something? Whether for a loved one or a complete stranger, all of us feel (to some degree or another), a feeling more powerful than the fear and disgust: love. It’s you and another person against something inhuman, and the bond between you is more than a desire for survival; to survive, all you would have to do is run away. But we’re better than that: we don’t leave a man behind, we don’t leave our sick and wounded to die with fear in their eyes. There is no more humbling experience than to love, because in loving truly, one gives up one’s ego and pride to share an experience with another.
I am not an explicitly religious person, but I do believe in a greater order, a reason for life and a purpose for reason. I believe that there is no greater purpose in life than to express the best part of our humanity, and in doing so, reflect and express the divine origins and reasons for our existence. A couple of weeks ago, I had a friendly conversation with a complete stranger in front of my apartment. She, a member of the church next door, asked me not long after our greeting, “Do you believe in God?”, and I had no reservations or discomfort in saying, “Yes, I do.” That is, in fact, why I chose to pursue medicine in the first place: because there is no greater expression of humanity than love, and I can think of no other profession that can most benefit from an abundance of love for humanity. No other profession involves the same expression of humanity every day: in each moment we hold a patient’s hand, or deliver news, or work hard to find the answer, or offer strength to another in need. We’re not training to be doctors so that we can be weak, malcontent, and impotent: we’re here to offer our strength and hope to others, and there is no strength offered in contempt, disdain, and negativity.
“To love another is to see the face of God.” – Les Miserables