To pursue a life in medicine requires much sacrifice. For medicine is not merely a career, it is not simply a vocation, it is a cult. A cult which has its own language, its own norms, its own pecking order. As with any cult, to enter into the field of medicine requires tremendous sacrifice. At times I look upon first and second year medical students and wonder if they are yet aware of the sacrifice they are making. At times I look at my own future and wonder if I myself am aware of the sacrifice I am making.
I am already well aware of the sacrifices I have made. Transplanting myself from the west coast to the east coast, ostensibly leaving my life behind, forfeiting family and friends, and replacing them with other prospective physicians who speak the same language, who “understand.”
Perhaps I feel the sacrifice most acutely during the beautiful, sunny, warm days that are so sparse in the part of the country in which I now reside, that when we are blessed with them it is an event worth celebrating. Waking before the sun rises and returning home only after it sets; the days are long, the concept of a weekend is a distant albeit tender memory.
When I wonder if it is worth the sacrifice, I reflect on my life before medical school. The ennui and perpetual boredom was deafening, as I was seeking something more, something which promised intellectual challenge coupled with the capacity to make some measurable contribution to society.
It is for this reason that I do not trust anyone who asserts they want to become a doctor simply because they “want to help people.” People who simply seek to help people become social workers, teachers, professions which actually make a damn difference in people’s lives. For many in underserved and overprivileged communities alike, health is an afterthought until it is compromised and manifests illness. Housing, food security, transportation, employment, health insurance, these are the determinants of health over which physicians are absolutely powerless.
Just as we are sequestered from society for the first two years of medical school, and only thereafter released to interact with sentient beings, medicine is first and foremost an intellectual exercise and secondly, a clinically relevant one.
The dearth of compassion in medicine is commensurate with the absence of creativity, and perhaps these are my primary and secondary concerns with medicine. Empathy is frowned upon where it compromises objectivity, and medicine offers no creative outlet; there are only guidelines to know, mechanisms of disease to memorize. There is a perpetual need in medicine to assimilate information passively and apply it actively in clinical practice.
And yet, compared to my peers, of whom I am convinced at least a few are robots, I feel my sacrifices less acutely. I still waste away my weekends binge watching the latest release on Netflix, squander my evenings with slow dinners, and spend the occasional leisurely morning in bed with my boyfriend reading the news. But all the while there is the interminable voice beckoning from the nether regions of my brain, “you should be studying right now…”