Taking care of patients is a great honor

As my husband and I try and make a long term financial plan for paying off my almost $200,000 in loans from medical school, I sit here wondering, why did I pay 200 grand so that I can get peed on, pooped on, bled on, screamed at and sworn at? I’ve delivered a baby without gloves on (it was an emergency).  I’ve been kicked so hard I almost fell off the bed.

In one hour this fall, two patients in our women’s emergency room looked me in the eye and screamed “F*&^ you!”  That occurred at 2am, probably on a Friday, after I spent all night running a busy emergency room rife with women with ectopic pregnancies, miscarriages, wound infections, pelvic inflammatory disease, cancer and all other varieties of disaster.  And I’m sure I often deserve a giant cursing out, you see I’m not always the most lovely human on the planet, but I can assure you that I did nothing but ask both those women simple questions that set them off.

Why did I sacrifice my twenties, my weekends, holidays, and sleeping at night to take care of screaming, crying women? I didn’t have a bridal shower, because I only had one weekend off in the six months before my wedding. My husband got of work early for Valentine’s Day and surprised me at home, so we could actually share the dinner that I was going to leave in the fridge for him before I had to run to the hospital.  I’m working at a job that pays less than medical school costs and without my husband couldn’t pay it back.  The interest rate alone is 6.8%, accruing thousands of dollars a month.

The funny thing about all of the drawbacks to being a doctor is that, I’ve never been happier.  Really.  Obviously I’m a little sick, but that’s ok.  I can’t remember a time that I’ve felt so proud of who I am and what I do, and I enjoy going to work almost everyday.  Even on the most horrible, body fluid filled, back straining day, I go home with a sense of satisfaction.   I’ve never been so determined to learn so that I can take good care of people.

I don’t have to sit at a desk or sit in long meetings.  My office is the hospital floor, labor and delivery, clinic and the emergency room.  I’m on my feet.  I get to learn how to operate and perform all kinds of procedures.  I get to meet amazing people every day, and I get to work with all sorts from medical assistants, nurses, OR techs, medical students, other residents, fellows, attendings, patients and families.  I get to teach and learn at the same time.   I have an amazing group of peers going through the same thing that can find humor in just about anything.

Taking care of patients, becoming an intimate part of their lives and their bodies, is a great honor.  And I exaggerate saying they all scream and cry.  Most, even though they have little and are often sick, are some of the most amazing women I have ever met, stoic and strong.  When a patient looks at me and says “thank you doctor”, at least for that moment I think I might be part of something good.

I recently got into a heated discussion with the anesthesia resident during a long surgery.  He told me that his dad, also an anesthesiologist, always wished he hadn’t gone into medicine.  This resident said that he wished he had gone into investment banking because one of his best friends already has six houses at age 32.  I told him that I loved being a resident and enjoyed taking care of patients, and that even though I have debt and might not be rich I live a very comfortable life.  He told me I would change my mind, especially once I have kids.

I can understand why any parent who has gone through the gruel of medical training wouldn’t want their kid to endure that amount of stress.   But I can tell you for sure that I didn’t make a mistake getting peed on, pooped on, bled on, screamed at and sworn at.  There’s no better job for a science nerd and adrenaline junky.  Becoming a doctor isn’t the easiest way to get rich quick, but if my kid wants to go through all of the same pain I have, I’ll tell them to go ahead.

Elizabeth Breuer is an obstetrician-gynecologist who blogs at OB Cookie.

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  • http://twitter.com/zdoc Marcy Zwelling

    Thanks Dr. Breuer for your comments.  I feel precisely the same way.  We are members of the MOST privileged profession in the world.  My frustrations are not about getting paid but about governmental and insurance interference.  
    Healthcare should NOT be political and our patients should be entitled to their right of self-determination and we should be able to enjoy the privilege of helping our patients and doing the right thing just because it is “right.”
    Thanks for all you do.  Your patients are so lucky to have you … 

  • Margaret Bortko

    Your $200,000  loan could be forgiven if you were to work in a “healthcare shortage” part of the country…a reservation in Montana or Arizona….a remote community in Alaska. Of course less prestige than in your urban setting.

    • Anonymous

      Yeah because, as she pointed out already, her job is so prestigious as she is being pooped and bled on.

  • Anonymous

    I am so thrilled to hear that somebody is happy practicing medicine.  I hope you feel the same way years from now.  Your patients are lucky to have you caring for them.  

  • http://twitter.com/DrAttai Dr. Deanna Attai

    I feel sorry for that anesthesiologist, and even sorrier for his patients. Medicine is too hard and demanding a career to go into for the wrong reasons. It’s all about the patients, plain and simple, and if that’s your focus, you will have a long and rewarding career.

    • Elizabeth Breuer

      Thank you for your kind words.  I hope that I like what I’m doing as much in ten years as I do now.

  • merc

    I was offended by your complaint of your medical school debt and interest rate “I’m working at a job that pays less than medical school costs and without my husband couldn’t pay it back. The interest rate alone is 6.8%, accruing thousands of dollars a month.”

    While I am please you connect with your work and your patients, it was totally your choice to incur that debt, and the interest rate.  The interest rate BTW isn’t horrible, it’s just a cost of doing buisness.

    Own your choices. 

    • Elizabeth Breuer

      Hi Merc, thanks for your comment.  I am confused what offends you.  I agree with you completely that it was my choice to incur this debt and I think that the decision was worth it.  I think my statement isn’t a complaint but a truth.  Medical school is extremely expensive and is very hard to pay back on a resident’s salary. 

      Do you really think that educating your future caretakers should be a business?  Medical school is free in almost every country but the United States.  The high cost of tuition plus an interest rate that is much higher than most mortgages actively drives bright, talented students away from primary care fields so that they can live a comfortable life.  

      I agree completely that I need to own my choices and I think I am trying.  I strive to do the best that I can to take care of patients at a very busy county hospital who have next to nothing.  I am not perfect at this job and can get upset or make mistakes just as anybody else.  I am proud of the decision that I made to become a doctor and even though it was an expensive choice, I am happy to pay the loans back.  

  • Anonymous

    You need to be 4 P proof: piss, poop, pus and
    puke! My husband figured out that during his residency he earned 33 cents an
    hour. I am a critical care nurse and I believe you and the rest of us who care
    for our fellow men can hold our heads up high (oops incoming…a flying oyster)
    and feel good that we do good for the world and don’t make missiles or cheat
    people out of money. At least we can look at ourselves in the mirror and know we tried to help.

  • Anonymous

    After 30 years as a surgeon who cares for kids, I am both honored and grateful for the patients who entrust me to care for their children.  I still love being a doctor.  
    BUT, I am also tired of being maligned by the press, targeted by insurers and hospitals, treated as if my experience is worthless, yelled at by patients when I run late because I am taking care of someone else, taking call and getting up in the middle of the night for a career average of once every 4-5 nights to answer questions at 3 a.m that really could wait until 6 a.m. (for which I do not get compensated monetarily.)  It’s very hard work and the appreciation factor is just not there.  I don’t have or want 5 houses, but I want to feel appreciated for the work I do.  I want to be paid fairly as a woman doctor  (we aren’t). And I want to see the next generation, who will be caring for me, get a decent education (they are not due to limited hours) and learn how to work well even when they are tired, because we all have to because someone needs us, now.  Also, I hope that I meet more patients who take responsibility for their health.  Although today I had a father of one of my patients who is under my care for his sleep apnea who quit chewing tobacco, lost 15 pounds, breathes better, is almost off his CPap machine and has his blood pressure under control with diet and only one medication, and he is only 38 years old.  It doesn’t get any better than that! 

  • Anonymous

    Spare me the bullshit!

    Our job is to mint money from people’s misery.

    • themedstudent

      ShawnBakerMD, if you are actually a healthcare provider and are upset at making a living that way, feel free to volunteer your services pro bono publico.

      Saying that doctors “mint money from people’s misery” is like saying farmers mint money from people’s hunger… ( fyi: http://farm.ewg.org/top_recips.php?fips=00000&progcode=total )

  • Anonymous

    Imagine that poor truck driver, who drives a truck all his life and has all his savings vanished with one heart attack.

    Elizabeth for a change……try helping some one for free when u become a big shot consultant…
    Doctors in India are paid 25000 rupees, which is like 30o dollars a month and they do 48 hours duties without a hitch.

    I think it’s part of our culture to complain and count pennies.

  • http://twitter.com/KarenSibertMD Karen Sibert MD

    Great to hear from someone so enthusiastic about her work!  My only regret is that your example of the non-enthusiastic doc had to be an anesthesiologist.  (I know it wasn’t on purpose; that’s just who it happened to be.)  But for the record, some of us go into anesthesiology for positive reasons, and are just as happy doing it as you are doing ob-gyn, even decades later!  I’ve always been fascinated with pulmonary medicine first and cardiology second, but really like critical care and being in the OR; anesthesiology is the perfect fit for me.  

    Remember the anesthesiologist in the Gray’s Anatomy episode?  The one who abandoned the patient in the OR with the bomb in his abdomen, and left Meredith the surgical intern there alone?  Sigh. 

    Oh well.  I’m happy most of the time that patients forget they ever met me–it means they’ve made an uncomplicated recovery from anesthesia and surgery, and will live happily ever after (I hope).  But I have one patient who emails me every year on the anniversary of the day I took care of him, just to let me know he’s doing well.  That’s the kind of reminder we all need once in a while that what we do really matters.  Best of luck with your career, and may you always love medicine.

  • Anonymous

    thank you for sharing your story and passion. It’s a great story that everyone before committing to medical school should think about. Resident life is not easy, most stressful but same time most rewarding. I had a baby during residency and we all know how hard residency is and at same time with motherhood. I do not regret it at all.  Best luck with your career and passion, and hope we are always fascinated about medicine and live and breath with it.

  • Anonymous

    Good for you.  You could have had similar negative results as with a nursing degree and been paid much less and pooped on more.  A good mind should never be wasted and I commend you for your perseverance. 

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