Nearly twelve years ago, Major League Baseball’s Cleveland Indians were losing to the Seattle Mariners 14-2 in the 6th inning. Cleveland, who were fighting off the resurgent Minnesota Twins and the pesky Chicago White Sox in a tight division race, were playing against a Mariners team that would finish the season tied for the most wins ever in a single season. Despite the seemingly insurmountable lead, Cleveland came back to win 15-14, making what has come to be known as The Impossible Return. This win ended up propelling them forward to an eventual division title.
No one had ever come back from a 12-run deficit to win a game before. Perhaps even more impressive, multiple teams in major league history have scored as many as 9 runs in the final inning alone to win a game. I love baseball, and one of the main reasons is because of games like these. It does not matter what the score is, or how you have played up to that point, you can always come back to win. In baseball, there is always hope.
Internship and residency have anecdotally been where hope and optimism go to die in young physicians. Mental illness, including depression, anxiety disorders, and substance abuse, have much higher rates among physicians in training and in practice than in the general population. Seemingly endless work hours seem to erode any shred of a personal life. A strong desire to do well by your patients and avoid the rage of moody attendings, mixed with the overwhelming expectation of learning all there is to know about medicine in the 21st century, can sometimes prove mentally and emotionally crippling. All of this contributes to significant burnout among physicians, which seems to be growing. Even though it’s not always apparent, life and medicine can also be like baseball—there is always hope.
As new interns and residents begin this month, this is the main point that I would encourage them to remember. Residency does not have to be a time of getting beat up, burnt out, or forgetting why you entered medicine in the first place. The ubiquitous refrain of becoming a physician to “help people” can easily get lost in the interest of merely keeping your head above water, unless you remember to focus on the patient as the object of your tiresome efforts.
But “hope” in medicine can easily be misconstrued. Hope should not always be in the ultimate cure of the disease, though that is oftentimes the goal. Hope is in making an impact on a life, on establishing and building personal relationships with those we work to assist. It is often lamented that medicine has lost its humanity through multiple changes in care, increased technology, over-emphasis on cost, bureaucrats and administrators disrupting the physician-patient relationship, and so on. Health care needs more humanity, and providing that through hope for patients that they can do what is needed to improve their quality of life, if not the length of their life, is the reward we entered medicine for. You can let all of your other frustrations melt away when you are in a room one-on-one with a patient who is coming to you for help and advice.
There is also great hope in the future of medicine. Many physicians will tell you the opposite, that health care is getting worse and there is nothing you can do about it. But with great upheaval and change comes the opportunity to work on the solution to the problem, and to ensure that a move to more patient-centered care that achieves positive health outcomes is not just a dream but a reality. We are all very lucky to be involved in medicine at a time like this, and we can play a part in making health care about what it should be: the patient.
Residency is tough. There is no getting around that. You will be frustrated at times. You will be tired often. You may go through periods of struggling with mental illness that is caused or worsened by your training. But remember that, just like to the Cleveland Indians in 2001 and in baseball every day, there is always hope. Hope for you, hope for your patient, and hope for us all. Make sure that you are the hope your patients look for, and allow them to be the hope that you need.
Kyle Bradford Jones is a family physician who blogs at Primary Care Progress.