Being a whole doctor serves patients best

From an early age, I was encouraged by my family to consider a career in medicine. I was told it was a well-respected profession, offering financial security and community respect. Seeing the white coats, stethoscopes, and grateful patients at my childhood doctors’ visits made the field mysterious and intriguing, and these stuck with me as I grew older. I also developed a love for music at an early age; I sang in a church choir and learned how to play the saxophone. However, it was the pipe organ that truly captured my interest when I was a teenager.  I started dreaming of giving public performances and playing in world-famous concert halls and cathedrals. The same mystery and intrigue surfaced again, but this time it was in the form of reverberating sounds in a large cathedral as the organ played its last notes. In the back of my mind, I started to wonder whether music could be compatible with a career in medicine and I entered college trying to make that a reality.

At fifteen, I started taking lessons on the pipe organ, and during college I began to take music more seriously. While I was studying for my pre-medicine courses, I also spent one to two hours daily practicing the pipe organ. I found that I liked my pre-medicine courses and playing music equally, and I found that with the stress of upcoming exams, it was sitting at the pipe organ that provided a natural refuge for me. By the time I graduated, I had a few recitals under my belt and I was gaining a reputation as an organist in the Boston area. If medicine had not worked out, a career as a professional organist with graduate study at a music conservatory was a serious consideration.

However, I started to realize during college that one needed to devote a lot of time in order to become a good doctor, and that studying hard for exams in my pre-medicine courses was only a glimpse of the amount of time I would have to put in my studies to become a physician. I thought that my dream of becoming both a successful organist and successful doctor was becoming less realistic, and I had to make a choice between medicine and music. I ultimately chose medicine, and prior to entering medical school, I made a decision to put music performance on hold.

Medical school was everything that I thought it would be: busy, hard, and stressful. I spent more time than I ever imagined studying for exams, and the long hours and frequent changes in my sleep cycle during my third year medical rotations made for periodic tense conversations between me and my loved ones. Without music, I felt incomplete, and a constant restlessness developed that started to affect my ability to fully care for my patients. It did not make matters easier that I kept on thinking about being a musician and the thrill of public performances that I missed.

It was in medical school that I realized how much of a part music had played in my life and how important it was to me, but I had thought that in order to become a good doctor, that part of my life had to be sacrificed. But when I went in to see my patients, I was not coming with my whole self, but only a part of my self. It was difficult for me to have full conversations with my patients or to be fully invested in my training because I felt incomplete. At times, I wondered why I had entered into medicine in the first place and thought about how things would be different if I had pursued a career in music. My dissatisfaction with medicine was at its highest in medical school, and I wondered if part of that dissatisfaction was due to leaving out such an important part of my life for the sake of medicine.

Burnout in the medical profession is a significant concern given the demands on our time by patients and other colleagues, and little time for self-care. I saw signs of this in myself during medical school, as well as in other medical students and residents that I worked with in the form of fatigue, decreased concentration and irritability. Most of the time, decreased sleep, long work hours and little time for leisure would contribute to burnout, and sometimes their ability to care for patients was compromised. Unfortunately, this is a significant problem in training programs due to the prevalence of burnout among trainees.

As awareness of this has grown, residency programs are now trying to implement strategies within their training to improve the experiences of medical students and residents to reduce the prevalence of burnout, such as establishing mentoring networks, counseling sessions and night float systems to provide avenues to discuss concerns and manage workload. Individual strategies such as yoga, music, reflective writing and spiritual activities have also been encouraged to improve burnout rates during training; further studies will need to be done to assess the effectiveness of these strategies.

During the lighter schedule of fourth year of medical school, I decided to take up playing the organ again. I immediately felt the change in my perspective of pursuing medicine and seeing patients. With music back in my life, I started to feel whole again, and this time I was not planning on letting it go. I sought ways of cultivating music despite my residency training and it ultimately became a source of stress relief, especially during the busy months. I used more time outside of the hospital to focus on music but I noticed that even though I was busier and saw more patients, I felt less burned out. I had more fulfilling conversations with my patients, I was connecting with my colleagues and patients on a deeper level, and I started to enjoy being a doctor again.

I realized that bringing all aspects of my life to medicine was making a difference, and despite a busy schedule, I was able to start performing the pipe organ publicly again. Despite the increased time required to integrate music back into my life, my medical training did not suffer; I completed residency and passed my internal medicine boards this year. My dream of bringing music and medicine together is starting to become a reality, and I look forward to pursuing this dream as I start cardiology fellowship in a few months. Being a whole doctor serves my patients best, even if a non-medical portion of my life plays one of the biggest parts.

Chiduzie Madubata is an internal medicine physician.

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