As a member of the general population, we see physicians as those who were born with a calling. Though society acknowledges that becoming a doctor is difficult, it is near impossible to fathom exactly what that title entails.
I was raised in a small rural community in which resources were quite limited. The nearest grocery store was a 35-minute drive away, there were no coffee shops or traffic lights, and we had but one physician. To me, he was for all intents and purposes an android functioning without waiver to keep our community alive. This doctor was an entity like the Oracle in the Matrix: never faltering if faced with the nightmares of trauma, and never flinching when witnessing human excessive emotion.
I decided at 15 years of age to become a physician.
I wanted to have all the answers. I wanted to have that stoic control of self. I wanted to be powerful like the physicians I had met throughout my life. And so I chased a dream that grew to become less of a career, and more an amalgamation of lofty romanticized ideals.
I pictured myself racing through hospital hallways with my stiff white coat flapping behind me as I journeyed to save some unfortunate person’s life; the weight of my stethoscope around my neck: the source and symbol of all my glory.
I imagined being the person people would run to when nobody could figure out the riddle, and I would immediately know the answer that would bring the patient back from the cold arms of death.
I envisioned a bounty of classic reverence when I arrived in a room: “Thank God, the doctor is here.”
But the path to becoming a physician is not easy.
We all hear horror stories of residents sleeping in closets for twenty minutes at a time just to complete a call shift. The arrogance of youth allowed me to hear those stories and flippantly see them as exaggerations of a reality that my mind did not believe.
On my first day as a clerk, I was arrogant in the comfort of my self-perceived expansive knowledge. I believed that the exams I had passed were proof I would save lives without a flutter of doubt or bead of sweat perspired. I approached the hospital wearing my starched white coat feeling pride that I would wear my stethoscope like a medal laced around my neck.
Everything changed the moment I stepped through those doors.
I learned very quickly that did not have all the answers. I was not able to contain emotions the way I saw doctors do on TV. At the end of the day, I took home the pain my patients and their families felt when they had frustrations and fears that which nothing could diffuse.
By noon of the first Friday on the job, I hid in a bathroom and cried. I was overwhelmed by the things I had seen, the frustrations of feeling lost, and the panic that comes with having to say “I don’t know” even though you want nothing more than to solve that puzzle and be that rock for a family lost at sea. I saw the heavy weight of the stethoscope around my neck not as a shining beacon, but as a weight that dragged me down.
However, I quickly learned that practicing medicine does not provide you the time to hide in bathrooms and cry. There is always another patient to see, another crisis to avert and another problem to attempt to solve. There are no lunch breaks, no emotional debriefings, and no time to reflect.
I became very comfortable with the phrase “I don’t know” and in doing so developed a humbling appreciation for those who did. Though I no longer felt arrogance or pride in my knowledge and abilities, I found solace in the quiet adoration that I received from my dog at the end of each 30-hour shift. Eventually, I learned not that human beings were born with an inherent ability to handle the perplexity of medicine; but rather, that normal people adapt when they walk through hospital doors to become something else.
In a simplified perspective, you have two choices in who you wish to become: You can build walls to protect yourself from the profuse horror and sadness that comes with becoming a physician, or you can remain open to emotions at the extremely high risk they will destroy you.
There is a cost for that stiff upper lip demeanor that I spent so many years aspiring for. And often that cost is your own humanity. It’s easier to remove yourself from the world crashing down around you than to hold the hand of the patient or person who can’t escape reality. But you cannot close yourself off solely when you are working. You will lose that feeling of having a soul overall. Love becomes blunted. Compassion is muted at best. In building that wall to escape the pain, you run the risk of closing yourself off from happiness as well.
There is a cost to being the physician who holds their patients’ hands. In sharing with their pain, you cannot help but feel it too. Those emotions can destroy you very easily, which likely is why my profession has such a high rate of alcoholism among other forms of escapism and self-destruction. Some days it can be very hard to see the light when you live in so much darkness.
I have flirted with both options, but eventually, I chose the latter.
The family of a patient stood by as their mother lay dying, comatose. It was a sudden and unexpected turn, and the family had understandable difficulty finding meaning in their situation.
One day they said to me, disheartened and lost at sea: “Mom is such a devoutly religious woman. Why would God do this to her?” And they looked to me for answers.
I stood in that room, quiet save for rhythmic breathing, and truly I did not know. I do not know why we suffer. But to be the physician that turns a deaf ear is not who I want to be.
After a time, I looked the family member in the eye and said, “I do not know much about religion, but from what I have been told, God tests the ones he loves the most.”
I could not save their mother, and I could not take away the family’s pain. But I could acknowledge it, I could speak, and I could be human. Those words were all I had. Simply by being human, I may have helped them bridge a gap toward acceptance of life in all its complexities which cannot be understood.
That afternoon I received my first embrace and ‘thank you’ as a medical professional. For the first time since clerkship began, I remembered why I wanted to fill this role.
The path to becoming a physician is not easy.
I don’t have all the answers, but I am comfortable with saying, “I do not know.”
Because what I do have is the ability to face suffering with both eyes open, and be human.
Sometimes being human is the only treatment that matters.
Angella Woodman is a physician.
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