“Ultimately, I am convinced that in my future lies not simply a profession performed ably, but a vocation performed lovingly and devotedly.”
Soon, after the coming pomp and circumstance fade into fond memories and well-framed photographs, I will be in the hospital. Soon, I will have my own patients in the clinic. With these occasions, life will be what I hoped it once would be some years ago – being a doctor, taking care of patients.
For some time now, a surreal life has taken the place of that vision. For all of the effort required in medical school, we were denizens of a bubble. While our collegiate friends worked in the “real world” and could do actual tangible “good,” we pored over schoolwork. Nothing we were required to do in medical school was really of benefit to anyone else, but it came with the promise that it would be, someday soon.
At the start, that “someday” was over one thousand days distant. The anatomy lab and the lecture hall were close. I recall pondering the utility of such a siloed education — first this subject, then that. Would any individual specialized fact help me in my goal to help others? Slowly we emerged from the first two years as from Plato’s cave. We climbed out from Step 1 of our board exams and entered the hospital of which we had caught only shadowy glimpses before.
If “knowledge” was the word for the first two years, so “enlightenment” was for the last two. Fact became actionable information, clumsy presentations became slightly less clumsy, and we developed our thought process as doctors. But in addition to medicine, we learned about the healthcare landscape. The mountainous insurance companies, the treacherous ravines of policy, and the influence of money on the health of those who sought care. Just when we became comfortable with navigating that landscape, a patient would present who, because of those external forces, couldn’t see the requisite specialist, or get the best drug available. Our eyes were opened, and our minds became skilled at adapting to meet them where they were.
The words of my epigraph come from my personal statement for med school admission. There are pressures at what would seem to be every turn — on the news and Internet, in the op-ed sections of esteemed journals, and even family and friends. These pressures come in the form of doubt, cynicism, and helplessness in the face of that healthcare landscape that has been moving at such a prodigious speed, leaving one to wonder if we can ever run fast enough to keep up. I don’t believe that any of us overlook these pressures.
Charged with the task of becoming ingenious thinkers, we just have found different answers for them. These are answers that allow us to greet each morning with excitement, no matter how early that morning might arrive, no matter how weary we may be from the previous night’s efforts. Through the challenges, I can smile, that as I graduate it is still the calling of my profession and vocation that still sustain me in greeting this morning of my life as a doctor.
Douglas Phelan is a family medicine resident.