Fall in love with medicine again

An excerpt from Remedy for Burnout: 7 Prescriptions Doctors Use to Find Meaning in Medicine.

A doctor’s self-worth can be tied up with a lot of issues.

How well can we make a diagnosis?

How elegantly can we perform the surgery?

How happy are our patients? Our staffs? Our families?

How many articles have we had published or how many lectures have we given?

The list goes on and on, doesn’t it?

For me, it’s a daily, sometimes hourly, battle to separate my self-worth from how I think other people perceive me. We all want our patients (not to mention our staffs and our families) to be head over heels about us all the time.

We want to feel we have made a difference, performed at our absolute best. We want to feel we’ve been the perfect doctor, the perfect parent, the perfect perfect spouse.

Therein lies the rub.

Perfection is the enemy of good.

In the OR, have you ever decided to tweak something a little bit, only to go from an “A-” outcome to a “C+,” all in the name of trying to be a little more perfect?

A study by the MacArthur Foundation showed good self- worth to be a strong predictor of good health and long life. So it seems likely that those who have a strong sense of self-worth would provide better health to others as well.

Those outside the medical profession are quick to say doctors have a skewed sense of increased self-worth and self-importance.

For those of us who live it daily, we know that most of the time we feel a strong sense of self is necessary, every day:

  • When we enter the emergency room to see a patient, not knowing what to expect
  • When we boldly begin a complicated case in the OR
  • When we deliver bad news to a patient about their pathology report

Our patients expect us to be certain and secure in our approach, our knowledge, and our self-worth.

These traits are what make us good doctors.

Sure, some doctors are guilty of having an inflated sense of self. Those are the ones who are certain they are really good doctors. I’m sure we all know the types I’m talking about. But, for the most part, we all just put our scrub pants on one leg at a time. And we all feel like crap when things don’t go well for our patients, even when we are doing our level best.

I had the good fortune to interview Dr. David Olansky, a dermatologist specializing in Mohs surgery for cancer patients. He revealed his thoughts on self-worth.

Dr. Olansky comes from a family of physicians. He said there was no pressure for him to become a doctor; it was just understood. He did have a short-lived stint as a trombone player. Seriously. But medicine won out.

“I can’t imagine doing anything else. Medicine fits me to a T. That’s one of the keys to happiness, when you and something where your karma and your dharma meet together: what you’re supposed to do and what you are doing,” he said.

Dr. Olansky shared a defining moment in his youth during our interview. As a fourth-year medical student, he went with his father to see a patient in a nursing home. The patient’s husband met his dad at the door. When the man saw his dad, it was “like a ton of bricks had been lifted off of him.”

Dr. Olansky said, “I realized no greater gift could have been given to that patient’s husband. He felt powerless before he saw my dad. It turned out to be an easy problem. But it made me realize the power we have, and we don’t even realize it,” he said. “I see that every day. It’s a tremendous gift to be able to help patients, physically and emotionally.”

Dr. Olansky said his father taught him “to be authentic.” He continued, “Be exactly who you are. The most important thing is to follow the Golden Rule. Treat other people as you would expect to be treated. Not everyone will like you, but you’ll be authentic and genuine.”

As I work with more and more doctors around the country, I am encouraged by what I am witnessing:

  • Doctors who completely left medicine then returned later, refreshed and recharged
  • Doctors who have slightly altered their original mode of practicing, discovered the parts of medicine they love most, then magnified them
  • Doctors who have added and subtracted from their recipes until the unique flavor of their practice is perfect for them

My mission is to help those of you who are sitting on the edge to fall in love with medicine again.

I know you still have a tiny glimmer of hope in your hearts. You still believe there are subtle twists and changes that you can make to take the rough edges off. You believe there’s still hope. You believe you can make what you once considered an awesome job tolerable and — on a good day — a great way to earn a living again.

How do I know? Because I have been where you are.

I’ve stood right there, looked at my practice, and found a flicker of hope still burning.

I examined my hope with a magnifying glass and it caught fire.

Starla Fitch is an ophthalmologist, speaker and personal coach.  She blogs at Love Medicine Again and is the author of Remedy for Burnout: 7 Prescriptions Doctors Use to Find Meaning in Medicine. She can also be reached on Twitter @StarlaFitchMD

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