How to rekindle your love of medicine


Recently, thousands of new residency and fellowship graduates have earned their wings and will be, mostly metaphorically, hanging out their shingles. Sadly, though, as the excitement of finally finishing training after decades of schooling wears off, even great work can become routine.

There is a parable about three men laying bricks. When asked what they were doing, the first man said, “Laying bricks.” The second man said, “Building a church.” And the third man said, “I’m building the house of God.” The first man had a job, the second a vocation, and the third had a calling.

Even the practice of medicine can become routine. Unlike an episode of ER or Grey’s anatomy, the days are not always filled with heroic saves and daring acts of bravery. Work can start to feel like laying bricks. In fact, it can start to feel like laying bricks that someone else keeps knocking down, that you have to keep re-laying.

My hope is that you spend your next 30 or 40 years not laying bricks, but instead you spend your careers building the House of Medicine. This is my advice to the new graduate, or to any who feel the need to rekindle their callings.

First, renew your own inspiration and cling to your passion like your life depends on it. I can’t imagine that as a child or as an idealistic, eager, young college student that any of you thought to yourselves: “I dream of being a doctor so that I can have good door-to-doc metrics.” “I want to be a doctor so that I can chart efficiently.” “I hope I can be a doctor so that I can maximize my RVUs.”

Now, none of those are bad things, and they could even good things. But they are not things that will feed your soul when the bricklaying gets tough, which it will. They are not the things that will keep you excited to get up every day. They are not things that will help you bounce back after the really tough cases.

If I could travel back in time and listen in on each of your interviews for medical school, I wonder what you said. I imagine that all of you at some point in your lives have said the words: “I want to be a doctor so that I can help people.” And now, all these years later you finally have the knowledge and skills to do that. You can help people. You can save lives. You can vanquish the evil specters of disease. You can take suffering people and make them whole. Isn’t that astounding? Isn’t that amazing? You have achieved your childhood dreams. You are a doctor, and you can help people.

Now, of course, we know that many times those evil specters of disease are too chronic, too ingrained or too complex to be healed by us. But while your ability to cure is limited, your capacity for compassion and empathy are not. Renew your inspiration and the passion you had when you first started on this journey. Hold onto it desperately, because your life depends on it.

Second, work hard. Finishing residency or fellowship is a laudable feat, but I won’t praise you for your talent, because talent is finite. Instead, I commend you for your hard work over the years. Take that work ethic and apply it to your new jobs. Be the doctor who goes the extra mile for her patients. Be the doctor who never avoids doing something because it takes too much effort. Be the doctor who raises his hand to volunteer. Be the doctor who helps her colleagues. Be the doctor who gladly learns and gladly teaches. Be the doctor who tries to be a little bit better each day. Be the doctor who walks into an overnight ER shift on a full-moon Monday to a stacked waiting room and says: “Bring it!” Be the kind of hard-working doctor that your 10-year-old self would be proud of. Talent is finite, but what you can achieve through hard work is limitless.

Third, do one thing. No one can do everything, but everyone can do one thing. Pick something in your department, your hospital or your community that you can improve. Choose something that you love, and make it better, or choose something that drives you crazy, and fix it. Most hospital systems will make you fight through a labyrinth of committees, processes, protocols and red tape to effect any meaningful change. It will take grit, determination, strategic thinking, and an unflappable can-do spirit. But you will probably discover that you do a good job of it. You could find it rewarding. You may find that you fall in love with building the House of Medicine in this way.

Those are my three pieces of advice to you: Renew your inspiration, work hard and do one thing.

Those of us who have gone before you are hoping you will find new and innovative ways to improve the health care system for all. Those who will come after you are relying on you to create a better working environment for future physicians that doesn’t shackle them with mindless administrative duties, endless mouse clicks and more face time with a computer than a patient. Patients are relying on you to find ways to fix the system so that they can receive the care they need in an affordable and sensible way.

But you do not have to do everything. Pick one thing. Work hard to make it better. And remember why you wanted to be a doctor in the first place. Remember your calling. Go out and build the House of Medicine.

Christina Shenvi is an emergency physician.

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