A bird slams into the glass. A bird slams into the glass. A bird slams into the glass. Over and over again, head first, determined to defeat its own reflection. A headbutt of bravado. I watched it, time and time again. From the inside, I studied the dozens of oily streaks smeared across the window. After a few minutes, the bird would fly away – sore or distracted from its battle with itself. I would resume my homeschool duties, cooking, or writing. An hour later, the sound of life bludgeoning itself against my home would, once again, shatter my new normal.
It would be comical if it wasn’t painful. Like the bird, I repeatedly bashed myself against the invisible constraints of outpatient medicine: 15-minute patient appointment slots, cookie-cutter algorithms, a dearth of physician leadership roles, an expansion of non-physician leadership roles, endless communications about cost savings rather than patient care, additional work with no additional time or reimbursement, and the shockingly incorrect assumption that working four weekdays instead of five equated to a lack of dedication or interest in job growth.
The most recent blow was being deemed “non-essential,” along with dozens of my colleagues. A physician furloughed in a pandemic. The words rolled off my lips thick and sticky like the nauseating cough syrup of my childhood. My colleague and I discussed what were we, no – who were we, if we were not physicians. We struggled with our identity, minus medicine. Daughter. Mother. Wife. Friend. All the beautiful, messy, evolving roles and the fabric of self – left with a gaping hole. The constant, the clean, the concrete, the sacred, the indelible identity of physician, now suddenly vanished. The role of healer and breadwinner stolen.
But who are we, if we are not physicians? My mother, a physician, always tells me that once you are a doctor, you are always a doctor. It doesn’t matter if you are no longer a clinician but now a researcher, a writer, a family caretaker, a businesswoman – once you have earned your medical degree and the scars of residency, you are forever a physician. It is part of you like your arm or heart or lips. My uncle, the dentist with a sly smile, frames it another way, a doctor’s hands are always clean. They are always ready – ready to soothe, to heal, to help. Is it a part of us that can’t be sold or bartered or paused or stolen like a commodity? Once earned, do we own it forever? Despite a furlough, moral injury, and a pandemic?
It is time to question ourselves. What does it mean to be a physician? What kind of physicians do we want to be? How do we want to practice medicine? My answer has led me to listen to myself, and leap. I have leaped into a fellowship that promotes wellness, health building, partnerships, and mindfulness. It is based on time, not with a patient, but with a person. A person with a condition that affects their identity. Now that is something I can relate to – a condition that disrupts your identity, your role, your sense of self, your function, and your participation in life.
The furlough forced me to stop beating myself against the glass and to stare into it. To pause and to be mindful. To see who I am and decide who I am becoming. I will always be a physician. I will always be a physician, whether I am seeing patients that day or not. I will always be a physician, whether they call me a doctor or a “health care provider.” I will always be a physician, whether I work part-time or full-time. I am forever a physician, whether in a pandemic or not. My hands are always clean. I am done ramming into the glass. I am done headbutting an outer image. I am ready to be the physician I was meant to be. It is time to pause, reflect, and decide what being a physician means to us. When we build our vision and embrace it, we better serve our patients and ourselves.
The author is an anonymous physician.
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