Dear Daniel,
To borrow a line from the Beatles, "I read the news today, oh boy...and though the news was rather sad. Well, I just had to laugh." There it was, another article detailing that physicians experience a higher prevalence of depression, burnout, suicidal ideation and a lower quality of life than age-matched members of the general population.
Steve Dudley
Yep, my son, you're in for a long haul. Are you sure you don't want to reconsider? After all, there are easier ways to make a buck, wouldn't you agree? It's not too late to put on the brakes and redirect your many talents. And, yes, just like the song, I just have to laugh as it hurts too much to cry, reflecting on the path laid out before you.
No doubt about it, life in medicine can be difficult. I think back to my own years of training. It was tough then—perhaps a tad tougher, because you had just been born and I had to juggle being a husband and parenting two small children with the demands of medical school and residency. My supervising residents and attendings had little regard for my life outside of the hospital, nor could they give a rip about my child who had just taken sick with a fever at Miss Laurie's Daycare.
Steve Dudley, DVM, MD, reflects on his career as a family physician with concern, pride, and optimism for his son, a pre-med student, who hopes to follow in his father's footsteps.
Speaking of that, I learned a new word the other day: "presenteeism." Great word. It means showing up to work when you are sick. I once worked with an emergency room physician who had caught an intestinal virus. He talked one of the nurses into hooking him up to a bag of IV fluid, which he wheeled around on a little pole from room to room so he could continue seeing patients. He wasn't about to let a little nausea and diarrhea stand in his way.
Any rational person might ask who wants to put up with all this? The years of study? Delayed gratification? Living at poverty level for so long? Putting marriage and relationships at risk while you pursue the dream of medicine? And then after you have tackled all of the above issues, you come out ill-prepared to fight new foes: mastering the ICD-9, soon to be ICD-10, codes, insurance companies, paperwork, running a business. It's downright daunting.
So why do I stick with it? Well, simply put, it's about the best darned gig around, that's why. In the face of doctor burnout, isolation and the stresses of running an office, there is nothing to rival the satisfaction of being a doctor. I may come home weary and burdened from seeing so many hurting people, but an inner peace suffuses me, often the most intensely on my roughest days. It comes from being able to stand back and reflect on my day, resting in the calm assurance that I am indeed doing some good out there, one patient at a time.
Where do I begin? Well, for starters, there's Frankie, a strapping 7-year-old who used to burst into tears every time I walked into the room when he was a toddler. Today, he high-fives me and calls me the best doctor in the world. His baby sister just had a febrile seizure and he's confident that I'll take good care of her. There's Gert. At 104, she's my oldest patient. With the twinkle in her eye and that smile of hers, she always lifts my spirits. Mr. Connors just had a stroke. At 51, this wasn't supposed to happen, but it did. Even though he's well-connected with his neurologist, he leans on me to help him navigate the maze of health challenges that have hit him like a freight train.
Time and again, I step into the room and quietly close the door. After some friendly banter about important matters such as this year's lousy tomato crop, good fishing holes, bicycle riding, and how my beloved Washington State Cougars are doing (usually not very well), I segue into the reason for the visit.
"What's going on today?"
That's when the magic happens. Time stops (or at least it should). I'm honored that patients entrust their health to me, putting faith in my ability to help them along the road to wellness. It's a humbling feeling to be in that position. And, at the end of the day, I can look back and say, yes indeed I did a little good in my corner of the primary care world. It's neither glamorous nor flashy to lance abscesses, treat toenail fungus, or battle with hypertension and diabetes, but it's a necessary calling and one that I am proud to be part of.
And when I reflect on your aspirations to enter medicine, I am filled with pride that you have chosen this career. I know you have the compassion and the talent to be an excellent and caring physician. I think of the time you took care of the burn on my back after my shirt caught fire (how was I to know the candle was so close?). You meticulously cleaned the wound, carefully extracting the shards of burnt shirt from flesh with the care and patience of a seasoned professional. I sensed your healing touch, even then. And when you decided to stuff a silly fish you found on the beach, you took to suturing his belly closed like an attending surgeon.
Of course, that's not to say that things aren't going to be tough. You've got many years of hard work and sleepless nights ahead of you. I reflect back to my own years of training when the alarm rang, signaling the beginning of another day. Yes, it was time to get up and do it all over again, tired or not.
You'll be very good at what you do, no doubt about it. Your love of learning will be rewarded in a career in which there will always be new frontiers to explore (we call it CME). I look forward to standing back and watching you as you develop into the fine young doctor you are called to be and welcome you as a future colleague.
I'll never be famous, and I doubt you will either. But I can promise you that your life in medicine will be one that is equally challenging, stimulating, and rewarding. What more could someone ask of a career?
Godspeed, Daniel. You'll do well. Of that, I am certain.
Love, Dad
