On Being a Doctor (Mom/Wife/Daughter/Sister/Friend) Person

A relative and I were recently having a conversation on what is the most life-defining decision one can make. We talked about how life-defining decisions could range from choice of profession or partner, choice to start a family, or even choosing to espouse certain viewpoints. In a recent On Being a Doctor essay, Dr. Neal Thomas discusses how coming close to death changed his attitudes on how to live his life (1):

When I awoke, I realized that my life plan had to change. I needed to keep those promises to myself. I came to the stark realization that life can change in an instant and that I had to place things in the proper perspective. I needed to walk the walk. I would work smarter. I would put my family first. I would try to live my life without regrets of what might have been. I could not and would not have my life defined by my job. Instead, my job should be only one part of who I am.

Dr. Thomas challenges that maybe medicine isn’t the thing that should define us fully. However, throughout training, countless instructors tell us that this profession is not a job, it is a calling. Considering it a calling means we are devoted to our patients, and that our work is more meaningful than a paycheck. However, there are concerns with that, too, Dr. Thomas suggests. Perhaps in this thinking, we do not value others’ work as much as our own or we push ourselves too hard for the sake of our work.

There is something extremely special about the work we do seeing patients. It is meaningful and important work. And I think for those who do this work with good intentions, it is a calling. We take care of people when they are vulnerable, building and respecting the sanctity of the patient–physician relationship. But I also realize that to be invested in this profession in an era of paperwork, documenting, EHR, and professional burdens, I must be true to the other parts of me as well. I know that life is fleeting, that moments can redefine the trajectories of life. I know this because I am a doctor who witnesses these journeys’ curves every day.

It’s admittedly difficult to balance this 30,000-foot view with the daily tasks we still have to complete. I haven’t perfected that process yet, but I think my brother may have an idea. He is a neurosurgeon and has dealt with patients at the most vulnerable moments of their lives. Ever since residency started for him, he never seems to be bothered by “little” things. Traffic, arguments, missing socks, all things that used to annoy him never seem to anymore. I’ve asked him why he seems never to be unphased by these things, why he never seems bogged down. His response, “Fatima, we’re alive, who cares.”

I’m still practicing that release, and when I get bogged down by life, I think of a particular patient in the ICU when I was a senior resident. I was doing a rotation in a community hospital. A young, otherwise healthy man was sent to the ICU from the ER. He had been sick for several days. By the time I met him, he was intubated. However, I learned about his vibrant life from his father who rarely left his side. He became sicker, too sick for ECMO. Eventually I had to discuss with the patient’s father what we should do if he coded, again. He asked me to try one round of compressions, and if it failed, to stop.

I didn’t need to tell him how sick his son was, and how he was barely hanging on, or that compressions may hurt more than help. I knew that this father knew how sick his son was, and I was going to do things on his terms. About an hour after that conversation, the patient coded. I ran the code, and I did the compressions myself. When it became clear the patient was gone, I said, “I’m going to call this, is everyone okay with that?” I needed to give our team—myself even—a moment to acknowledge that this young man’s life was over, that we felt the sadness of his life ending too soon, and that it was difficult because he could have been any one of us.

Reference

1. Thomas NJ. Physician, heal thyself. Ann Intern Med. 2019;170:135. [PMID: 30641568] doi:10.7326/M18-2032