Saturday, August 23, 2008

Sweetie, Please Don't Go to Med School


It happens so fast. Yesterday she was happily hurling projectile poop at us as we changed her diaper. Today she's dealing with her first acne break-out. Yesterday he was literally a bouncing baby boy, using our laps as a trampoline while we held him under his arms. Today he's teaching us about solar flares and planetary orbits.

We have dreams for them. We dream that she'll be able to write and sing and act to her heart's content but not fall prey to the seamier side of theater life. We dream that he'll keep reading voraciously, participating in sports, and finding wonder in science in a way that gives him love of his work and confidence in himself. We dream they'll enjoy the work of their hands and/or minds and be pleased with the outcome. We dream they'll find love, the love of people who will know them truly well and appreciate how special they both are, and cherish them, and support them.

But there's something I do not dream for them, which the blog MothersInMedicine reminded me of today. I don't want them to become doctors. That is, unless it's really, really, really their hearts' deepest desire and they'll die of grief unless they do it.

In the post "Mothers, Don't Let Your Daughters Be Doctors," Fizzy captured my thoughts exactly from the time my own daughter was younger:

People ask me if I plan to encourage my daughter to become a doctor. At this point, I'd settle for her not coloring all over the walls, but my specific answer to that question is, "Absolutely not."

In fact, not only will I not encourage her to become a doctor, but I will actively discourage her from entering a life in medicine. I will tell her every awful story I can think of about the abuse med students, residents, and (I can only presume) attendings are put through.

Not all doctors feel this way. But many do, because they want their children to be appreciated rather than insulted, and to have a life. "But Mommy," my kids might say, "You have a life." Well, yes, I have a life now. I spend time with them now. But I missed out on so much that was precious before, and I still can't be with them as much as I'd like, during these, their too-transient childhood years. Today she has a break-out. Tomorrow she'll be in her college senior play. And the day after that she'll be on her honeymoon. I suppose for every woman who makes the choice to work outside the home as well as within it, this is the problem. We knew this going into that choice. We made the choice with our eyes open, knowing the consequences. That doesn't mean we have to like everything that we have to accept about this path.

I can only hope that despite my training and my job, they didn't feel neglected. I hope they felt I was there for them anyway. I hope they feel some of what this child-of-a-doctor wrote - that time spent with her parent was memorable and precious, and that some missed award ceremonies and school plays were forgive-able. I hope. I hope they know I wanted to be there, tried to be there, for everything, and that they were always, always present, front and center, in my mind and heart.

Do I regret choosing this career? No.

Do I like my work? Yes.

Would I be sad to have to change my work? Well, it depends on the alternative! I do feel there's a spiritual element to my reasons for having chosen medicine, so I wouldn't leave that decision lightly...

Would I do it all again? Hmm...probably not. I don't know that the exhaustion, emotional abuse, sleep deprivation, and indentured servitude would be worth repeating...for any reason...

But would I have changed the life I've lived so far in any major way? No. I treasure the life I've had and the family we've grown to be, together.

I just hope my children choose something else.



(Photos: One of my cuties feeding the alpacas at our friends' farm; and, me and the cuties enjoying the top of the Oak Ridge Trail on the grounds of Castle in the Clouds.)

21 comments:

Patty said...

Interesting to read this.

Every oboist I know doesn't want their children to become an oboist, and most of us don't want our children to become professional musicians.

Surely we don't work as hard as doctors, and we absolutely don't work as many hours. But it's a rough life, pretty darn stressful, and the pay is ... well ... for me it's not very good.

I guess the big question is, which professions are the sort that parents say "DO THIS!"?

Mostly, though, I wanted my kids to do whatever was their passion. What I've found, though, is that not everyone even has a passion. They just have a job. And for some that's okay too.

I do feel for those who are unhappy in their jobs. I feel for those who only complain. I wonder if they ever think of doing something else, even if they take a loss of income. I might whine on occasion, but I can't imagine doing anything else, and it brings great joy to me. I hope sometimes it brings joy to others as well.

T. said...

"I guess the big question is, which professions are the sort that parents say 'DO THIS!'? "

Great question, Patty!

There's a doctor-blogger, Fat Doctor, who left a comment on the post "Mothers, Don't Let Your Daughters Be Doctors" who said she'd like her son to be a plumber or electrician.

I know my husband has being-a-builder or woodworker daydreams, and I'd certainly love it if my kids were handy (I'm not).

The most job-satisfied patient I ever met was a bricklayer. There's something to be said for working with your hands and seeing the finished product at the end of the day - I think it definitely boosts mental health! (Elaine Fine just posted an article about the relationship between manual work and depression, or lack thereof - I think I might have to explore that more...Does that mean musicians, artists, and craftspeople are generally happier people...?)

Patty said...

Oh my ... I've heard of tons of artist types with depression. I don't see my colleagues as any different than the rest of the world. We have introverts, extroverts, happy folk, sad folk, incredibly wonderful people and some of the worst people I've ever met. I've also met incredibly intelligent musicians and some that are about as intelligent as wallpaper. I've even met some incredibly boring people (but they tend to play that way too).

So I dunno. I just think we are who we are (not sure if it's due to nurture or nature or both).

But I ramble. What a surprise, eh?

Bardiac said...

When I read these sorts of things, especially the ones that fantasize about folding jeans at the Gap, I have to wonder if the writers ever held a job other than the one they have, especially a job that involves low pay, low self-determination, and rude customers.

I think you should ask people in whatever job if they'd recommend it to their kid. I bet not many folks folding jeans at the Gap want to do it for much longer themselves, much less want their kids aiming there as a career.

Most jobs just need to get done; you do them, and then you do other things. Hopefully you get enough pay that you can afford the other things, like feeding your kids, paying rent. I'm thinking it's a whole lot harder to feel good about leaving your kid when you can't afford good daycare, harder to send him/her off to school when the local school is lousy and you can't afford to move where there are better schools, when your kid eats the free school breakfast/lunch because you can't afford sufficient food at home.

Sorry, this sounds sort of mean, but I'm in a profession where we pretty much discourage our students from going on because we know how miserable just getting a job is. But from the outside, other people think it's pretty darned ideal. (And, in many ways, it is pretty neat, but outsiders don't see the downsides. It's still a heck of a lot better than a retail clothing job!)

T. said...

"low pay, low self-determination, and rude customers" - you've just described the life of a resident, except you left out the part about chronic fatigue and psychological abuse. It was definitely hard paying for good childcare on 30- or 40K a year, and awful wondering if, like some of my patients, my kids were going to end up with their heads bashed into a wall by a babysitter. I think childcare problems and worries are common to all who work outside the home, not just those who work at the Gap. And I do think a lot of physicians who write about the frustrations of working in medicine DO have experience in other jobs, just judging by my own colleagues' work experiences.

"I bet not many folks folding jeans at the Gap want to do it for much longer themselves, much less want their kids aiming there as a career."
I think it might be a little presumptuous to make a pronouncement like this as a generally applicable statement. I'd like to recommend Edwin Leap's exceptional column on the dignity of work - ALL work - here: http://www.kevinmd.com/blog/2008/07/edwin-leap-giving-back.html

"from the outside, other people think it's pretty darned ideal. (And, in many ways, it is pretty neat, but outsiders don't see the downsides.)" That, in turn, describes life after residency pretty well. No one who hasn't been through medical training could possibly understand why many doctors emerge from it with so much pain, bitterness, disillusionment, and emotional exhaustion in addition to the quarter-of-a-million-dollar debt. But those who do, understandably, aren't super-excited about encouraging their kids to go through the same...

Resident Anesthesiologist Guy (RAG) said...

I worked over the summer between years 1 and 2 of medical school. It was the easiest thing - you had a goal, got it done, and were out the door when the time came. A lot of people complained, but I thought it wasn't bad at all - coming from the year long hell I'd just been through. I wonder what I'd think now going through 2 months of internship?

Personally I feel the same way - don't go into medicine. I wouldn't do it again, so why would I encourage my kids to go through it?

T said...

RAG, just reading your blog (http://thechloroformrag.blogspot.com/) brings it all back like a bad dream...you write so vividly about the intern/residency experience, and it's all so true - the overwhelming amount of work, the physical exhaustion, the mental torture, the being-treated-like-you're-scum-instead-of-human...Wish you didn't write so well!

Bardiac said...

I'm sorry, I didn't mean to sound as harsh as that came off.

I spoke as one who did fold clothes for a living (and pick up after people trying on clothes, etc), though not at the Gap, and no one I worked with wanted to be there for long. It's an honest living, and I respect people who do it, but none of the folks I knew when I did it wanted to be there any longer than they had to.

RAG, if you hate it, why not find something you like better? No one else is going to make you happy in your work, and we spend a lot of time working, so finding something you like is really important.

I'm sure residency is horrid. It sounds so, at any rate. Again, my apologies for sounding more harsh than I meant to.

T. said...

Bardiac, it's impossible to become a fully qualified practitioner of medicine in this country without residency, so to ask "why don't you find something you like better" is like asking someone who dreams of a strong military career to quit just because boot camp is HELL.

Almost ALL of us, I think, "hate it so much" when we're going through it, though as I said there are a few who don't.

Anonymous said...

Hi all,

Wow great discussion everybody!

As a 4th year med student attempting to get into a residency...I question myself many times as to why I chose this path?

I worked hard my entire life to get to this point. Served tables with horrible guests who would snap their fingers at me, but all I kept my mind on was that 12 hour mark and $300 solid cash that would go straight to my bank account to fund for med school. I kept telling myself, get through this and you're almost there!

Now as a 4th year, I study long hard hours, stay up late at night, so I can answer the questions the resident and attending ask, so I don't sound/look like an Ijiot. I look around me at the unhappy, sleep deprived doctors, medical students and at my friends travelling the world and taking breaths of life that I feel like I'm missing and again I think man why did I do this?

Here it comes, the big BUT...
BUT, I chose to spend the time I do have happy because this is my life long dream (and I think it has been for every doctor, if it wasn't you would have quit earlier when Step 1 took your lungs and stepped on them). I enjoy walking my dog in between the breaks and playing with him and fake stomping his tail. I enjoy the meals I make and garnishing them with extra care. I enjoy the shower I take in the morning with my ever expensive body wash that I can't afford and will be paying triple for when those interest payments pull a Step 1 and crush my lungs again. I enjoy questioning my fiance on pathophysiology and treatments and watching his dimples fight a smile when he pretends he doesn't know the answer, so I can feel good about my egotistical self. As pathetic and luny as this may sound, I chose to enjoy the time I spend in medicine. Either meeting a patient who has it worse than me, or studying, I chose to enjoy every moment that God has given me and that my patient doesn't have.

Ok, so let me wrap up my poetism. I believe the power of the mind is quite strong. I think it's how you chose to view it. What will I tell my children? I don't know...there are easier ways to make money in this world. But, I remember what it's like wanting it sooooooo soooo BAD (med school), if it's what they really want, let them have it. I'm sure my/your parenting and love will provide all the support they need...I always go crying to my mommy (eg. after the mean man snapped his fingers at me at the serving job or the mean, rude circulating nurse kept taking me by the shoulders like I'm an object and slamming me against the OR wall because he doesn't have any courtesy). All I know is I'm not going to treat my students/ patients the horrible way I have been treated. I strongly believe this phase of medicine is old and is washing out with the newer face of med students coming in. We're all tired of it, so let's change it instead of giving up on it!

Cheerio,
E

ps. The Ob/Gyn circulator seriously needs to chill!

Jo said...

Perspective from the other side of the divide...

My mother, my grandmother and all of my aunts were nurses. I assumed, from about age six that I was going to be a nurse, too. Yet, as soon as I was old enough to really be thinking about it seriously (age ten or eleven), my mother sat me down and used all of her powers of persuasion to stop me going down the nursing route.

So I didn't. I now work as an administrator in a lovely little company, having got a degree in History. I don't regret the change of career, and I certainly don't resent my mother for pushing me away from medicine. However, every so often, I think about the ability to make a difference; I don't have that in this job, and I never really will. In medicine, I would be able to go home at the end of the day and think that I'd helped someone, be it in saving a life, easing someone's pain, or even (as my mother so often was when she was a Macmillan nurse), just being there at the end.

propspony said...

Love the alpacas. Think you could mail me one? :-)

Map said...

Really enjoy your blog. As a mom of an eight year old and five year old, I can certainly understand what you mean by wanting my children to pursue "whatever makes them happy." At this point, I would not encourage my children from entering medicine, myself having just finished an anesthesiology residency (full of abuse, mind games, etc). But here is the interesting part: throughout my education, my father never suggested that I enter anesthesiology. After watching how much he enjoyed his job over the past 30 years as an anesthesiolgist, I guess I just decided to follow in his footsteps. It is true -children learn by example.

T. said...

Anonymous - I wish you well as you finish up med school and embark on the next step! Thank you for your thoughtful remarks.

Jo - it's great to have your perspective. I think people in health care sometimes wonder as much as anyone if they're really "making a difference." It's corny, but I think the film It's a Wonderful Life has a wonderful point to make on the subject - I'm hopeful that no matter what our work may be, we can and do make a difference in our little corner of the world by who we are/become and how we do things as much as by what we do!

Propspony - aren't they adorable? And they make such a cute, sweet humming sound...

Map - so glad you stopped by. Congrats on being done with residency! Anesthesia's still the most enjoyable field in medicine, in my totally un-biased opinion! :)

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katy (aka funny girl) said...

Similarly, I don't want my daughter to marry a surgeon! The other day I met a girl whose husband just switched from surgery to anesthesia after three years of residency and I blurted out "good for you!" Not only because of my inherent love of the drugs (and their pushers!) but because I knew that this meant she and her children would at least have some kind of life with their husband/father.

Also, a friend recently contacted me to get my opinion on going to nursing school. I have to admit I tried to talk her out of it. Like you said, if after that she still really, really, really wants to do it, then it's probably the right thing. But there's no need to disguise all the pain and tears and heartache and bedbaths and adult diaper changes and lack of sleep and general misery!!

T. said...

I tried to talk a good friend out of starting med school at our age, but she was pretty determined...also, SOOOOOOO talented both in terms of what it takes to be a totally brilliant physician as well as a spiritual giant/humanitarian/compassionate human being of unparalleled inner strength and character...so if it's truly her heart's desire, then I say, may the road rise up to meet her, and I will support her every step of the way...

Anonymous said...

I don't get it-

Are you discouraging your children from medicine because of the interim years in residency? Residency doesn't last forever. When someone is considering a career in medicine, shouldn't they focus on the end product and the opportunities that await them at the end of their education and training?

Also, when people make the statement, "I would never do it [medicine] again", what exactly do they mean? Does it mean they would never do it again in this life time? Well in that case, I couldn't imagine anyone with the desire to obtain the same professional professional degree and status more than once... On the other hand, if they mean that IF they were to "restart" their life ( from zygote to an adult), would they choose medicine as a career path again? In this case though, there's a fallacy in thought. Knowing how hard and bitter it was to get to where you are now, who wouldn't want to try something else (we're curious, after all, of new experiences)? This statement has always confused me.

I deeply apologize if this whole post comes off in a critical tone. I'm desperately undecided in this whole pre-med process and whenever I read someone express an absolute NO toward medicine, I can't help but be shocked. Is it THAT bad?

- some undergrad

T. said...

We all took that attitude - "Residency doesn't last forever; keep your eyes on the prize" when we started out. That's because we didn't REALLY know, and couldn't REALLY imagine, what it was like.

Yes, it's that bad.

When my mid-30's close friend was trying to decide, I told her, "Don't do it." Now she's halfway through her first year and she's already had moments of wondering if she made a mistake.

But then, we ALL had those moments, throughout the whole process.

I have met very few physicians who could say to me that "it was all worth it." In fact, no one has EVER actually said that to me about medicine. The ONE doctor who comes to mind who would "do it all again" even if she knew the hardships involved is a SINGLE woman with NO children. Believe me, that makes a HUGE difference. Medicine is not family-friendly.

But as I said in my post - a fact that should NOT be ignored despite the over-arching message in the post - I like my work and cherish the live I've lived so far. And, deep down, I do love medicine - MEDICINE, not the culture it comes with.

Anonymous said...

Dr. T,
Thank you for your response.

- some undergrad

T. said...

At LAST, I found a physician with a positive, affirming, beautifully written statement about why medicine IS worth it. Reading this post by Edwin Leap restored my faith a little and reminded me of why the part of me that loves medicine loves medicine:

http://edwinleap.com/blog/?p=718.

He's right, of course. Medicine is difficult but beautiful. I still hate, absolutely despise, overnight call, but I still love taking care of people.

I guess it's up to every individual to search his or her heart to discern whether there's a true calling there.