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I’m glad I did that

February 2nd, 2004 · 4 Comments

I was reluctant to write Why I didn’t become a doctor. I didn’t know how well I could describe my entire experience in one weblog post. Many factors influenced me and to share the entire story in detail would be far too lengthy for a blog. So I chose to emphasize the angle from Enoch’s original post.

Leaving the medical program was a very difficult decision for me to make, and I’ve had a hard time talking about it. When I would share some of my story with others, I’d often encounter incredulity – people couldn’t believe I had rejected my medical school acceptance – and even years later, people would try to change my mind and make me reconsider medicine. I started to feel skeptical myself and to doubt my own decision. I got tired of talking about it; all it gave me was grief.

I feared that posting this story on my blog would lead to more debating and battling. I dreaded it and dragged my feet. But instead, what I’ve discovered through the other bloggers who’ve responded to my post, has only confirmed to me that I made the right decision.

Enoch was a friend of mine and a fellow classmate in the medical program, although I’m not sure how much time we spent back then discussing my decision. After losing contact for many years, we’ve gotten back in touch again through blogging.

As an MD, and my classmate, he encouraged me, responding to my sentence “Reading his(enoch’s) blog medmusings gives me glimpses of what I’m missing…” with his comment:

“what i’m missing”?!?!? I’d rather be home with my daughter, and Tania work instead! 😉 Or so i think…

Lisa Williams provided a perspective:

Yet so often we are made to feel ashamed of our native impulses, as if they were a sign of weakness rather than of humanity. Those who decide to honor those native impulses should not feel they have failed, and those whose professions make them confront those native fears should be supported and cared for as they manage the terror and grief that we file away under the word “stress.”

I felt Lisa saying “it’s okay” either way – something I rarely heard. The comments on her post also encouraged me. I appreciated the elegant and respectful way she stated her understanding of our impulses and humanity.

Chris Rangel MD also told me that how I had felt in the ER was okay:

But her shocked reaction as a layperson to the stark clinical coldness of medical personnel in the presence of death is not unusual. I would say that most sane emotional beings would be equally shocked at how calm and disconnected medical staff can be when surrounded by death and suffering.

I appreciated his insight as a physician into my experience.

What I’ve always wondered is why no one tried to talk to me about what had happened. Why didn’t one of the nurses or doctors or even med students try to ask me how I was doing after the man died? Or express some kind of understanding of where I might be coming from, as a college student, a kid, who wasn’t used to hospital life, patient deaths and the rigorous emotional demands of medicine? In retrospect, perhaps I should have spoken up, although I felt ashamed of my feelings since I seemed to be alone in them. I also though would have appreciated if someone had either prepared me for this experience or tried to talk to me about it afterwards. I would have appreciated it if someone had told me that my shocked feeling was normal and natural. I wish someone had said to me back then what Chris Rangel wrote to me this week.

One thought I had, after reading his post, was that perhaps the medical staff around me were desensitized, due to their adaptation to their profession, and perhaps they didn’t realize or remember how I might be feeling.

Or what I am also realizing from what I’m reading on these blogs, is that the desensitization of medical professionals is not something taught explicitly in medical school or something undertaken intentionally. It’s not a text book or a ten step course someone can take you through. It happens. It happens as a means of survival. It is the way the brain adapts to the stress. The way the work gets done well. And I imagine that means it happens differently for each person too.
Chris Rangel again:

This tendency to become desensitized to stimuli that would usually cause an emotional reaction is simply the brain’s ability to adapt and cope with new situations. This occurs all the time in many different situations and with many different professions and does not represent a completely intentional or conscious decision. Despite what Julie thinks, this sort of detachment is essential for people working in emotionally charged environments. It is not a sign of disrespect nor an indication of the loss of one’s compassion or humanity. It is a sign of coping.

I’m grateful for people who are willing to undergo all that medicine requires of them to become physicians. I have trusted my life and the lives of my three babies to medical doctors. I’m glad that there are others who are willing to pursue that path.

But I didn’t want to become desensitized to death. Although I had spent most of my young life focussed on medicine, preparing myself mentally, academically, this experience in the ER was the first time I came face to face with what I would need to do emotionally in order to become a physician. And I realized I didn’t want to do it. It would have been very difficult to do. For me, who I am, medicine was not a good fit. I would have changed a lot as a person and paid a high cost while learning to cope. But I didn’t see it until I was there in the ER watching a man die. And all these years later, I feel that I’ve only seen this truth with more clarity this past week.

After participating in this blog dialogue, I’m realizing even more that I am glad I did what I did. I’m glad I decided to leave medicine. And I’m glad I blogged about it.

Tags: journal

4 responses so far ↓

  • 1 medmusings // Feb 4, 2004 at 5:20 pm

    Why to not become a doctor

    Update: Julie elablorates on her journey, finding more confirmation of her choice to not continue in medical training, to avoid becoming desensitized to death. my original post: Whereas many physician bloggers talk about why they went into medicine, or…

  • 2 medmusings // Feb 6, 2004 at 2:16 am

    More on why not to and why to go into medicine: sensitization to suffering

    Julie responds to Lisa and Rangel MD’s comments on her initial post on “Why I didn’t become a doctor”. She finds confirmation in her choice by her refusal to become “desensitized to death” — explained by Rangel as a natural coping mechanism to facing …

  • 3 MD // Feb 8, 2004 at 2:04 pm

    The odd thing about my being a pathologist (not forensic) is that yes, I am de-sensitized in that I can look at human organs and a dead body without thinking: “Oh my god, that is a dead body!” But I am more sensitized to the good things – life seems more precious to me now partly because I deal with illness and death every day. I can’t sweat the small stuff – I just feel I know too much. It has made me simultaneously hardier and gentler. But that is what medicine did for me. Not everyone has that same experience.

    You were very brave to do what you did. It takes courage to say: no. This is not what I want. Too many people get caught up in medicine and get carried along by the sheer momentum.

    Thank you for sharing this experience.

  • 4 Seedlings & Sprouts // Feb 12, 2004 at 12:25 am

    Another perspective

    on my post Why I didn’t become a doctor from Paula, a physician and poet describing herself as one who holds the title of “world’s longest maternity leave” and “world’s oldest intern.” I enjoyed reading her experiences, the pictures in…