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Changes and costs: pursuing the medical path

February 6th, 2004 · 1 Comment

Enoch’s probably a bit sleep-deprived too after being up late last night with his ill daughter. But at 2 am he wrote a thoughtful post about his experience in medicine, responding to my last piece in our dialogue.

I’m grateful to read what Enoch shared. Had I stayed in the program, I would have gotten my MD along with him. Many times though when I’ve tried to talk about my decision with other pre-meds, physicians or classmates, it’s been difficult. Enoch though has encouraged me in many ways, especially through our recent blog dialogue on this topic, and I appreciate his honesty in this post as he describes the price he paid in his marriage and how his attitude towards death has changed since residency.
Here are some excerpts:

She would have “changed a lot as a person and paid a high cost” which is true. It launched my mind on two memes, how i’ve changed in my attitudes towards death, and what cost has been paid for me to get here.

When I think of the costs, I look back not only on my parents’ financial sacrifice, but on the 7 additional years after undergrad in which Tania lacked my company and attention, and wonder “was it worth it?!?” My marriage did suffer, even with the support we received from friends & church. Unfortunately it continued to suffer during a few years at Medicalogic, an electronic medical record company, but then I returned to practice, and now do think it’s worth it. Why? For one, on the personal side, I’ve made time to spend with my family which many dads don’t get to do as much in Silicon Valley… I’m growing both on the personal and professional side, and enjoying both thoroughly, something that I think is rare around these parts.

My attitude towards death has changed a lot since training. While in residency, focused on intensive hospital based care, I learned how to heal the most infirm and was enthusiastic about it. Today in outpatient clinic, a partner and I reviewed the day, and talked about the nanogenarians and centarians we saw. They’d enjoyed fulfilling lives, and now neared the end…. My partner & I both took a step back and reflected that when we reached this milestone, we’d want to have clearly indicated in our living wills that we’d have enough morphine to curb our air hunger, and ease our troubled bodies into God’s eager arms. Were we desensitized from the suffering? I certainly wasn’t crying at the bedside, but i did feel for the patient. Enough that I had to divert my eyes as I passed, and quietly prayed for peace in both body & soul. In this case, instead of being desensitized to death, I looked forward to its relief. If I had been the attending physician, I suppose I was desensitized enough to keep presence of mind to complete the tasks needed, i.e. arrange hospice and morphine schedules, but I still would have empathized with the suffering.

I suppose in less supportive environments such as the ER there’s more desensitization to death because of the trauma and codes. In an outpatient environment though, suffering is less acute, and after difficult cases the staff do sometimes cry on each others’ shoulders and decompress by sitting and sharing with each other how they feel. In the clinic, this doesn’t have to happen too often fortunately. But if you have good partners, you’ll find the people to cry with, vent with, rant with, and laugh with. It happens in the background, after the work’s done. This balance, of providing relief of suffering, then finding those who can help you through empathizing with the suffering, is part of what’s satisfying about medicine. As you care for people, find care for yourself. For me, God’s a big part of that. [more on that later] ….

I’m grateful for the time Enoch took to write out what happened to him after we parted ways, and his experiences with suffering and sensitization. What a picture he painted, with laughter and tears, ranting and venting, his wife and his baby and God. And I hope Natalie’s recovering and sleeping well so that they all can get some rest tonight. God bless.

Tags: journal

1 response so far ↓

  • 1 enoch // Feb 6, 2004 at 11:19 pm

    thanks for your prayers, she’s better today, but still really clingy. Loved your post on managing 3. Gives me a view into how much it took my mom to raise me & my 2 brothers. More strength to you, mama! Our prayers are with you…