Now that you, the reader, have become house staff, the time has come to change your mindset from one of competition to one of collaboration with your peers. The path that leads to achieving the MD or DO degree is one of often single-minded pursuit of academic victory. The competition has been fierce.
One of the trickier things to learn as a young doctor is how to navigate boundaries between patient, doctor, family and friends. Medical school teaches us that it is unethical to treat yourself or your close family due to a lack of objectivity that can affect judgement. It is fairly obvious why doing otherwise can create poor medical care due to blind spots created by subjectivity, hope, selective listening, personal agendas, and bias for a certain approach to treatment.
Medical training and practice exposes us simultaneously to the beauty and tragedy of life. As a resident, you are thrown into a strange world in which death will often sit as an unwanted companion in the room with you and your patient.
A page, an email, a text will request that you report to the program director’s office to have a conversation about a complaint against you. You are terrified, offended, maybe irritated. As you leave rounds to walk to the office, your adrenaline pumps.
I never thought it could possibly happen to me. As a practicing physician with an active chemical dependency to opiates and benzodiazepines, I fell down the rabbit hole with an intensity that I never believed possible. Although I am blessed and fortunate to have climbed out of that abyss, I have never forgotten some of the things that led me to the precipice.
I first heard of Yayoi Kusama last year when her spellbinding exhibit came to the Smithsonian’s Hirshhorn Museum and Sculpture Garden in Washington, D.C. Admittedly late to the international zeitgeist of Kusama, what initially drew me in was her story — a Japanese-American avant-garde artist who suffered from severe mental illness and successfully transformed that suffering into riveting artwork.
Every job is different, but my experiences so far have drawn a very stark contrast to life as a resident. Now imagine, if you can: you stroll into work at whatever time you want. You round on your patients, write notes and leave. The rest of the day you give verbal orders over the phone while you hang out at the beach.
Writing is the greatest self-excavation tool I have found. It was always something I enjoyed, but during my medical training it became something much more important than that.
George Orwell said, “If people cannot write well, they cannot think well, and if they cannot think well, others will do their thinking for them.” If Orwell was right, the profession of medicine and the patients it cares for could be in big trouble.
Danielle Ofri, MD, PhD, is a physician at Bellevue Hospital, the oldest public hospital in country. She writes about medicine and the doctor-patient connection for The New York Times and her writings have been featured in the Los Angeles Times, The Washington Post, the New England Journal of Medicine, the Lancet, and on CNN.com and National Public Radio. She is the author of four books, numerous essays, and the co-founder and editor-in-chief of the Bellevue Literary Review.
One of the most difficult transitions a young medical student makes is the graduation from bench science and classroom learning to the clinical application of knowledge in the clerkship years of training. Wide-eyed and at times naïve, physicians in training wade, or are sometimes thrown headlong, into life on the wards. These young doctors-to-be are inundated with patient stories; they bear witness to hardship and loss as the patients under their care are often at their nadir.
Dr. Christine Montross is an Assistant Professor of Psychiatry and Human Behavior and the Director of Counseling Resources at the Warren Alpert Medical School of Brown University. Her first, Body of Work, is a thoughtful meditation on medical school anatomy lab, the history of dissection and our fascination with the human body. In Falling into the Fire, Dr. Montross recounts striking cases from her psychiatry training, and the paradox of diagnosis when ambiguity is so rife in medicine.