Saturday, May 28, 2005

I want to be a doctor to help people...

Recently, a friend of mine who is at a crossroads in her life (she’s trying to decide whether or not to attend medical school) sent me an innocent email asking me to comment about why I ended up in medicine. Here is part of her note:

Often when we talk you mention wanting to be a part of change, something larger than yourself. What exactly do you want to change? What are you seeking to accomplish and how do you think medicine or having an MD helps you? If you had the option of doing something in your life differently what would you do?

Now initially, those look like harmless questions, but as I began to type my reply, I was forced to think about what I was saying instead of giving some superficial conversational response: ”Well, I was good at science, and I wanted to help people…” The more I tried to write coherently, the more I realized that there were some shadows cast in to that part of my self-consciousness. I realized that I did not have the answers accessible off the top of my head, and then I became concerned about what the answers might be if I probed deeper.

Now if someone asks these types of questions to your face, most people quickly formulate a logical response that reflects good past judgment and little regret in their life path. Most folks I know would not choose a casual conversation as an opportunity to examine the values and motivations that form their psychological foundation and risk discovering an array of unsound and incongruent ideas that are in imminent threat of collapse. However, when one is alone at a computer trying to type a brief but honest response, one risks entering into a level of introspection that exposes all of the internal dissonance that we usually are able to suppress by just staying busy.

But at this point, the lid on Pandora’s box is slightly ajar, and I want to take an honest assessment of myself. When I changed my career objective from engineering to medicine, I always used to brag, that I would always be willing to admit when something was not right for me, and I would never stay in a job or career, just because I had worked so long to achieve it. But that was easy to say when I was “throwing away” a couple of semesters of courses in materials science and unit operations (I studied chemical engineering in undergrad). Now that I have endured some real trials, the mindset of always being willing to throw my life into reverse seems more frightening. I have experienced some tribulation to get here. Residency has been especially arduous: the grueling call schedule, the verbal abuse from attending physicians, the sorrow of losing patients, the shame of making mistakes, the loneliness of a new city thousands of miles from your family, the insecurity of wondering if you measure up, the pain of being stuck by a needle or blade in the operating room, the anxiety of whether that needle or blade exposed you to HIV or Hepatitis C, the passing of your 20’s, the sacrifice of your personal life, and finally the heartache you endure as you come so close to human suffering everyday. I have to admit that after enduring all of this, I’m much less cavalier about the possibility of discovering that I need to make a U-turn on the road to fulfillment.

Even so, I feel that I should be courageous, and honestly examine myself and my career to assess whether I should continue down this path or not. More over, I should be courageous, because of who I claim to be spiritually. I should never be attached to anything in this life to the point that I am unwilling to follow God’s leading. If God revealed to me that medicine was not my path, I should have the faith to follow His lead, and know that He has a greater purpose for my life. My spirit is willing, but as usual the flesh is weak, so I feel “unsteady” as I examine the last eight years under the retrospectascope. Unsteady or not, I’m moving ahead...

Question #1: Often when we talk you mention wanting to be a part of change, something larger than yourself. What exactly do you want to change?

What do I want to change? To state it simply…I want to be a blessing to somebody. I want to be a servant, and meet someone’s need. I want to change someone's situation...for the better. Now I clearly did not have to go to medical school to serve my fellow man. I have to be honest here…when I decided to go to medical school, the career path fit my desire for service, but it also appealed to my bourgeois sensibilities of professional success. There is no denying the fact that as much as my mouth was saying “I want to be a doctor to help people”, there was a self-centered part of my heart that appreciated the social and financial rewards that are associated with medicine. Who am I kidding? I wanted to help people as long as I was pushing a fly whip, living in an obscenely expensive house, and was able to satisfy all of my worldly desires.

Now almost ten years later, my values have evolved. For instance, I’m much less concerned with my future earnings than I used to be. Don’t get me wrong, I would not mind a new car and owning a home, but those achievements seem inevitable at this point, and the difference between making $50,000 a year (what a resident makes), and $500,000 a year, is a transition from comfort to opulence. I actually fear making too much money, because with maturity, I can see the inherent problems that wealth brings.

I may have evolved in terms of my financial goals, but pride still inflates my desire for social respectability. Of course, medicine has been a big let down in this area. The prestige that I associated with being a physician has not come to fruition. Doctors are seen as villains as often as they are seen as saviors. Oh yeah, let me not forget all the attention from the opposite sex I’m supposed to enjoy. What woman wants a man who is never around, and when he is around, falls asleep every five minutes? On paper, women are attracted to surgeons…they are intelligent, successful, and capable…just like on paper, men are attracted to fashion models. But in reality, just like those fashion models are all image, and can turn out to be self absorbed, dim-witted, anorexics…so too, surgeons often turn out to be workaholic, sleep-deprived, grumpy, egomaniacs that are insufferable to be around. To be honest, I think my experience as a surgeon has had discernible effects on my personality, and I’d be lying to myself if I did not admit that some of these effects have eroded my amiability. The point I’m trying to get across is that being a physician is not usually conducive to healthy relationships, and that my personal life has suffered along this journey.

This brings me back to my reminiscing about why I chose a medical career ten years ago in the first place. Of course now, my desire to be a doctor is no longer augmented by the financial and social benefits, because: 1) I am less enamored with wealth, and 2) The social cost of medicine is higher than I thought it would be. So at this point in my life, when I say "I want to be a doctor to help people", I think my motives are less conflicted than they were ten years ago. But that leads me to the second question.

Question #2: What are you seeking to accomplish and how do you think medicine or having an MD helps you?

Like I alluded to before, it does not take a brain surgeon to help someone in need, so why am I still pursuing medicine? What am I seeking to accomplish? How does medicine help? It’s easy for me to say that I want to help people or serve my fellow man, but then never specify how I’m going to do it. This is the trademark banter of politicians, but I too engage in rhetorical humanitarianism with no pragmatic long-term service objective. Is it because I’m not sincere? I sincerely hope not. Actually, I honestly feel a great obligation to serve my fellow man. I have seen some of the most profound suffering during my time in hospitals, and I’m cognizant of the disadvantages that many people have to achieving any meaning in life. I, on the other hand, have enjoyed superb health, academic success, financial security, religious freedom, a loving family, and countless other blessings. When I survey the circumstances that life has placed me in, I can’t help but recall the words of Jesus recorded by Luke (12:48): “to whom much is given, much will be required”. (By the way, Luke was a well-educated Greek physician, unlike many of his gospel-writing contemporaries who were poorly educated second-class citizens of the Roman empire, so Luke knew what it meant to be richly blessed). I, like Luke, am aware that “much has been given” to me, and I can’t help but wonder what “will be required?”

One of the biggest spiritual anxieties I have is “what if I am not being sensitive to God’s instruction to serve?” This being said, I don’t feel that I have received some grand vision about God’s plan for my life. I believe He has a plan, but maybe I have not been ready to receive it. Maybe when the plan has been revealed to me, all I saw was a heavy cross to bear, and rejected it subconsciously. Or maybe God just gives me enough direction to take the next few steps (God’s word is a lamp unto my feet and a light unto my path - Psalm 119:105) I’m not sure, but in the meantime, I try to live each day and be sensitive to opportunities I have to express love and serve. Don’t get it twisted…I’m as flawed as the next man, and I’m not always successful at expressing love, and some days I’m down right self-absorbed. However, one of the great things about medicine is there are multiple opportunities to serve every day. Whether it be taking a few minutes to talk to patients or family members, or actually doing some therapeutic intervention (scalpel please). My job comes with many opportunities to help people. Now, maybe, this is what God’s plan is for me…to serve quietly one patient at a time, but I want to be prepared to do more if God has something else for me to do. That’s why I’m pre-occupied with falling in love with prestige and money, because I’d hate to be so in love with my career, that I would be unwilling to follow my calling out of medicine if that time came. Maybe all the education and training is just building up intellectual capital to be used at a later date in some other capacity. Luke was behind the scenes, likely attending to other sick Christians, but his detail-oriented medical training allowed him to record the most chronologically and thorough account of Jesus’ life, as well as the book of Acts which outlines the history of the early church. What I’m saying is that I’m content with medicine for now because it allows me to help people, pay my rent, and invest in myself simultaneously. I just pray that if the time comes to move on, I have the faith to go where I’m called…even if the cross appears too heavy to bear.

Question #3: If you had the option of doing something in your life differently what would you do?

This is the question that I was most worried about answering when I started trying to reply to the original email. However now that I have relented and uncovered my ears to any possible inner voices of dissent, I can see that there was nothing to fear. That wonderful thing called “spiritual perspective” has moved in and reminded me that life is fleeting anyway. I could get run over by a car on my way to church tomorrow morning. Why waste energy getting all worried about what I accomplish in my life in the future. I should be content with worrying about what I accomplish in the next 24 hours. What difference does it make whether or not I continue in medicine? Do I have the faith to believe that my life could have a purpose beyond medicine? The resounding answer is "yes" (at least in this moment of spiritual clarity). So, I can say I have no regrets because my experiences (good and bad) have shaped me, and to reject my past, would be to reject who I have become.

In my weaker moments, I judge myself as not smart enough, lazy, and unloveable, but I think most people do that from time to time. Fortunately, these feelings rarely last, as there is always a reminder that God has provided me with all the intelligence, energy, and love I need to be His disciple. So I would not do anything differently…I would still go to medical school and surgical residency, because, I am able to see now that my future is still wide open. It’s not limited by my past. I may very well live out my days as a quiet clinician helping my patients the best I can. Or, I might serve out my days in some position of great influence and authority. On the other hand, God’s plan for me might be to suffer or to die young, but regardless of the path, His mercy and grace will be sufficient to sustain me through whatever highs or lows I’m called to endure.

Well that was quite a journey through my mind. I feel like a great burden was lifted off me. I’m sure I will continue to have weak moments when I feel the weight of the pressures of the world wearing on me, and in those times I have to remember to “cast my burden on the Lord and He will sustain me” (Psalm 55:22).

Thanks to anyone who took the time to follow me through this “what if” experiment. I hope it has blessed you. It has certainly blessed me. Up until writing this, I have been very anxious about returning to residency in a year. This 2 year hiatus as a graduate student is probably the last oppurtunity I will have for a long time to reflect on the sacrifice that is required to be a surgeon. It’s hard to reflect objectively when you are in the midst of the trials of the work. But in this moment of clarity, I’m able to remember some important things. I remember that I still get a thrill when I make that first incision into someone’s abdomen. I remember that I still feel like a hero when I fix simple problems. I remember I still enjoy that awe that children show to someone in a white coat. I remember that I can still make someone’s day because a surgeon took the time to talk to them. I remember how much I love being part of a team of committed nurses, doctors, and therapists all working toward the same goal. Most of all, I remember that I still like being a doctor.

Your brother in the call to serve,
chad


I wanted to change the world. But I have found that the only thing one can be sure of changing is oneself.-Aldous Huxley-

3 Comments:

At Tue Jun 21, 08:32:00 PM, Blogger Mr. Wilson said...

I had to edit this shit for typos...it flew out of me too fast...delete the first one

That paragraph about the surgeon/fashion model is kind of interesting. I have always told people that I think for you, being a surgeon is a lot like it must be for a woman to be a lingerie model. it breeds these huge expectations and carries so much social significance that you, the invividual, might not get seen and noticed.

with that said, you are turning 31 next week, and you have been encountering women your whole life who have high expectations of you:
-expectations that you don't feel like sacrificing to meet,
-expectations you don't have the courage to risk not meeting, suffering through their reactions of disappointment and maybe even anger.

when you were a teenager, it was just that you were a handsome, well-mannered little fella that obviously had a future. and then you had that great family that appeared to be loving and capable of turning out some fairly well adjusted guy. in spite of all that you weren't the most arrogant dude on the block. of course you didn't want to dissappoint them by having feelings and desires that didn't make you the person they thought you might be and attracted them them in the first place...

in college you weren't a drinker and no one ever saw you making time with multiple women. you were distinguishing yourself academically in a difficult major that many thought took some kind of preternatural brilliance and discipline to succeed in. you had a car, you were in pretty good shape. this is who you were from a superficial perspective, but I am sure you were aware of your image and you did things to make you an attractive guy. what college guy doesn't? so you ate a lot of protein and actually cared about your appearance...i cannot show you many men that age who aren't compensating for something trying to be more desirable. its a product of the media and the american culture and you are lucky if you ever stop mitigating its hold on you own self-confidence. but no 20 year old should be expected to transcend. of course you were human too and any woman worth her salt was going to have to accept your limitations no matter how much promise you held.

in med school you really started to shine. top med school in the country, respected by your peers. deeply spiritual and concerned with being a good ethical human being without developing judgmental attitudes that lead to malice and anger towards others. i am sure the women are swirling around you at this point, but strangely it takes the self- confidence of a stipper in a jailhouse bachellor party to probably approach you so pretend you don't notice all of the attention. you feel guilt and ashamed for revelling in it at all and use it as evidence of your lack of maturity...never mind your own mother STILL obsesses over here wait and your father still blushes and beams with pride when someone pays him a compliment.

now you are a surgical resident...poised on the brink of financial success, it is amazing that you still manage to be so down to earth still asking more and more of yourself. your empathy for your patients and people in general is off the chart.
and you are writing this brilliant blog that gives access to your inner world. and you look upon yourself as someone who is going to ultimately disappoint a woman so why bother?

chad, i am sorry to tell you this but you are bullshitting yourself, primarily out of fear. you can rationalize that you don't meet a lot of suitable women up there in Lebanon, but MY friends call me to ask me how far New Hampshire is from Connecticutt and Boston on the off chance they can hang out with you when they are in New England. These are my friends...you are that great and amazing of a person to be around almost all of the time. I think it is your own fear of how they will react to you being human that you cannot overcome. So what if you are sometimes grumpy and irritable? Is that so hard to understand? You think having to put up with those things is the trial of Job, and you don't want to try anyone. Or maybe you don't know how to let them chose to suffer so you don't give them the option.

But you know what the real fear is. You fear your own power and how you have seen it consume women before. I see it in the way that you still try to act indifferent towards Cynthia just in case so that you don't feel like you might be keeping her on the hook. But what about your needs Chad? Why suffer alone so fearful of what you can do to a woman? Why assume that you cannot be good for people or that you have to protect them from you? Why assume that no one will be able to deal with the reality of you? I know the real you. I know how brutal you can be...I know how aloof you can be...I know the depths of all that stuff in you and I ain't scared and I love you just the same. There is a world of people out ther that will also love you in spite of all that but you have to be open to the idea and strong enough to weather the storm of disappointing them and angering them from time to time. Let them chose how to respond to those feelings every once in a while. Think of your own self just once.

Okay, maybe this whole commentary was me projecting my inner world on you, but I just see so many similarities in us, and actually I see some things in me that you seem to have going on exponentially. You are a complex dude. On the one hand you know you own superficial worth and you have made choices that increase that worth. But ultimately you have always known that making those choices meant there was a place in you that needed other people to find worth in you. There is no shame in that Chad. We all do things to be loved...and especially when we have been competing for it our entire lives.

Maybe I am way off base. If so just delete this comment from your blog...other than that...

your equally troubled brother

Kacy

 
At Thu Jun 23, 01:13:00 PM, Anonymous Zartactivist said...

So Chad,

Responding on this blog is very awkward for me, since I am slightly shy with regard to my personal philosophies, and am strangely extroverted in many other areas of my life.
Here’s to revealing myself to your other friends and family members (a little scary but I am now committed to doing things “afraid”).

I generally give you my opinion even when we disagree, which is actually not all that often. You can do with this what you want…

You are the prophet of your own life.

I think most people who call themselves Christians don’t really believe that statement.
Instead they over-spiritualize things and act as though God is a cosmic fatalist….yet, the reality is that people have significantly more control over their lives than they really want to admit.

At the end of the day, my opinion doesn’t really matter, but you know from years of experience that whatever it is, it will usually be grounded in the word...so here goes.

When you wrote that you’ve considered that “ God’s plan for you might be to suffer or to die young” 2 things immediatley popped into my head: Mathew 13:3 and Revelations 12:11

Mathew 13:3
"And he spake many things unto them in parables, saying, Behold, a sower went forth to sow…"
On it’s face, it is the most unprolific statement, but I think it’s revolutionary in that it reveals the character of our God. It occurred to me one day, several months ago that mankind operates in complete opposition to this statement.
The world system operates under a mechanism whereby we work like academic slaves, first, so we can “earn” a myriad of titles. Once you have the title, then you work like a dog to win the promotion, so you can gain greater accolades. We are trained monkeys in an approval addiction game. Hamsters on wheels, and mice with fair bait have a better chance of winning at that game babe.

It’s just like the Father though, to do things differently. He calls us “sowers” first. He calls us by our names, and THEN the action or faith steps follow. He walks us through the fulfillment of who we are to become.

Second thing...
Revelations 12:11
And they overcame him by the blood of the Lamb, and by the word of their testimony…
It doesn’t say that God’s testimony overcame….it says yours, by the word of YOUR testimony, Chad.
So what is your testimony really? You have what you do today because of what you’ve spoken over your life. My prayer for you for over a year has been for you to have wholeness in your life. Shalom! Nothing missing …and nothing broken…But if we’re not in agreement it doesn’t matter what I pray, or what anyone else does…you know the terms and results of agreement.
I am by no means saying that you should deny how you feel. This blogging thing seems to be cathartic for you, and by the way, I am not shocked or surprised by any of the things you’ve written because I already understood …(thoughts less blurry, and with more detail now though). Just don’t allow yourself to repeat Job’s mistake over and over again.
Job 3:25
"For the thing which I greatly feared is come upon me, and that which I was afraid of is come unto me."

(People seriously need to read this story and stop repeating the stupid phrase, ”the Lord giveth and the Lord taketh away”; that statement is proof positive that people really don’t actually READ the Bible, they just skim and then establish false doctrine on the basis of a catch phrase).

Sorry, venting…

So this entry actually gets no closure, because really it is an open door.

ZT

 
At Mon Sep 19, 11:11:00 AM, Blogger Morgan said...

Hmm, you answered it in a personal point of view yet explained it in a technical way. Well, there will always be different reasons. But I like when you said "I want to be a servant." Only a special few wish to serve others and you're one of 'em, Chad! Keep it up! You'll be blessed for your service. :)

~Morgan Humble

 

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