Think Carefully Before Jumping

[ChemMed]

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Below is an excerpt from my diary now that I am in residency for internal medicine. I reread it often because I do think this way on my bad days and the points are valid. Now I should say that I don't regret the choice I made. 70% of the time I like what I do, but when the days are bad they can be really bad.

All I ask is that people think carefully before jumping into this path. You are smart. You are trying. You deserve to let yourself have time contemplating what medicine really can mean. Often you are coming from a prior career like I did. This forum helped me out alot when I was changing careers so this is my controversial contribution.

Think Carefully Before Jumping:

"I can't quite because my life is based on my training. My finances are ****ed but I'm done. I want 7 days on and 7 days off. I want to live again. I want to worry about the color of my socks and not about the dying patient in ICU rm 4 who is 94 and still full code; meaning I have to break her ribs to perform CPR because that is how it is effective and the family can't ****ing decide to let this poor woman go to god.

I want to hike a mountain and discover the science in nature once more. I want to be allowed to be curious w/o breaking my mind over another person’s rules. I want to create. I want to do art. I want to dance. I don’t want to deal w/ societies **** ups any longer. Welcome to medicine kids. Hope your hard work will be worth it… "

 

[yogurt0531]

Sounds like you are a little burned out.

 

[cabinbuilder]

No, not burned out. Just giving the reality of residency and beyond depending on what you ultimate career path your residency takes you. I love my job 95% of the time but do agree that families don't every come to decisions easily and dealing with a 90+ person in ICU who is still a full code really sucks. Just like the people who come into urgent care with their shoulder pain that has been there for a year and 1) expect you to magically make the pain go away TODAY, or 2) don't like any of the options placed before them and get upset when you are not the orthopedic surgeon and can't just "do something". OR the mom with a kid who has vomited once who wants medicine to make it stop because heaven forbid vomiting is such a bad thing. Or the kid with the 103F temp who has been burning up all day due to ear infection and the mom hasn't given any tylenol and wonders if antibiotics are really necessary because, "we don't take medicine in our family". And why did you come into urgent care for help? Sigh.... this is the world we live in, the life of a doctor.

 

[ChemMed]

Cabinbuilder is right. I am not burned out. Expect to have these types of days in medicine, especially residency. They can be bad, but having an outlet to deal with the emotions is important, because you are human. I rock climb, ski, read and cuddle with the 80lb hound that lives on my couch.

I do my job and most the time I'm actually helping people get better. That feels good. There are a lot of uncontrollable factors though like POAs who want their 94 year old mother full code when she is legitimately passing on and the younger sibling who disagrees or the fist fight that happens in the hospital hallway over it. Yes, that has happened. Other things are what Cabinbuilder mentioned. Other things involve lack of insurance for legitimately sick frequent fliers like the repeat offender DKA patient who kept coming in not because he wasn't compliant but that he couldn't literally afford the medications.

One of our attendings realized this and now he goes to his office for medicine pro bono. There are kind people in this field. We get into it because some part of us is altruistic. We are fighting a system that doesn't really care about that part though and that is frustrating. I do it because when you have the good days they can be just as good as that bad day I posted. Knowing though that this is what medicine is I think is what is important to realize. It is an uphill battle to actually give good quality care sometimes and people who want to enter this field should at least be aware of that.

 

[yogurt0531]

I guess my experience working as a nurse has toughened up my heart. There is only so much you can do for your patients. Beyond that, I offer my empathy but I don't feel bad because of the things I am not capable of doing.

 

[Gurby]

I want to hike a mountain and discover the science in nature once more. I want to be allowed to be curious w/o breaking my mind over another person’s rules. I want to create. I want to do art. I want to dance. I don’t want to deal w/ societies **** ups any longer. Welcome to medicine kids. Hope your hard work will be worth it… "

I've often thought to myself that being a doctor is probably kind of like being one of the X-Men.

Being Wolverine would probably be pretty awesome, and you'd always be saving the day which would be cool. It's a lot of responsibility though, and you don't really have any influence over your work schedule! Becoming a doctor is not so much signing up for a job as it is dedicating your life to something (though I gather it is possible to achieve a more normal work-life balance in many fields if that is very important to you).

 

[bashwell]

I've often thought to myself that being a doctor is probably kind of like being one of the X-Men.

Being Wolverine would probably be pretty awesome, and you'd always be saving the day which would be cool. It's a lot of responsibility though, and you don't really have any influence over your work schedule! Becoming a doctor is not so much signing up for a job as it is dedicating your life to something (though I gather it is possible to achieve a more normal work-life balance in many fields if that is very important to you).

It's more like sometimes saving the day, sometimes delivering bad news, sometimes doing neither but instead lots and lots of mundane stuff like rounding, paperwork for hours on end, etc.

It also depends on what you mean by "saving the day". I suspect most premed students think "saving the day" means something like saving a crashing patient, but that's not what most doctors do on a daily basis. Don't get me wrong, we do important work, and "save the day" in many different ways (e.g. a radiologist or pathologist diagnosing a malignant tumor, an endocrinologist helping a patient control their diabetes, a pediatrician giving vaccinations, a gastroenterologist managing GERD), but these ways aren't usually considered "exciting". Sure, most specialties have their exciting cases, but check out the bread and butter cases that each field most commonly sees to get a more balanced view.

I prefer to say what the Scrubs theme song says: "I'm no Superman".

 

[Law2Doc]

I've often thought to myself that being a doctor is probably kind of like being one of the X-Men.

Being Wolverine would probably be pretty awesome, and you'd always be saving the day which would be cool. It's a lot of responsibility though, and you don't really have any influence over your work schedule! Becoming a doctor is not so much signing up for a job as it is dedicating your life to something (though I gather it is possible to achieve a more normal work-life balance in many fields if that is very important to you).

I think OPs point is you wouldn't be Wolverine. You'd be more like Rogue -- in seclusion other than at work, not able to enjoy time with family or friends...

 

[Labrat07]

I have no doubt in my mind that posts like this came from good intentions. But do you really think it'll persuade premed to change their mind?? You were in their shoes once. You should know the answer. IMO, the best advice you can give is shadow a lot, work with patient contact a lot... Even then, it's not a sure way to know if it's for you or not. Those experience just scratch the surface. It depends on the person. We have to walk it. Most of us are stubborn fools anyway. Hopefully, some have the courage to quit early if they know it's not for them. I'm pretty sure most of us will agree with you in the future but that's not a certainty.

 

[gmbz]

Some food for thought, There are some Non-trads that are at dead end jobs, or places that do not allow any critical thinking whatsoever. To those people all of the doom and gloom might be not.

I will never forget meeting this male nurse that was in his 60's when I was back in nursing school. He technically was the highest paid staff employee at the hospital. He worked 6 12 hour shift's a week (3 over time / pick up). I asked him if he got burnt out doing this one day. He laughed and stated that for 15 years before going into nursing school he was a used car salesmen working 70+ hours a week making nothing and not enjoying himself. To him, this was amazing, hard work, but rewarding and paying well.

Perspective is everything imho.

 

[pageantry]

Some food for thought, There are some Non-trads that are at dead end jobs, or places that do not allow any critical thinking whatsoever. To those people all of the doom and gloom might be not. ...

Perspective is everything imho.

Before I started down this path I was in a job where I was sexually harassed at least once a week. Therapy and going back to school saved my life.

That sounds extreme, but working conditions like that are not actually all that uncommon, if you're a woman and poor. I'm lucky that I come from a socioeconomic background that let me imagine I might "deserve" something better (nobody deserves anything.)

I'm grateful I'll have a job which, even if the intellectual work becomes rote, still has a lot of inherent opportunity to create meaningful interactions. And I won't be as vulnerable due to poverty or perceived class/educational distinctions. I can make sure women around me are less vulnerable in those ways too. And if anyone tries to assault me I'll get three orderlies to strap 'em to a gurney.

Anyway, that's what I think about when people complain about medicine not being as wonderful as they think it ought to be.

 

[cabinbuilder]

Some food for thought, There are some Non-trads that are at dead end jobs, or places that do not allow any critical thinking whatsoever. To those people all of the doom and gloom might be not.

I will never forget meeting this male nurse that was in his 60's when I was back in nursing school. He technically was the highest paid staff employee at the hospital. He worked 6 12 hour shift's a week (3 over time / pick up). I asked him if he got burnt out doing this one day. He laughed and stated that for 15 years before going into nursing school he was a used car salesmen working 70+ hours a week making nothing and not enjoying himself. To him, this was amazing, hard work, but rewarding and paying well.

Perspective is everything imho.

THIS: I was homeless, scraped by paycheck to paycheck. Lived without running water for 5 years and took showers at work. I am so thankful every day that I got to be a doctor. That I will always have a job. That I will never be homeless again. That I will always be able to make money, etc. I went to med school with 2 small children, I wanted a better less hard life for them.

It is about perspective because the alternative really sucked. Been there.

 

[QuesoFresco]

THIS: I was homeless, scraped by patycheck to paycheck. Lived without running water for 5 years and took showers at work. I am so thankful every day that I got to be a doctor. That I will always have a job. That I will never be homeless again. That I will always be able to make money, etc.

It is about perspective because the alternative really sucked. Been there.

Exactly. In grad school, I always wondered if I could cut it in a medical program. If I was intelligent and hard-working enough to make it through. While I don't regret anything I've learned in my MSW and find it will be extremely relevant in medicine, it helped me to appreciate myself more fully. Other graduate students complain about deadlines, the work load, and their field placements. Most do not work while in school. I on the other hand worked two jobs through undergrad, saved up money in a full-time job paying about $35K, returned to graduate school, and still work 2 part-time jobs with a 15 hour course load (that includes a 20 hour a week field placement). There are days I work from 5AM - 7PM and only after getting home do I start homework or research. I took out federal loans but the bare minimum to try and stave off debt. Even still, no one paid for my education but me - it was always something I just had to do. I do well in school for scholarships and eat from a WIC cookbook. When I think about medical school, my honest to god first thought it always, "I can't wait to focus intently on one thing." I know that's not 100% accurate or fair to med students, but you get my meaning.

That being said, the OP has a point and it is just as important to consider. As a creative person, I worry about getting into this field and losing a very important part of myself. And what about traveling, writing, and hiking? Those things are part of my self-care. Will I burn out without those? Maybe. I'm lucky however; most of my FOMO has subsided into my thirties because staying at home is just as much (if not more) fun than going out. Can everyone shelve their interests for an extended time and flounder in anonymity while training? No. This sentiment is probably for them.

Important points all around. TL;DR: I am poor.

 

[QuesoFresco]

And for some reason this post appeared twice and I can't delete the latter.

TL;DR: I'm poor and unable to make internet work.

 

[QofQuimica]

I've often thought to myself that being a doctor is probably kind of like being one of the X-Men.

No, it's more like a dream I once had as a resident where I was standing outside of my house on a beach, watching a giant tidal wave come toward me. The wave got taller and taller and came closer and closer, until it was towering over me. As it began to break and crash down upon my puny house and body, my response was to take the deepest breath I could and hold it. Because while you know you can't fix the total devastation that is our medical system, somehow you still can't accept total defeat and give up altogether. And sometimes even the smallest act of resistance can still do some good.

BTW, welcome back, Chem. Glad to see you here again.

 

[pageantry]

Holy crap, Q, that describes how I feel about medicine PERFECTLY.

So scared to go under but, for me, there's nowhere else to go.

 

[QofQuimica]

Holy crap, Q, that describes how I feel about medicine PERFECTLY.

So scared to go under but, for me, there's nowhere else to go.

Well, I don't pretend to be any expert at interpreting dreams, but this one didn't take much interpreting. 😉