You certainly can't find your fulfillment in patients being grateful. If that's where your fulfillment lies, you'll be let down in every medical specialty out there. The numbers might vary a little, but in every specialty, you'll have a lot of patients that respect you and thank you, and you will have a lot of patients that treat you like a pill dispenser and you'll never be able to please them. Your fulfillment can't come from finding that perfect specialty with great patient care and no red tape, because they typically don't exist. It can't come from finding the specialty that is able to work outside of our deeply problematic healthcare system, or from anything else that really doesn't exist. Your fulfillment has to come from something that won't be broken by insurance companies, medical hierarchy, or ungrateful patients. I can't tell you where to find that fulfillment/meaning, but I can tell you where you won't find it. If your standards for happiness are salary, prestige, respect, or changing the world, you never really "achieve" those. You've got to be happy and fulfilled outside of work, and then with the work you choose to do every day. For me, the little things give me fulfillment. All of my jobs have been disappointments because we usually have unrealistic expectations going into a new job. But in the middle of entitled patients, insurance companies that work against you, and a broken healthcare system, you've got to find meaning, fulfillment, or "calling" in the one patient whose life you change, the one sick child you make smile and for a few seconds they forget that they're in a hospital when they should be outside playing with their friends. I know this is easier said than done, and specialties have different balances of good and bad, but you won't find one where only grateful people come down with the type of illness you work with. Find the area of medicine you're most interested in, and find fulfillment in the small things.
