Tuesday, August 26, 2008

The Speech I Never Gave

Being on a medical school faculty, I have just listened to a slew of speeches welcoming the new students. Everyone from older students to the dean exhorted the students to be diligent, caring, dedicated and so on, and tried to capture the transformation that occurs between layman and doctor. The students all seemed overwhelmed, being told medicine would be a rewarding but all consuming life. While the speakers honored the families from whom the students came, none said anything to reassure them that their future lives might include families of their own. I listened with the ears of the lonely single woman I was on my first day of medical school, and I felt the mixture of aspiration and despair the dean’s vision evoked.

As my family has observed, I always want to be the bride at every wedding and the corpse at every wake. Sitting there, I tried to think what I would want to tell the students, especially the incoming women, about what lies ahead. I suspect a more feminine image of devotion and change might have been of comfort to them. After all, they are joining a profession, not a convent or a monastery.

Becoming a doctor, I would have said, is a lot like becoming a mother. When you imagine it, based on the images of motherhood that surround you, the vicarious experience of friends or family, and your own experience as a child, you imagine the change occurs suddenly and thoroughly. The baby is placed in your arms, you expect to be flooded with tenderness, to know what to do in every circumstance, and to have the respect of those around you. In fact, the process is gradual. The day you find out you are carrying a child is like the day you get your medical school acceptance letter. The child grows in your mind and occupies many different roles before it ever becomes a flesh and blood reality. How many different specialties did we practice in our heads, before we put on our first white jacket and tried to find a comfortable place to stash the stethoscope? Delivering the baby, like the first day in anatomy lab, doesn’t suddenly make you a mom, or a doctor, not the way you imagined it would. It takes time, sleepless nights, anxious days, moments of profound resentment and moments of even greater tenderness before you fall in love with this child, a love that evolves and changes as the child becomes more and more complex and separate from you. As with medicine, the more fully you embrace this new focal point in your life, the more your inner sense of self changes. Various milestones—the child’s smile, the end of your first period of exams—mark progress toward your new self, but the real transformation occurs privately. It can be sudden—the day someone calls you mommy, or doctor, and you don’t jump. More often, it is retrospective. You look back and realize that somewhere in the past few weeks, months or years, you have become what you and others have expected for so long—still yourself, yet profoundly and irrevocably other than what you were the day you first began to dream.

Do not be afraid, I would have said to them. The sacrifices you will be making will not be more than you can bear, and the rewards will be more than you can imagine.

12 comments:

  1. Thank you so much for writing that. I am a mother of 3 and am in the process of applying for medical school for next year. I often struggle with what the reality of meshing being a mother and being a physician will look like. I often worry that these two passions in my will spend most of their time butting heads. Thank you for saying it will be worth it--just what I needed to hear tonight. :)

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  2. Beautiful. I needed this tonight.

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  3. This is such a wonderful metaphor and a beautiful speech. I would have loved to hear you give this.

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  4. I really appreciate you drawing the comparison of becoming a doctor to becoming a mother.

    I wrote previously: "Deep down inside, the pager tells doctors that they are wanted, needed, even yearned for. Feeling the soft buzz of a hospital pager likely excites the same reward-center of the brain as during suckling and oxytocin-induced milk ejection. The pager is a technological marvel for bringing doctors the sensation of being needed like a nursing mother on an instantaneous basis: even in the dead of night and asleep in a comfortable bed, the doctor will arise and dutifully provide life-healing sustenance for the patient."

    Adding some imagery of breast-feeding an infant as an allegory of responding to hospital pages, I think, would greatly augment your already fantastic speech.

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  5. As a mother and a pre-med student just embarking on this life-changing journey, this was a phenomenal post for me. Thank you.

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  6. As a mother and a pre-med student just embarking on this life-changing journey, this was a phenomenal post for me. Thank you.

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  7. Medschoolmommy and Kelley,

    Reading your comments gave me a warm smile.

    I became a mommy in residency, fellowship, and private practice. All enhanced my experience of being a doctor and my capabilities as a doctor.

    Yes, both parenting and doctoring are challenging, but also rewarding and changing all the time.

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  8. You are absolutely right-this is what I was thinking and feeling during our white coat ceremony three years ago. And although I am not a mother (yet), I had serious doubts about being able to pull it all off after listening to everyone during my orientation week of medical school. I am now in my fourth year, engaged and trying to listen to strong women like you when planning my future. Thanks so much for the post!

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  9. just beautiful and so true. i hope you're able to make the speech out loud next time!

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  10. Thank you for that.

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  11. I missed this the first time around. What a great post!

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  12. I know this is way after the fact but thank you for this post . Its no secret that the journey will be hard, however that is all we hear, thank you for providing hope and making the struggle sound doable and worth it. Whatever class of incoming students gets to actually hear your speech, their journey will be better because of it.

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