Monday, October 10, 2011

I am, too, committed (or maybe I should be)

I’ve been away for a while now, birthing, or perhaps mid-wifing, two books. For me, editing seeps into writing and rewriting for others, to the point where I am not sure whether I wish I’d said that, or I did say that. What on earth was I thinking, involving myself in two projects with competing deadlines, and then volunteering to write an index?

Now that everything is in the uber-editor’s inbox, I can blog again. It feels like when my last child got her driver’s license and could get herself to school on her own, or when my first child finally slept through the night, or the day they all were in school for a full six hours, or the first weekend that they all went to grandma’s, or…

Here is what I didn’t have time to write in May: At graduation, I again heard the speech about putting patients first, sacrificing ourselves to medicine. I could see all the graduating students, especially the women, looking vaguely shifty-eyed, wondering what those exhortations would mean to them and their hopes for a full and balanced life.

I think beyond valuing the contribution of privileged males, medicine suffers from its institutional history. The structures of medicine and medical education are eerily like those of the Catholic Church and the military—institutions in which celibate young men with great physical stamina have the greatest value in perpetuating the institution. I do believe in the value of altruism, selflessness, and commitment—but I also believe these can be expressed in many contexts. When I am in the office, I will do for my patients whatever I can, above and beyond what they pay me to do. When I am on call, I stay late. But I do not think that I am any less of a dedicated professional (a word originally applied to priests) because I also worked part time for many years while my children were younger, pursue hobbies now that they are grown, and comfortably wear many different hats and uniforms, depending on the day.

I wish that just once the graduation speaker would say this out loud—it is, after all, what all of us, men and women, really do and mean in our lives after training.


  1. Juliaink -

    As a 2nd year medical student, your comments about the limits and levels of sacrificing yourself to medicine resonate with me. At my school, we are frequently reminded that medicine needs to be the number one priority in our lives, that it is more important than anything else - including our family etc. etc. The underlying theme of this message is that if you aren't willing to do this, you not only won't be a good doctor but you will be neglecting your duty to society as well.

    I'm very happy with my decision to enter this field and I aspire to be the most competent and compassionate doctor I can be, but I resent the idea that my future job needs to always, always, always be more important than anything else in my life. Obviously I'm far from being a practicing physician and perhaps my views will change, but at the moment this dogma strikes me as extreme and untenable for the majority of future physicians. I'm sick of feeling guilty (and selfish) for not holding this view, so thanks for your post on the matter.

  2. well put. i hope you have the opportunity to give that speech one day.

  3. Congratulations on reaching an endpoint with your recent projects! That is such a great feeling.

    I find the parallels with the military and the Catholic Church interesting and astute. I'm not sure I would have seen that without prompting. But you are right. Just as women and married men could certainly add value to the Catholic Church, so physicians devoted to family as well as medicine can add value to patient care.

    I can't help but think that a physician with extracurricular life experiences can connect better with patients than one wrapped up in medicine to the exclusion of all else. (Maybe the physician suicide rate would drop, too, if more of us had a better lifestyle.)

  4. I should have said, "female and married male priests" instead of "women and married men," sorry!

  5. Instead, we can just quietly reassure those around us that a balanced life can be had... and you can still be a good doctor. I know this idea has been appealing to men and women in this institution for a while, thanks to the women who brought the idea into our profession.

  6. Hey dr julialink, congratulations on giving birth to, or is it parenting/nurturing the writing of 2 (TWO!) books, amidst everything else you do, and do so sincerely. I am looking forward to reading these someday soon!


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