Wednesday, December 11, 2013

A Different Perspective

The title for this topic week is change; specifically how becoming a doctor alters one's life.  There is no question of change, only how.  For me, the most profound change is the perspective I have gained from training and experience, which has been both comforting and distressing.  The ultimate goal is to find a balance in the enjoyment of what you do despite the inside look at inherent system and personal flaws that are revealed on that long journey.

As a pathologist in a large group practice, I work intimately with my co-workers sharing tough cases.  As a fresh trainee I had a lot more defenses built up about showing a "stupid" consult.  Over time, as I have become more comfortable and developed relationships with my partners, it has become easier.  Some cases are diagnostically challenging, and just as a clinician doesn't always nail the patient's disease with the first test they order, a first glance at the tissue doesn't always provide clarity into the disease process.  Even though we are all trained to render similar services, we each have our strengths and weaknesses based on training level and personality types, and I am thankful that I do not practice solo because we are so much better as a team.  And I don't mean just us pathologists - I am also thankful that I can open the EMR and get input from radiology, pulmonology, oncology, and all the clinicians or just pick up the phone.  Communication often makes a difficult case crystal clear.

Numerous recent articles are highlighting the drawbacks of our medical system, and having inside perspective makes a lot of it ring true.  "You're Getting Too Much Healthcare" by Jamie Santa Cruz was published in The Atlantic this week and Elizabeth Rosenthal is doing an illuminating series in the New York Times I have been following called "Paying Till It Hurts."  Sure, every system has its positives and negatives, but it's easy to become disillusioned when you get first hand experience navigating the real world and jumping through all the hoops that seem distant from your idealistic image of yourself as a pure patient advocate.  One of the most challenging things I work on is finding value and purpose in the many things I do that help the patient, and not getting too frustrated over the more mundane and nonsensical aspects of medicine that I witness - many of which appear business driven.  Having a rich life outside of work with children, family, relationship, friends, exercise, etc. - all of that helps round out the negatives.  An alternative would be to bail on the system - something I have witnessed a handful or so of my classmates do over the last ten plus years since I have graduated.  They have found happy and fulfilling lives outside of medicine.  I don't think there is a wrong choice; everyone has their own path to follow.  Mine is certainly in constant evolution.

Up to this point in my journey, I have shed a lot of the insecurities of youth but gained insecurities of experience; the latter being much more tolerable and rationally tackled through knowledge and resources.  I have been elated by success and ravaged by missteps.  I have been buoyed by support from this community of women and also retreated from it to nurture myself and my kids.  Change is inevitable when you choose this road.  Although some of it feels reactionary, which can yield cynicism and doubt, the most important changes are those gained from knowledge and experience - lifelong processes - the kind of glacial change that affects your core being.  This kind of change brings a sense of control, purpose, maturity, and peace into your daily challenges and decision making, both inside and outside of the hospital.

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