Walnut Creek, California, USA
|Image by Amira Athanasios|
Defining Medicine. The bolded script screamed at me from a massive poster hung six stories high along the side of the university hospital on my first day of medical school. Like most millennials, I pursued medicine with a deep conviction to make a difference. Coming from a humanities background, I was passionate about a health care that not only fixes bodies but also heals lives. I swooned during orientation as our dean quoted William Osler, “The secret of caring for the patient is caring for the patient.” However, in retrospect, I realized I had also chosen medicine out of an ill-conceived and exaggerated fear of that dreaded 9-to-5: the day in, day out, utter monotony with which I unfoundedly viewed the vast majority of daily life. In my naive mind, medicine could never be monotonous because it is primarily focused on caring for a patient: an ultimately intimate and sacred task.
Throughout my pre-clinical years, I held to these rosy platitudes. During study breaks I read doctors such as Oliver Sacks, Danielle Ofri, and Paul Kalanithi, and was excited when our lectures were interrupted by impassioned tangents on health policy or inspiring patient stories. The power of medicine to change lives made small glimmering appearances, leaving me eager for my third year, when I could finally experience the making a difference myself. During the first few months of third year I felt like a flailing fish out of water. I struggled not to forget any word uttered by our attendings, not take up too much space, not to lose my stethoscope, and not to forget to eat, sleep, or breathe. When I finally regained my confidence as a student doctor, I realized the one priority I had forgotten amidst my many anxieties was caring for my patient.
Towards the beginning of my psychiatry rotation, we admitted a young girl to the inpatient unit. My colleague was conducting the primary interview in the presence of the care team. It was clear that this girl was in a state of extreme mania as she stumbled over her words and dramatically recounted the details of her suicide attempt. In the middle of her story, somewhere between her jumping into the pool and finally arriving at the hospital my mind wandered. Caught in the middle of a day-dream, I suddenly heard the voice of my younger self screaming inside my own head: This, in front of you, is the dream you have worked for: this girl, this illness, this story. How dare you think of anything else! Not only was I part of this patient’s team and responsible for her care, but she was baring her soul in a call for help, a privilege to which I had become so accustomed from which now I was so easily distracted.
The whirlwind of third-year medical school, with its long clinical hours, on top of endless studying and trying to maintain some semblance of a balanced life, leave one emotionally drained. Yet I was shocked by how easily patients—their stories, their expectations—could be forgotten. I was even more shocked by how I forgot my patients almost as quickly as I began to know them. As I sat, untouched by this young girl’s narrative, she challenged my old fear of monotony. On further reflection, I realized that what I really feared was my own stagnation—that I could go through day after day without being changed myself. And this young girl with mania presented me with a greater fear still: that the very place to which I ran to avoid mundaneness has become mundane. If I could not be deeply affected by a patient’s story and the intimacy of such a relationship, then I indeed had succumbed to the monotony I had so feared and rejected. It was I who had become mundane, not the world or any profession!
Perhaps it is not so much about the work we do but the perspective we carry. A meaningful perspective will not only ease my existential fear, but also make me a better doctor. I recall a physician who said: “I see myself in every patient. It predisposes to emotional burnout, but it’s the only way I can practice.” While carrying the emotion of patients may feel burdensome, studies have shown that doctors who find meaning in their practice are actually better protected against burnout.
We all find meaning in different ways. This young girl reminded me to look for meaning by listening to, learning from, and remembering my patients’ stories. I will not remember every patient. At times my mind will wander to what’s for lunch during the patient encounter. I imagine I will always chuckle a bit at some of the naïve platitudes of my younger self. Nevertheless, I strive to start every day excited to be changed by my patients, and thank them for the constant reminder that it is in them that I find meaning as a doctor. I pray that holding to this perspective is what will make all the difference.
AMIRA ATHANASIOS is a fourth year medical student at the George Washington University. She graduated from Scripps College and is passionate about the intersections of gender, culture, religion, and medicine. She intends to pursue Child and Adolescent Psychiatry.