Thursday, March 30, 2006


"Our number one responsibility as doctors is to convince our patients not to take medicine"
-One of my teachers

. . .

I think I'm starting to pinpoint what strikes me as weird about peds, at least part of it. All doctors are sarcastic. And more than occasionally, they are sarcastic about their patients. There's even an article in the most recent issue of the New England Journal of Medicine discssing physician humor and how it is occassionally inappropriate. Tellingly, it was written by a med student. But that's an aside.

I was saying, doctors are sarcastic. And pediatricians are no different. But since I like kids, and think most of them are pretty cute, it is jarring to hear the sarcastic commentary I expect from physicians stemming from the cute 18 month old we just saw. Maybe, subconsciously, there's an element of "you deserve this because of your lifestyle choices" underlying the bitter humor on a medicine ward. I feel on peds like the disciples questioning Jesus: "Who sinned, this man or his father, that he was born blind?"

Of course, in neither instance is the dark humor justified. I'm here, after all, because it's my calling to care for these people, no matter how they got their hurts. Which is why military doctors in Iraq care for insurgents as well as American and coalition troops. It's our responsibility. But I think the dark humor is a release, a way of distancing ourselves from the sick, because though we may want to care for the sick, we don't want to be the sick. I don't know. I'm just figuring this out.


MrStandfast said...

Somehow I feel it needs to be said that doctors are people too. I think doctors forget that more than the rest of us. I guess what I really mean is, if I have to take a recorded statement from someone for a slip and fall in Marcus Hook, Steve leans out of his cubicle and goes "hey you want me to knock a few teeth out of your mouth before you go down there? I'd hate for you not to fit in."

There's something dark in that as well, and I guess you could make the case for innapropriate.
People don't like death. We don't like the smell, the taste, or the thought. We like frailty and decay almost less, it just reminds us of death without having the decency to actually be death. It's insidious like Tim the Ostler.

I imagine that dark humor is a release. Like the majority of "releases" though, I think it ammounts to a kind of giving up, or hopelessness at least. I think it comes from something weary and regrettable, and I think we ought to fight against it. I cannot think it's responsible for me to ridicule people any more than it is for a doctor, and certainly no less.
I come back to my first comment. Doctors are elevated in society for a couple of reasons. I think the foremost one is because they are proof that we're civilized, and that we can defend ourselves from the omnipresent enemy of decay in all its forms. It is partially because they're highly educated, but that's only because of the first reason. Also, so are lawyers and accountants and they are despised and neglected respectively. But you are all of you no different than your patients, and one might think that to be the underlying source of this dark humor.

Does it come from a weary disdain for people in pain? An assumption of being so far above the petty and sick world? Or from the nagging suspicion that you might be next. I imagine it's both.

MrStandfast said...

That sounded more bitter than I meant it to. I love doctors. I'm related to one.

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