Sunday, November 26, 2006


It is isn't difficult to find the pain in life. It may even be easier in the world of blogging, since I think there's a remarkable tendency in people to be more open about the tragedy they experience in an online forum than in person. So today I wasn't particularly surprised when, following some links from another person's blog, I randomly found a blog that deals almost entirely with the pain the writer has experienced. What makes this even remotely relevant is the fact that her theme is infertility and she writes extensively about her relationship with physicians and midwives.

Obviously, if you've read any of my posts, I'm not going into OB/Gyn, but I was reminded in reading her words of two things. One, that medicine, to me, to the practicioner, is a job, albeit a very fulfilling one, but one that can easily be seen as just a job. It is entirely possible, and probably common, to drift into autopilot and see patients as nothing more than a set of problems to resolve.

Two, that this withdrawal into oneself, leads to very poor writing. People are interesting as people, and interesting to write about only as people. Unfortunately, the best writing comes from difficult circumstances. There is a reason stories end with "and they lived happily ever after": it's a great close if you like that kind of story, but it's a rotten opener. We want tension, dragon-slaying and damsel-rescuing first.

So this explains to me a few things. The reason I've had difficulty writing anything interesting (to me anyway) lately is that I've fallen into that tired, withdrawn state that regards patients as problems, for despite the fact that it sounds cliche (and really is, within medical writing) it is, oddly, true. And that to write anything interesting I need to be assisting people who are dealing with stress. When I'm writing, I'm generally happy, or at least fulfilled. So, where I am most happy is with patient contact in stressful situations. It's also where I find it easiest to see patients as people and be the kind of doctor I would want to have.

That's a lot of threads of reasoning left untied. If I may be indulged a general resolution paragraph, I'm trying to say that I've been writing poorly lately, due to the fact that I've not been enjoying my job, and I've been acting as the kind of doctor people love to hate, the kind that sees only the problem and not the person. It took reading a patient's perspective to return me to this healthier view of my profession. It is not my desire to be this kind of physician, and I realize to avoid being that type of physician, I need to deal with people who are sick, and I need to deal with them in a longer-term setting than consult cardiology.

This may also mean that cardiology isn't for me. Cardiology attracts a set of people who act more like surgeons towards their patients than any other medical subspecialty. They are great, and manage to maintain their humanity and compassion in that environment, but since I'm more the handholding type, that may not be my niche. We'll have to see.

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