Monday, April 23, 2007

Slowing down

Osler was a bit of a bore, truly. I got about 300 pages into the 1200 page behemoth of Cushing's work and decided to switch to Michael Bliss's bio, which at 700 something pages seemed more manageable. Cushing wrote to an audience already familiar with Osler, in an atmosphere of hero-worship. Bliss, though certainly not as accomplished a writer, had the advantage of distance in time from his subject, and gave a perspective I could more easily understand. Still portraying a medical hero, surely, but without assuming I already knew why he was heroic.

But as heroes go, I found Osler more demotivating than otherwise. He certainly had an incredible amount of energy and a singular drive to learn everything he could about medicine. And he balanced his pursuits with reading classics and modern literature, so what's not to love? But I think, upon reaching the end of four years of toil towards an almost mythical end, with "MD" on a paper after my name, that I'm a bit demotivated. Certainly, the end is exciting, but I have to re-examine my motivations for coming to medical school. Most of my friends through high school and beyond wanted to go into medicine, or at least we all said we did. I often point to that as the reason I got here at all: peer pressure. Is that going to be enough to sustain me in residency? Time will tell. But reading about Osler, who published over 700 articles in his lifetime, while writing a textbook that would become the standard work for some 50 years, leaves this particular audience feeling inadequate.

But more than just Osler, my motivation for work has been pretty slim. Given the freedom of a month almost entirely without responsibility, I've been desperately visiting all the museums and restaurants the metropolis has to offer that I've missed in the past years while studying. I've been catching up on reading for fun, sometimes combining the two pursuits, sitting outside some particularly interesting animal's cage at the zoo while poring over the Patrick O'Brian novel I'm finishing. (and as an aside, I find that the higher the animal, the more disheartening the sight of them in a zoo. Fish are fine, and the smaller birds seem to enjoy their large faux-jungle enclosure, but I could see in the eyes of an orangutan the same look I've noticed in depressed patients.) All of this has left little time or inclination towards medical reflection.

I have, however, found a place to live at my residency site, begun packing my things, and started the process of saying goodbye to friends, beginning indolently the next step in this journey. 25 days to go till graduation.

3 comments:

tinea said...

Whatever motivations got you into medical school, there was very little chance that they would continue to be your reasons for staying. That doesn't mean you are in a career that you shouldn't be in. Your old posts show how much you can love being a doctor and can be inspired by what you do. You've chosen a career in which you will be challenged, and as hard as that can be, it makes it all that much more worthwhile - even if you don't produce hundreds upon hundreds of publications...

Besides, Erdos (with his 1500+ math articles) makes Osler look like a slacker.

Enjoy the break while you have it. Soon the countdown will be in the single digits...

Nathan said...

Ah yes, but Erdos was a mathematician who co-wrote most of his papers, while Osler spread his energies over classics, history, basic sciences, comparative anatomy, pathology and medicine, authoring and completely rewriting a textbok through seven editions.

All that said though, Osler's primary contribution to medicine was an attitude, not a body of knowledge per se. The essential difference in the disciplines is that much of medicine is interpersonal, and must be learned at the bedside. It is quite possible to dwell in a hole and be a phenomonal mathematician. Perhaps even desirable. :P

medstudentitis said...

I think from reading all of your posts it points to something much greater than peer pressure as tinea said. We all change our reasons for doing the things we do as we grow and we try on new explanations for who we are. I hope you find a new reason that fits like a glove and sustains you through residency. I have no doubt that there are a million reasons why you'll be a great doctor, your empathy and compassion for patients being one of them.