Being a physician

When I was a boy, the doctor was God – or in my case, Goddess, as the pediatrician was female. Dr. Nutting knew all, soothed all. She had all the answers. Probably she did a lot of ‘wait and watch’ and palliative care and mere assurance, but even those mawkish interventions were curative. Just going to see her made me feel better. It was she and what sort of doctor she portrayed inspired me to go into medicine.
That was 30 years ago at least; not only I have changed but so has Medicine. I did not become a pediatrician, when I learned this is mostly dealing with parents. When I went to my medical advisor to inform him I no longer wanted to pursue cardiology but psychiatry, his countenance dropped as if I had said I was dropping out of school to join a commune. He advised against it. Psychiatry was hard work. It paid badly. But mostly it would consist of dealing with people no one else can stand. Not very promising words.

By the way, they don’t teach you well in medical school how to choose a specialty. Most go by ‘gee, I like the heart, so I will be a cardiologist”. Rather, one needs to consider
a) what kinds of problems you like to work upon, and must they be ‘complete”?
b) do you like to work with your hands or your mind?
c) when you like to work on them?
d) how important is it to be adored by patients and public?
If the answers are
a) human behavior
b) the mind
c) 8AM-5PM, M-F thank you very much
d) not at all
– then psychiatry is the way to go.
Cardiology is plumbing, and procedures, and dealing with patients 24/7. After my umpteenth case of heart failure, one day on rounds I had a case of a man with heart failure who attempted suicide by swallowing razorblades. This intrigued me. How did the man have such conviction to do such an act. What did it ‘mean’? My fellow cardiologists could not care less; they wanted to know what his digoxin level was. I realized then I liked working with my head and in matters of the mind.

In a later entry, I will write about how one becomes a shrink.