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Choices on Becoming A Healer
Why do people go into medicine? Or become social workers? Or psychologists? Or naturopaths and homeopaths? Why go through years of training and gruesome, unpaid clinical internships? Why not go into economics or weapons manufacturing or lobbying?
I know why my father did. He walked back and forth to the NYU medical school campus every day from the north Bronx because he loved medicine. He loved the science of it, the magic of it, the relief it brought to people who were suffering. Now, 89 years old and no longer practicing, he still becomes giddy just talking about it. Still goes to Grand Rounds at the hospital. Still reads the journals from front to back, even the ads.
In those early days when I was very little, he got up when there was an emergency, picked up that worn, alligator bag and headed out for a "house call" (imagine that!) at three in the morning. He got paid for his time--nothing wrong with that. But he didn't worry about what some bureaucrat was going to say about whether it was "warranted" or not. He went because he was needed. Even if it was more hand-holding than anything else.
I am as certain as I can be of anything in this fallen world that my father did NOT go into medicine to get rich or famous. He didn't have dreams of being on that day's equivalent of Oprah or being hailed as the great new magic man by the New York Times. He never imagined what the insurance companies would do to medicine. He did his job and took care of his family. He worked hard, took jobs sometimes that he didn't like so much, and helped people out. As it turned out, we were never poor and that was enough for us.
Now, it's a different story. Although I know there are many young people who still have the heart and soul to join Doctors without Borders or head out with the Peace Corps or sign up for clinic jobs with poor, hurting, sick people in small, dusty towns along the southern edge of New Mexico, there are way more who are vying for the top spots in the lucrative specialties (cosmetic surgery, dermatology) that will get them Park Avenue salaries, status, and something to really twitter about.
It's not all their fault, I admit. Expectations about doctors have changed on our parts, too. They're being trained by pharmaceutical companies instead of independent physicians. And we've made the fatal error of setting them up as demi-gods and demanding that they do the impossible. So, now (as opposed to when my father had his practice) when something bad happens, we sue them. It's the McDonald's coffee cup syndrome. We stick burning hot coffee between our legs as we drive and then haul everyone but our own poor judgment into court. We eat too much, sit too much, and whine too much. Then when we get sick, we want it to go away fast so we can eat too much again. If my father had had a patient like that years ago, he wouldn't have given him a pill. He would've read him the riot act.
What's happened to us? What's happened to doctors?
The Ultimate Disconnect: Doctors as Participating Providers instead of Community Memberse hH
The other day a patient told a story of how she got her first kitten. It wasn't anything like what one might expect. As it turned out, her family doctor was over for dinner with his wife andhehad found a kitten.
"Your doctor came over for dinner?" I asked, truly surprised.
"Yeah, he always did. He was like part of our family," she sat back with her memory like she was reading a favorite old book.
"He was your doctor and your parents' doctor?" I wondered stupidly.
"Yeah, why?"
The last time I heard about a doctor visiting a patient's house to celebrate a social occasion was the last time I watched Little House on the Prairie.
In professional practice those boundary crossings are utterly verboten. I know of one social worker (who's really an administrator, not a therapist) who won't even acknowledge a patient in public unless the patient comes up to him first. And even then he's as circumspect as a mouse in a cat house. And I can't remember the last time I was alone with a doctor. In both exams and consultations, there is always a nurse or assistant present as a live witness to ward off the evil spirits of the legal system.
