Wednesday, March 16, 2016

Thrivers and Survivors

Hey, I'm on Twitter! I'm now reachable by people that haven't had the (dis)pleasure of knowing me all these years. With that in mind, it's time to reveal a little more about my professional self.

I'm done with clinical medicine. Perhaps not permanently, but indefinitely. I might do a locum here or there, dabble in this or that, but my days as a full-time, card-carrying general practitioner are over.

What's so unusual about that, you ask? There are blog posts and Facebook groups and op-eds all over the place with doctors throwing out their stethoscopes and walking away. My dissatisfaction, however, has nothing to do with lifestyle, paperwork, or money. It's about where I do and don't fit in as a doctor.

I've written a 70,000+ word book detailing my journeyman's career in medicine. Needless to say the story can't be whittled into a single blog post. However, reading this from a past President of the Canadian Medical Association gave me pause:

The thrust of the opinion piece (tirade?) is that doctors are in it too much for themselves, and society is getting fed up with it. Medicine is not a 9-5 job, and doctors need to hold themselves accountable as professionals.

My first thought reading it? What a dick. Not that being a dick is necessarily bad...

Sorry, couldn't resist...I am, after all, an Asshole. But more to the point, I think the author is expecting all doctors to project character traits that many of them do not, and probably cannot, possess.

Since my days as an intern, I've found that there are essentially three kinds of doctors. The first are the docs that thrive on medicine. We all know someone like this. They aren't necessarily alpha types, overbearing, or even big-headed. They just have an unquenchable passion for medicine and are energized by the work. They're the born big-H heroes.

The majority of doctors thrive in the work. They're fulfilled by medicine, enjoy medicine, and feel duty-bound to the practice of medicine. Once in a while, however, they need to step away to stay human.

(Yes, I'm a geek for Classical Studies and comic book movies. Sue me.)

I fall into the third category of doctor, the minority of MDs that don't thrive but merely survive. Residency feels like an ordeal, if not just a prolonged hazing ritual. The work is enjoyable at times, but is often just drudgery. You do what you have to do to get by, not shirking your duties but finding little thrill in their discharge. The risk for burnout and substance problems in Survivors is high.

I'm not sure medicine can ever move forward until doctors reconcile themselves to these core differences between one another. The Thrivers-on can set the example but shouldn't assume only they should call the shots. The Thrivers-in should be unafraid to advocate for what's fair to them as professionals working many long years in a high-stress job. And the Survivors? Do your damnedest to find your happy niche, roll with the punches from your colleagues...and never be afraid to get help. If you have to, don't be afraid to walk away either.

Walking away might seem like the most irresponsible thing you can do--a flip of the bird at the taxpayers that subsidized your education, and a betrayal of suffering people that desperately need help--but it isn't. Sometimes it's the only way to preserve your sense of humanity or family life. It's the alternatives to quitting that are much, much worse.

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