Monday, August 13, 2012

What is a Doctor?

I am writing the first blog of my lifetime.  The word 'blog" was not part of my lexicon until the past decade.  That thought caused me to think about how I define the role of a doctor and how a doctor's life ensues.

When I first contemplated becoming a doctor, I asked my mother what she thought I should do for a career.  I grew up in Eastern Canada on an Irish potato farm and am the youngest of eight children.  Women had a very different role than men and were not deemed to be a lot of help on the farm.  My mother responded, “Well, you are a girl, so you could be a teacher, a secretary, or a nurse.”  I asked my best friend if I was smart enough to be a doctor and she replied, “No, I don’t think you are.”  So, I decided to make an appointment with the family doctor and ask him for direction.  I found his answers more helpful.

He encouraged me to apply to Dalhousie University in Halifax, Nova Scotia, an old, respected British University.  With that in mind, I completed the application by myself and sent the stamped envelope in the mail.  Much to my pleasure, I received an acceptance letter a few months later.  With no alternative back-up plan, I was on my way to start a new life, trying to get into medical school.

I thought that I wanted to be a doctor because I liked science and I felt joy from helping others, including animals.  My view of a doctor was similar to the Norman Rockwell picture.  Dr. Goodine, my family doctor, represented all of the positive virtues that an “All-American” or “All-Canadian” doctor could represent.  He cared for the entire family, diagnosed the myriad of health conditions that exist, and was a person you could trust and ask for guidance or talk to about life’s challenges.

I moved to Halifax at the age of 17.  I was a country girl, and everyone at Dalhousie looked smarter and better dressed than me.  There were 1,200 people in my first year biology class.  Little did I know that when I would show up for year two, there would only be 100.  Well, I was on my way making it through the pre-med requisites.  Not telling a soul that I would apply to medical school due to the fierce competition and my very realistic fear of not making the cut.

The day that the acceptance letter from Memorial University School of Medicine in Newfoundland arrived, I called and spoke with my father.  I was eager to learn the results and asked him to read it for me.  He asked for me to wait until my mother returned from her hair appointment so she could read it.  Feeling desperate to learn the news, I pressured him into opening it.

Having to quit school in the 3rd grade to help support his 14 siblings, my father was embarrassed by his poor reading skills, but nonetheless slowly read the formal letter.  I felt so sorry that I had embarrassed and pressured him into showing me this.  I dealt with the emotion of feeling so honored that he was willing to disclose this deficit in light of how much it mattered to me.  Yes, I had been accepted to medical school.  I thought I had won the lotto!

After completing four years in Newfoundland, my vision of being a doctor changed a bit.  I was not living the “image of the country doctor” anymore.  Instead, I was someone who trained in a large, up-to-date medical facility in a city located in the far north, serving the residents of Newfoundland, Labrador, The Northwest Territories and anyone visiting the northeastern part of Canada.

Being a graduate of MUN meant you would be someone that would make the med school proud.  You would show humility, care for your patients, and be grateful for having had the opportunity to do so every day of your life.  You would have had a lot of hands on experience.  In med school, I had delivered over 100 babies, was able to reduce a simple fracture, run a code, suture a laceration, and perform a history and physical.  With this experience, I then decided to move to the USA and study Internal Medicine in Akron, Ohio.  Surely, I was well prepared.

When I started my internship in Akron, my first patient was a man who had tried to end his life with a gun and we were to harvest his organs.  I had never seen a gunshot wound, let alone something that was this terrible.  I came to learn what “clinic patients” were.  I thought that the residency program had saved the sicker patients for us since we were studying Internal Medicine.  I soon realized that these were people with Medicaid or no insurance.  They were just sicker because they were so poor.  Not sure if I understood, but I loved caring for these people.

By the end of the three year residency, being a doctor meant running the ICU/CCU, resuscitating people, taking care of very sick people in the hospital and sometimes working 36-48 hours straight.  Being the only woman in my program initially felt strange.  Most of my role models were men, and that was fine.  All in all, it was good, but different than I had expected.

When I graduated at age 28 as a Board Certified Internal Medicine Specialist and started private practice, being a doctor meant working all night, taking care of in-hospital patients, and working all day, taking care of outpatients.  Sometimes, I would leave the office for an emergency and get to come back and care for those patients who had no choice but wait.

When my son David was born, the next door office became a nursery.  Being a doctor then meant caring for my patients and a baby, while running a practice.  David would accompany me to the hospital on rounds as he grew.  Nurses were terrified to see this new woman doctor coming to the hospital and ICU with her baby.

With one year of bed confinement from the complications of overzealous use of IVF medications, I would have the time to learn other ways to heal.  Boredom forced me to take a distance learning Complimentary Medicine Course.  I would learn how to help patients in ways that were not restricted to drugs and surgery, and I would listen to the science and studies supporting these claims.  After bringing three more children into the world, I would learn a very new way to be a doctor.  I would learn over time how to help people in an integrative manner.  Busy times.

Now, I am 53 years old.  I have been a doctor for 28 years.  I do not go to the hospital anymore.  All patients are outpatient.  My concept of being a doctor has changed yet again.  I think that being a doctor requires us to help people help themselves, live their optimal life, avoid drugs and surgeries if possible, stay fit in body and mind, and find life-work balance.

Occasionally, making a new diagnosis improves a patient’s life.  More often, talking with him/her and helping that person sort his/her life out brings relief.  Rather than just reaching for another pill, I can refer to the highly skilled team of Integrative Providers at Nova to help the patient find the best way for them to achieve wellness.  What I treat is no longer the mere absence of disease.  My greatest teachers have been my coworkers and my patients.

I have the privilege to work with 150 wonderful people at Nova who support me and the patients every day.  In their specific jobs and with their unique training and experience, the team of caregivers and support staff cause Nova patients to feel cared for and respected.  Being a doctor has allowed me to learn so many things other than medicine.

I wonder what I will think being a doctor is in five years, or even 10 years?  It really is the best career I could have ever had.  Thanks to an admission committee that believed in me, too.    

In Health,