Friday, January 25, 2008

The Next Wave of Doctors

This is the season for recruitment of the new wave of residents into postgraduate training programs at medical centers around the country. Young men and women, seniors in medical school, interview for positions in residency programs which provide them the practical training in their chosen fields. The time spent touring various programs offers each the opportunity to see firsthand what the hospital and teaching faculty offers to their individual educational goals. They dress in dark suits and their hair is combed, their faces fresh, enthusiastic, and young. They arrive in groups, often on a Friday and spend the day seeing and being seen (for our program directors are carefully sizing them up as well).

Today I saw a group of half a dozen of these young "doctors to be" escorted through our hospital, walking through the intensive care unit and the corridors outside the emergency room, led by a senior resident of our program who fielded questions and cast our program in the best possible light. Historically, our training programs fills easily; these are highly sought positions at a well respected hospital offering residency training in Internal Medicine, Surgery, Radiology, and Anesthesiology.

I must say, these applicants look younger all the time. I remember when I was in their shoes, dressed in my suit, stockings and low heeled pumps back in 1979. I interviewed for positions in Internal Medicine at programs throughout Texas and a few out-of-state locations. Denny and I were in our second year of marriage, 25 years old, and we applied as a couple which meant that either we both were accepted at the same institution or not at all. Our top choice was to stay put at U.T. Health Science Center at Houston and fortunately, that all worked out.

Now almost 30 years later, when I see these youthful faces, excited about their future in medicine, propelled forward by a genuine passion for their chosen fields, energetic, and eager to learn from mentors and colleagues, I'm reminded how much my life in the field has changed over this period of time. Obviously, I've lost some of the "hey wow" attitude and have gained an uncanny ability to predict (or at least not be surprised) by outcomes. I have matured and allowed experience, one day at a time to flourish. I have grown into the white coat and go about my daily tasks with a familiarity that is such second nature that I am barely conscious of how I move through my day. I am struck by the countless decisions that I make on behalf of those entrusted to my care. But I never forget how humbled I am by the many unpredictable twists and turns that mark each day, the fact that medicine never sleeps, and the uniqueness of each patient encounter. I am always grateful for the trust my patients place in my abilities and experience as I participate in the walk through the storm, be it minor or major.

For all my years in the profession, I am most in awe of our abilities as human beings; as caretakers, caregivers, and listeners, as people privileged to touch the raw edged souls of those in greatest need. Seemingly small gestures, choice of words, extra moments, a lighthearted comment, or even a tear at the right moment become hugely relevant to the connection. Today I sat with the parents of a patient who is critically ill. I chose to preface some disturbing news with the hopeful statement that their daughter's "youth and healthy body" were in her favor and that in my experience (the accumulating years offer me rich examples on which to base my comments) individuals in this particular predicament generally have a favorable outcome. The journey may be long, frustrating, and complex but hope, not in the form of a promise of success but a probability of a win, is the gift I can give to those most terrified. To see their tears, whether outwardly or inwardly expressed, to feel my own in the same way, to acknowledge the connection between us and to savor the powerful reminder that we are all indelibly linked one to another is the meaning. THIS is what we are called to do in tandem with the exercise of diagnosis and treatment.

So, to these youthful new recruits; go forth, learn, grow and experience just what it means to carry the terrifying, yet powerful and important burden of your chosen field. And step up to the plate quickly so that I can continue to step away. I have been there, I have seen, I have wept and I have laughed. There are wins and there are losses. But there is always a time when comfort, the only thing left to give, is the most important gift of all.

In fact, in 1979 when Denny and I graduated from medical school, we received a gift from his sister Maureen; a framed print of the quote..."To cure sometimes, to assuage often, to comfort always". We connected with these thoughts then in a simplistic way but as the years passed, with more understanding, depth, and recognition. This, young doctors, is "it".


  1. I am touched that you referred to the quote of so many years ago. In my profession of teaching there is always a whirlwind of politics and personal egos trying to divert my attention away from the reason I stay with this job: the children who have suffered emotionally at such a young age because they can't read. It never fails to give me chills when I hear a parent say, "Thank you for giving me back my child!" I looked through an old collection of quotes I've saved over the years and found this one which speaks to my heart:

    "He who helps a child helps humanity with an immediateness which no other help given to a human creature in any other stage of life can possibly give again."

  2. Wish this piece could be handed out to young hopeful new doctors. Filled with wisdom. An op-ed piece on NPR for their "This I Believe" stories? Worth downloading the criteria and editing a rewrite. This is good.


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