Culture Withdrawal

image credit: picserver.org

When I was first cutting back my hours to see if I could continue in medicine with a little more breathing room in my schedule (turns out, no), I got a bit of pushback about the "culture" of medicine in general, and ob/gyn in particular. And I get it. Doctors need to be there for their patients, and they should be there. But what happens when your doctor is out of town or unavailable? You either wait (if the situation allows) or you see someone else who doesn't know you or your history. That has obvious disadvantages for patient care, but I would argue that the disadvantages of sleep-deprived and/or burned out physicians can be just as significant. Is this "culture" a one-way street? Or a dead end?

When physicians go out into the world to practice, they have been taught that patients take priority over everything else, and of course this is true. But the problem with that way of life is that one's own life and family and pursuits are always going to come in second, at best. Patients are more important than your kid's piano recital. Than your wife's birthday. Than that one hour of sleep that you were hoping to get tonight. That is the necessary sacrifice in medicine, and thank heavens some people are willing to make it. Otherwise, who would deliver your baby at 3 in the morning or take out your appendix on the weekend? But not everyone is willing to make that sacrifice. And it's hard to know, when you're enrolling in medical school all bright-eyed and idealistic, exactly what that sacrifice is going to feel like when you are called on to make it. Oh sure, people try to warn you. But if you're like most medical students, you don't listen. Or you think it couldn't be that bad. Or you think that the person warning you is just jaded (which they are, but for good reason).

The topic of change seems to keep cropping up wherever I go - I see it in movies and read about it magazines. For example, I read a People magazine article featuring singer Tim McGraw; he said, "it got to a point in my life where the outcomes weren't the ones I wanted. I felt like changing was the only choice I had.." Now he was talking about quitting drinking, which isn't quite the same thing as walking away from one's career, but come to think of it, maybe there are some parallels after all. When I left medicine, I went through withdrawal. I continued to hear a "phantom pager" for about a year. Auditory hallucinations, check! I felt traumatized by the culture and lifestyle I had been a part of for over a decade. DTs? I had to re-establish relationships that had suffered from the hours I'd been working and the stress I'd been under. Is that one of the 12 steps?

It turns out that, like a lot of drinkers, I couldn't just "cut back" on medical practice. I had to quit cold turkey. And, like a lot of former drinkers, I tend to proselytize when asked about my conversion to a more normal lifestyle. I am filled with love and admiration for my former colleagues who can "hold their medicine," but I was just not one of them. Withdrawal was tough (see The Unhappy Known, among other posts), but now, 12 steps or so later, I am out the other side and life is grand.