a thankful cynic.
Cynics (Κυνικοί, Cynici) were an influential group of philosophers from the ancient school of Cynicism. Their philosophy was that the purpose of life was to live a life of Virtue in agreement with Nature. ...
en.wikipedia.org/wiki/Cynic
It is well know that it is intolerable to be around a group of physicians together when you are "an outsider" (someone not in medicine), and we all acknowledge that fact.. I was with a couple tonight while at work who mentioned over our paper-plated "Thanksgiving dinner" they were thankful they are not both in medicine. I agreed with the sentiment immediately. I have never dated someone in medicine and have no intention to ever do so... It is probably nice on some level to have someone who understands your frustrations and feelings and schedule, but at the same time, I do plenty of that work via introspection of myself and chatting with colleagues.. I need to get away from that crap sometimes.
In medicine, we often just kind of talk and vent to each other about experiences when we get together. It's probably similar in any profession, I imagine... and there are some things that may (and probably do) come off as crass and uncaring to other people, but we are also just people dealing with difficult stuff and tend to channel our experiences together for a sort of support system. It's not meant to be offensive or derogatory toward the patients or violate the patient/doctor relationship, but I have heard many times that it is intolerable to be around if you are not in medicine. Like we are speaking a foreign language.. A crass, demeaning, offensive foreign language.
I got to thinking and writing tonight about about the topic of my job as an educator in medicine. A friend, who is a high school teacher, recently made an observation to me that he feels educators in general "don't care," and then specifically also that medical professionals don't care. He made this observation after being around a group of residents at a social event. It's an unfortunate and incorrect perception. I am not a teacher, but I am definitely an educator in my profession. In fact, it's most of my job to teach patients about how to take care of themselves and their loved ones and why and when and how often and until what end.. So I think I can relate. I believe that no one would do this often frustrating job of teaching, whether in schools or being physicians, if they didn't care on an innate level.. Mainly because it's so. damned. hard. This job would simply not be worth it in any realm if you didn't believe or hope that you are doing something good in the end.
It's recruiting season in residency. The time of year when we get bi-weekly batches of starry-eyed applicants to our program - young idealists who have no clue yet about how hard it will be - mingling in November with burnt out residents who are struggling with their decision and the many sacrifices it has entailed... I can't speak for everyone, but as for myself, it was the most challenging experience I've had.. I have changed. But I think this job has had some tremendous rewards and has offered me insights to lives of others that no other job would have offered. It has allowed me access to privacies and secrets of other people, forced me to explain newly discovered life-changing diagnoses to patients, and to experience intense sadnesses and frustrations that I did not know existed.. and all this on a very personal level involving other human beings.
I often say I "hate my job." Like that, BAM. It sucks, I hate it... But reflecting tonight, while at work, I think it is worth disclaiming my hatred of my job with the fact that I also work very hard. It was hard for me to imagine working 80 hours a week on a regular basis before residency. Now it is routine and relatively easy. It is all still intensely challenging and will continue to be so, from many different aspects.. From the perspective of the complexity of the academics and broad scope of medicine, to the fascinating but puzzling ethics of many cases, to finally the knowledge that no matter what we do or think or how hard we work, we are ultimately not in control of what will happen... there is this variable of "fate" that constantly evades us... no matter how much we know or control or how hard we work.. And it changed me a great deal to live through this experience..
My "regret for the decision to become a doctor" came within a context. It is not the full story to put my words in that way.. I am a human being going through an incredibly taxing experience, and I am reacting the way many other human beings do when they are put through the meat grinder of residency.
It's interesting, I remember thinking something very distinctly in my intern year. I remember seeing a senior resident who exuded so much bitterness and was so jaded and cynical.. And I thought, "If I ever become that way, I'm quitting." Well, I have very often been that way now. In fact, more often than not. I have found that the real grit of life and medicine -- the stuff that doesn't get edited or played -- will often make me feel quite cynical. Residency made me that way because I am no longer in fairy tail land of school learning calculus or physiology. Instead, suddenly I am being paged to the ER at 3am after not sleeping for 21 hours to admit a drunk alcoholic with Hep C who hocks a loogie directly into my mouth... So why haven't I stuck to my promise and quit? It's a good question. I tried, I thought about it and still do.. I have become every bit as cynical as my colleague.. So why am I still here?.. I think mainly because I don't think it is fair to say I have become "uncaring" because I am now cynical.. But more accurately that I have drastically changed my perspective.. things disappoint me and I react.. But also the things that make me happy have changed.. Like the fact that I am truly thankful to be working a 14 hour shift tonight, on Thanksgiving... I remember working a call shift on Thanksgiving at the children's hospital my intern year and being so bitter about it... then working night float for both Christmas and New Years, and hating my life.. But now I am thankful, because the fact that I am working tonight means I had some free time during the day today to go skiing for a few hours which is something that I love and makes me very happy.. Perspective changes.
It is impossible to survive this without some element of cynicism.. Here is one story. I admitted a kid the other night in his early 20s. He was actively dying. We didn't know why and couldn't find family members, but we suspected a drug overdose/ingestion... although his tox screens were all negative. We had to intubate him and artificially breathe for him and put him on medications to support his heart so that he could get enough blood to his brain. We didn't know if he would ever wake up or whether his brain would still work when he did... The police helped us to finally find family after he had been here for several days.. Every number we tried was disconnected or would not answer.. The police finally broke into his mother's house to find her neck slashed.. When the patient finally woke up, he admitted to murdering his mother and then trying to kill himself... We discharged him straight to jail..
How 'bout this one? A 13 year old patient recently established with me. She's almost 300lb. With diabetes, chronic pelvic pain, and endometriosis.. She got admitted to the hospital and the doctor called me concerned that she's requesting oxycontin for her back pain... Apparently, her mom's been giving it to her...
These are the types of things we are often dealing with and struggling with when we are baseline sleep deprived and working hard. Never knowing what the right thing is, often learning that many times our efforts are futile anyway.. We get people again and again - "bouncebacks" we call them - with the same problems over and over and going round and round in circles... but we continue because of the hope that the cycle will break. And also, perhaps mainly, for the ones who are not going in circles....
I recently saw that same resident again now after she has finished residency and started her first job... the one who appeared so sad and jaded and cynical.. The one I feared to become.. And she was glowing. She is so thankful for how rewarding and manageable her career is so far.. She is getting enough sleep and her perspective has shifted again. This is the dream residency promises us..
I think often it is better to acknowledge and give voice to our discontents and disappointments, and then also to accept them and move on, having learned and experienced something new... I think when we are honest with ourselves about how we feel, we move ever so slightly toward that golden prize of both becoming who we want to be and also finding who we want to be with..
So now, here I am. I haven't quit yet. But I have changed. I'm no longer hopeful and/or continually disappointed that I may be able to fix things, resolve injustices, or solve problems that are out of my control.. Instead, I am now thankful for things like making a dying person more at peace by listening, for explaining something to a patient who didn't understand before, for continually learning and being surprised every day... and yes, I am also thankful that I "don't care" as much anymore about "failing" when we get bouncebacks, when people are hurtful toward me unjustly, when bad things happen to good people, when I make mistakes, because all that caring about everything was destroying me... and I had to learn to let some of it go in order to move forward.. but it came with some cynicism..
My perspective just changed. And I'm thankful for that. Here's to hoping it will change again. This time for the better.
It is well know that it is intolerable to be around a group of physicians together when you are "an outsider" (someone not in medicine), and we all acknowledge that fact.. I was with a couple tonight while at work who mentioned over our paper-plated "Thanksgiving dinner" they were thankful they are not both in medicine. I agreed with the sentiment immediately. I have never dated someone in medicine and have no intention to ever do so... It is probably nice on some level to have someone who understands your frustrations and feelings and schedule, but at the same time, I do plenty of that work via introspection of myself and chatting with colleagues.. I need to get away from that crap sometimes.
In medicine, we often just kind of talk and vent to each other about experiences when we get together. It's probably similar in any profession, I imagine... and there are some things that may (and probably do) come off as crass and uncaring to other people, but we are also just people dealing with difficult stuff and tend to channel our experiences together for a sort of support system. It's not meant to be offensive or derogatory toward the patients or violate the patient/doctor relationship, but I have heard many times that it is intolerable to be around if you are not in medicine. Like we are speaking a foreign language.. A crass, demeaning, offensive foreign language.
I got to thinking and writing tonight about about the topic of my job as an educator in medicine. A friend, who is a high school teacher, recently made an observation to me that he feels educators in general "don't care," and then specifically also that medical professionals don't care. He made this observation after being around a group of residents at a social event. It's an unfortunate and incorrect perception. I am not a teacher, but I am definitely an educator in my profession. In fact, it's most of my job to teach patients about how to take care of themselves and their loved ones and why and when and how often and until what end.. So I think I can relate. I believe that no one would do this often frustrating job of teaching, whether in schools or being physicians, if they didn't care on an innate level.. Mainly because it's so. damned. hard. This job would simply not be worth it in any realm if you didn't believe or hope that you are doing something good in the end.
It's recruiting season in residency. The time of year when we get bi-weekly batches of starry-eyed applicants to our program - young idealists who have no clue yet about how hard it will be - mingling in November with burnt out residents who are struggling with their decision and the many sacrifices it has entailed... I can't speak for everyone, but as for myself, it was the most challenging experience I've had.. I have changed. But I think this job has had some tremendous rewards and has offered me insights to lives of others that no other job would have offered. It has allowed me access to privacies and secrets of other people, forced me to explain newly discovered life-changing diagnoses to patients, and to experience intense sadnesses and frustrations that I did not know existed.. and all this on a very personal level involving other human beings.
I often say I "hate my job." Like that, BAM. It sucks, I hate it... But reflecting tonight, while at work, I think it is worth disclaiming my hatred of my job with the fact that I also work very hard. It was hard for me to imagine working 80 hours a week on a regular basis before residency. Now it is routine and relatively easy. It is all still intensely challenging and will continue to be so, from many different aspects.. From the perspective of the complexity of the academics and broad scope of medicine, to the fascinating but puzzling ethics of many cases, to finally the knowledge that no matter what we do or think or how hard we work, we are ultimately not in control of what will happen... there is this variable of "fate" that constantly evades us... no matter how much we know or control or how hard we work.. And it changed me a great deal to live through this experience..
My "regret for the decision to become a doctor" came within a context. It is not the full story to put my words in that way.. I am a human being going through an incredibly taxing experience, and I am reacting the way many other human beings do when they are put through the meat grinder of residency.
It's interesting, I remember thinking something very distinctly in my intern year. I remember seeing a senior resident who exuded so much bitterness and was so jaded and cynical.. And I thought, "If I ever become that way, I'm quitting." Well, I have very often been that way now. In fact, more often than not. I have found that the real grit of life and medicine -- the stuff that doesn't get edited or played -- will often make me feel quite cynical. Residency made me that way because I am no longer in fairy tail land of school learning calculus or physiology. Instead, suddenly I am being paged to the ER at 3am after not sleeping for 21 hours to admit a drunk alcoholic with Hep C who hocks a loogie directly into my mouth... So why haven't I stuck to my promise and quit? It's a good question. I tried, I thought about it and still do.. I have become every bit as cynical as my colleague.. So why am I still here?.. I think mainly because I don't think it is fair to say I have become "uncaring" because I am now cynical.. But more accurately that I have drastically changed my perspective.. things disappoint me and I react.. But also the things that make me happy have changed.. Like the fact that I am truly thankful to be working a 14 hour shift tonight, on Thanksgiving... I remember working a call shift on Thanksgiving at the children's hospital my intern year and being so bitter about it... then working night float for both Christmas and New Years, and hating my life.. But now I am thankful, because the fact that I am working tonight means I had some free time during the day today to go skiing for a few hours which is something that I love and makes me very happy.. Perspective changes.
It is impossible to survive this without some element of cynicism.. Here is one story. I admitted a kid the other night in his early 20s. He was actively dying. We didn't know why and couldn't find family members, but we suspected a drug overdose/ingestion... although his tox screens were all negative. We had to intubate him and artificially breathe for him and put him on medications to support his heart so that he could get enough blood to his brain. We didn't know if he would ever wake up or whether his brain would still work when he did... The police helped us to finally find family after he had been here for several days.. Every number we tried was disconnected or would not answer.. The police finally broke into his mother's house to find her neck slashed.. When the patient finally woke up, he admitted to murdering his mother and then trying to kill himself... We discharged him straight to jail..
How 'bout this one? A 13 year old patient recently established with me. She's almost 300lb. With diabetes, chronic pelvic pain, and endometriosis.. She got admitted to the hospital and the doctor called me concerned that she's requesting oxycontin for her back pain... Apparently, her mom's been giving it to her...
These are the types of things we are often dealing with and struggling with when we are baseline sleep deprived and working hard. Never knowing what the right thing is, often learning that many times our efforts are futile anyway.. We get people again and again - "bouncebacks" we call them - with the same problems over and over and going round and round in circles... but we continue because of the hope that the cycle will break. And also, perhaps mainly, for the ones who are not going in circles....
I recently saw that same resident again now after she has finished residency and started her first job... the one who appeared so sad and jaded and cynical.. The one I feared to become.. And she was glowing. She is so thankful for how rewarding and manageable her career is so far.. She is getting enough sleep and her perspective has shifted again. This is the dream residency promises us..
I think often it is better to acknowledge and give voice to our discontents and disappointments, and then also to accept them and move on, having learned and experienced something new... I think when we are honest with ourselves about how we feel, we move ever so slightly toward that golden prize of both becoming who we want to be and also finding who we want to be with..
So now, here I am. I haven't quit yet. But I have changed. I'm no longer hopeful and/or continually disappointed that I may be able to fix things, resolve injustices, or solve problems that are out of my control.. Instead, I am now thankful for things like making a dying person more at peace by listening, for explaining something to a patient who didn't understand before, for continually learning and being surprised every day... and yes, I am also thankful that I "don't care" as much anymore about "failing" when we get bouncebacks, when people are hurtful toward me unjustly, when bad things happen to good people, when I make mistakes, because all that caring about everything was destroying me... and I had to learn to let some of it go in order to move forward.. but it came with some cynicism..
My perspective just changed. And I'm thankful for that. Here's to hoping it will change again. This time for the better.
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"Idealism is what precedes experience, cynicism is what follows."-David Wolf
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"The power of accurate observation is commonly called cynicism by those who have not got it."-George Bernard Shaw
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"Life is not an easy matter... You cannot live through it without falling into frustration and cynicism unless you have before you a great idea which raises you above personal misery, above weakness, above all kinds of perfidy and baseness." -Leon Trotsky
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"Cynic, n: a blackguard whose faulty vision sees things as they are, not as they ought to be."-Ambrose Bierce
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"Most cynics are really crushed romantics: they've been hurt, they're sensitive, and their cynicism is a shell that's protecting this tiny, dear part in them that's still alive." -Jeff Bridges
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