The day I quit medicine was a Thursday, in 2004.
I was a freshly minted intern, arriving at my teaching hospital with that uniquely confusing mix of optimism and imposter syndrome that had defined my medical education.
I thought I was ready.
Instead, I was hopelessly lost. 1/
I was a freshly minted intern, arriving at my teaching hospital with that uniquely confusing mix of optimism and imposter syndrome that had defined my medical education.
I thought I was ready.
Instead, I was hopelessly lost. 1/
Things came to a head early one Thursday morning.
I remember it was a Thursday, because I wanted so badly to have the coming weekend off. To have at least that to look forward to.
As I sat on the Orange Line subway, in Boston, a thought occurred to me.
I could quit. 2/
I remember it was a Thursday, because I wanted so badly to have the coming weekend off. To have at least that to look forward to.
As I sat on the Orange Line subway, in Boston, a thought occurred to me.
I could quit. 2/
Oh how easy it could be. To just sit there, and let the train doors close. Miss my stop.
A life without being paged, or being on call. Without so many decisions carrying such grave consequences. With free weekends, always.
A life outside of medicine.
An actual life. 3/
A life without being paged, or being on call. Without so many decisions carrying such grave consequences. With free weekends, always.
A life outside of medicine.
An actual life. 3/
And so I quit medicine.
Except not medicine on the whole.
Just medicine as I knew it.
I’d come too far, worked too hard, and cared too much to throw it all away now.
Instead, I decided to “reset” my relationship with medicine.
To stop being my own most brutal critic. 4/
Except not medicine on the whole.
Just medicine as I knew it.
I’d come too far, worked too hard, and cared too much to throw it all away now.
Instead, I decided to “reset” my relationship with medicine.
To stop being my own most brutal critic. 4/
I think about that moment often. How liberated I felt afterwards.
I had searched so long for the heart of medicine, only to realize it was still beating within me.
My passion.
I decided to set myself free, from the judgment of others.
I was here to learn, and I would. 5/
I had searched so long for the heart of medicine, only to realize it was still beating within me.
My passion.
I decided to set myself free, from the judgment of others.
I was here to learn, and I would. 5/
I got off the train, and went to work that day, and put all thoughts of quitting out of my mind.
Seventeen years later, I’m thinking about that moment again.
The reset.
I’m sitting in my car in the hospital parking lot, and I don’t want to get out. I want to keep driving. 6/
Seventeen years later, I’m thinking about that moment again.
The reset.
I’m sitting in my car in the hospital parking lot, and I don’t want to get out. I want to keep driving. 6/
Something inside me isn’t clicking the way it used to.
My job has become something it never was before, and yet always was: just a job.
I don’t know if it’s the creeping cynicism. The looming specter of the Monster emerging from the shadows yet again.
The futility of it. 7/
My job has become something it never was before, and yet always was: just a job.
I don’t know if it’s the creeping cynicism. The looming specter of the Monster emerging from the shadows yet again.
The futility of it. 7/
Maybe it’s knowing that I’m just a cog in the machine.
The constant noise, the climbing workload, the relentless pressure of bureaucracy and benchmarks.
I get out of my car, adjust my stethoscope around my neck, and head into the hospital.
Enough.
Time to find my faith. 8/
The constant noise, the climbing workload, the relentless pressure of bureaucracy and benchmarks.
I get out of my car, adjust my stethoscope around my neck, and head into the hospital.
Enough.
Time to find my faith. 8/
The funny thing about searching for something, is that when you finally stop searching, that’s when you see clearly. That’s when you find it.
I get on the elevator, and go up to one of the general medical floors.
I’m here to see a patient I’ve known for many years. 9/
I get on the elevator, and go up to one of the general medical floors.
I’m here to see a patient I’ve known for many years. 9/
She greets me with a smile, clasping my hand in both of hers.
Her room is filled with balloons, saying “happy birthday!”
I glance at her date of birth on my sign-out list. It isn’t her birthday.
“Who are the balloons for?”
She grins. “For Horatio!”
“Who’s Horatio?” 10/
Her room is filled with balloons, saying “happy birthday!”
I glance at her date of birth on my sign-out list. It isn’t her birthday.
“Who are the balloons for?”
She grins. “For Horatio!”
“Who’s Horatio?” 10/
She smiles gleefully, like she’s about to spill the beans on a major secret, “Horatio… is my kidney.”
She’s a kidney transplant recipient. I took care of her before her transplant, and now after.
“You named your kidney?”
She nods.
I can’t help but smile. “Why Horatio?” 11/
She’s a kidney transplant recipient. I took care of her before her transplant, and now after.
“You named your kidney?”
She nods.
I can’t help but smile. “Why Horatio?” 11/
“I love CSI, my favorite character is Horatio.”
As she speaks, a part of me is listening attentively. And a part of me is looking at these balloons that she got to celebrate the date of her kidney transplant.
Our worlds are built piece by piece, and every piece matters. 12/
As she speaks, a part of me is listening attentively. And a part of me is looking at these balloons that she got to celebrate the date of her kidney transplant.
Our worlds are built piece by piece, and every piece matters. 12/
We talk about her transplant function, she’s doing better. Then I mention that she looks tired, and the conversation takes an unexpected turn.
“Of course I’m tired Doctor T, I’m in a hospital.”
I sigh, “No sleep?”
She scoffs, “In here? Forget it!”
We both fall silent. 13/
“Of course I’m tired Doctor T, I’m in a hospital.”
I sigh, “No sleep?”
She scoffs, “In here? Forget it!”
We both fall silent. 13/
She breaks the silence. “You know, if hospitals really wanted to help patients, they’d let them sleep. Everyone else’s schedule would just have to accommodate the patient’s sleep.”
I nod.
She continues, “And hospital food should be delicious! Not tasteless, but real!” 14/
I nod.
She continues, “And hospital food should be delicious! Not tasteless, but real!” 14/
I remain silent, she’s on a roll.
“And you should encourage visitors. And make it easy to get your entire records for the stay. And have the most comfortable beds.”
I finally speak up, “Good sleep, good eats, good sheets.”
She laughs, “Yes! Just that. Simple things.” 15/
“And you should encourage visitors. And make it easy to get your entire records for the stay. And have the most comfortable beds.”
I finally speak up, “Good sleep, good eats, good sheets.”
She laughs, “Yes! Just that. Simple things.” 15/
I think about that. A hospital built from the ground up to center the patients.
Entire medication, and lab, and rounding schedules, and the very architecture itself, built around the patient experience alone.
Gourmet food from a variety of cuisines.
Quality sheets. 16/
Entire medication, and lab, and rounding schedules, and the very architecture itself, built around the patient experience alone.
Gourmet food from a variety of cuisines.
Quality sheets. 16/
No crushing bills awaiting the patient on discharge. Fully covered care for everyone, without the psychological weight of how to pay.
Diverse and empathic staff not under the pressure of productivity/profitability.
A reset on the modern hospital healthcare delivery system. 17/
Diverse and empathic staff not under the pressure of productivity/profitability.
A reset on the modern hospital healthcare delivery system. 17/
We finish our visit, and I move on with my day.
The interaction with my patient has reminded me of something crucial.
So much power lies in our ability to reset.
Reset our minds. Reset our paradigms. Reset our systems.
Be the reset.
The interaction with my patient has reminded me of something crucial.
So much power lies in our ability to reset.
Reset our minds. Reset our paradigms. Reset our systems.
Be the reset.
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