My Motivation

I was going to post this later, after HC:Part 4, but I’ve been inspired by the last line of PalMD’s post here. Part 4 is coming tomorrow.

In the short life of this blog a number of commentors and emailers have asked what my motivation is. They usually mean to imply that I’m a pharma shill, or that I don’t care about children. Offensive implications aside, it’s still a good question. The answer is the same as the answer I give to another question: Why do I want to be a doctor?

Why have I decided to spend 4 years in college, 4 years in medical school, and 3-7 years in post-medical-school training just to be a doctor.

 I get asked if I do it for the money. A lot. I don’t do it for the money. In fact right now, I have more debt in student loans than my parent’s mortgage. Since my bachelors is in engineering, I’ve put off earning pretty decent money for 7 to 10 years, which balances out that salary thing quite a bit. So no, not the money.

I get asked if I do it because I have a God complex. Admittedly I’m not the most humble person in the world. This was true long before med school, and will be true long afterwards. But it’s a big stretch to say I have a God complex.

I get asked a hundred other silly questions. Is it because medicine is just cool? Notably one surgical patient said “It must be because yesterday you got to have your hand in my belly, it’s either that, or the nurses… it must be the nurses.” I have the utmost of respect for nurses, and the patient in question did too, I think that was the morphine talking. No it’s not any of those.

I’m in medicine now, because I can’t think of a more beautiful profession. As doctors, we hold the most sacred of all trusts. It is the most intimate of all relationships. In my training, people tell me secrets that they won’t even tell their spouses, or their children. Sometimes I elicit secrets they even try to hide from themselves.

 No one is more vulnerable, more laid bare, than a patient in need. With all of our talk of patient autonomy, in reality, you place your life in someone else’s trust when you go to a doctor.

Patients, and we are all patients – today, tomorrow, some day, we are all patients –  place our lives, and our loved ones in doctors’ hands.

When you see a doctor, the good ones aren’t motivated by that insurance payout, though that’s necessary to pay the bills. They aren’t motivated by how interesting the human body is, though it is more captivating than anything else in existence. The best doctors know that at the end of the day, it is our privilege as a profession to care for the health of  our community, our society, and our world.

Think for a second about what that means. We are not responsible for only our small subset – the few patients we can see in a day. As a collective we are responsible for, and accountable to, the world.

As physicians, it is our responsibility, it is our honor and our supreme privilege to serve people in the most basic, and most important of ways.  

That’s why I’m going to be a doctor.  That’s why I write here. It’s why I demand citations, why the burden of proof is so high. How can we trust the lives of billions to the diseased ramblings of some voodoo practitioner? It’s why I react strongly to the pseudo scientists and pseudo doctors.  How can someone who truly believes that we act for society even suggest the physically impossible, the unlikely, unproven, and dangerous? Offering false hope is beyond the pale, and insulting to the world.

 It’s  why I object when some amateur – and it’s invariably amateurs – cites gibberish to back their brand of nonsense. It’s why I take it personally when someone purports to know the secrets of the universe.  If you possess such secrets, why not prove them? Doing otherwise is not just an insult to my profession. It’s an insult to the public trust – that we hold above all else.  

It’s why I am offended, and infuriated, when a Doctor betrays that trust. When a doctor, through sins of commission, or sins of omission, betrays the very basis of our profession, our covenant with society, that cuts most deeply of all.

To me, there is only one solution to all of these betrayals. Light must be shown on them. Bright lights. We can maintain the public trust only by policing it ourselves, and by policing those purporting to act in such trust.

That’s my motivation.  I want to light a candle – because one blog is no spotlight – to shine a light on these pests that would destroy the foundation of my profession – it is my honor, and my privilege to do so.








(Edited for grammar on 4/18/09)
Explore posts in the same categories: Medicine, Not Science, Personal

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13 Comments on “My Motivation”

  1. :wild applause!:

    This is how I wish every doctor would feel! I am so glad you are part of this world’s healthcare future!

  2. leigh Says:

    that was beautiful.

  3. Doug Cutler Says:

    You don’t need my approval, but this is what I like to see in a doctor. Your motivations are pure and I hope and pray they always stay that way.

  4. Dr Benway Says:


    In my case, I picked medicine because I’m easily bored. Fashion? Boring. Money? Boring. Politics? Boring. The usual small talk everyone does all day? Boring.

    I imagined I could cut to the chase, move beyond the bullshit, as a doctor.

    I also imagined that most of my doctoring day would involve human relationships. The last thing I wanted was a desk job shuckin’ paperwork and writing friggin’ book reports.

    Wuz rong bout last bit akshually.

  5. ddw11 Says:

    Yeah, that.

  6. Danimal Says:

    I am not a doctor, but I played one as a kid. Now that was fun!

  7. Charles W Says:

    Hey, thanks for the great blog! I clicked through from Orac a couple weeks ago and have devoured every post, particularly the comment threads. Keep it up!

  8. I really respect all of the physicians who blog on the anti-woo, pro-evidence and science side of the world. I have no clue where you have the time, and how you provide such passion, without being uncivil.

    I went to medical school and graduate school (going for one of those MD/PhD programs, because I had no clue what I wanted to do at 19, except for being good in science). I ended up being much more interested in the business side of the medical industry, and I wanted to bring products to market that physicians and scientists could use to improve the state of healthcare. There are some things I’ve brought to market that I believe have been important to healthcare (I lead the launch of a drug that ended allergic reactions in a particular medical procedure), and I’ve had enormous failures (a drug eluting PTCA catheter that did absolutely nothing to prevent restenosis).

    Reading this article, I nearly cried, because it reminded me of the reasons I wanted to go into medicine in the first place. I joke frequently that I wanted a Ferrari in my driveway, and I didn’t want to earn an intern’s or resident’s wages (that, in my day, if amortized over the hours on call and in the hospital, might have actually been below minimum wage). But I wanted to be a physician to make the world a better place, even if it’s just a small amount.

    I give a speech to new sales reps hired into medical device companies. I tell them that they have an honorable job, because every morning when they wake up, they are doing their small part to help healthcare workers deliver better care to patients. That has been the single thing that has motivated me over the years.

    So even though I never practiced medicine (except for those 4th year clinical rotations, which I hope are better experiences than for today’s students), my motivation for choosing my career is still the same as it was when I walked into the auditorium where I received my first orientation.

    I never thought about it until reading this blog this morning. Really, thanks for writing it.

  9. Elennaro Says:

    I’m a med student in my second year. I stumbled upon a link to this post on Orac’s blog. It has had three effects on me:
    1) Since you are obviously eloquent, and a gifted writer, I am bookmarking this blog.
    2) I feel a little more proud of what I am going to be. Thank you.
    3) I’m going to start a blog of my own. More voices need to be heard against pseudoscience.

    I actually did not start for the reasons you gave. The reason I started was the captivating intricacies of the human body, which fascinated me – still fascinate me. I entered with the express purpose of going into medical research. But the few internships I have had have told me now – I want to be a doctor. I want to do my part to care for the health of people – and, ultimately mean something for humanity this way.

    Thank you for this beautiful written representation of the way I think.

  10. mamatales Says:

    Not been keeping track of your blog as regularly as I should.
    Impressed with your “My Motivation”.


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