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)