I remember the moment I truly realized being a physician was my vocation. Overwhelmed with emotion and a true sense of purpose, I can recall that celestial moment like it was yesterday.
My personal statement became the slate to which my story was scribed, and medical school interviews became the perfect opportunity for me to tell it. As I’m sure most of you remember, that first medical school acceptance was an incredible validation. All the coursework, MCAT, shadowing hours, and volunteering had paid off and I was finally on my way to fulfilling my dreams.
The symbolic white coat ceremony made me think “I made it.” Clad in the color of healing, I was more enthusiastic than ever to start learning about medicine. I’m sure like most of you, the pre-clinical years of medical school weren’t much of a change of pace from your undergraduate studies; just more volume. It was challenging, but exciting to begin to piece together the biology and physiology learned in college with medicine.
For most of us, Step I preparation was the most challenging part of medical school and perhaps for some, the hardest time in their lives. But still, I was excited to finally see all the hard work I had put in during the first two years, paid off on the board examinations. And now finally, the wait was over. The clinical years were upon us. Nervous, anxious, unsure of how to “take care of” patients, mixed with skeptical excitement, we set out for the wards. After those first few weeks of trying to figure out what an electronic health record was or if the H&P I completed was long enough at three pages, I started to feel like I knew how to navigate the hospital/clinic.
However, over the course of the first clinical year, the clerkships, the long hours, those thoughts in my head that I didn’t learn any of this during the first two years, took a toll.
I may not be able to identify a specific moment, but there was a gradual transition from the once excited, vivacious medical student, to someone who had been fatigued, exhausted by the workload, excess of information, shelf exams, and the reality that not all patients are standardized or easy to care for. I think I found myself more than once asking myself, “Where did that passion go? Is this still what I want to do with my life? Is it worth it?” On top of this, I wondered, “How do I continue through my last year with the zeal necessary to succeed and what do I do when residency comes?” I saw so many residents that were completely exhausted by their workload that seemed more administrative than it did clinical.
I asked myself, “What keeps them going?”
I realized I was able to cope with these emotions and answer these questions because I learned to look for and savor the humility of the profession; the privilege it is to care for the sick and suffering. I wanted to share with you, a patient encounter in medical school that I believe best illustrates this concept.
A 40-year-old man with a history of hypertension was transferred from an outside hospital to the vascular surgery service with a left lower extremity thrombosis leading to dry gangrene and compartment syndrome resulting in a left ankle disarticulation and 4-compartment fasciotomies.
His definitive surgery was scheduled for a Saturday, which was my scheduled day off. I came in on Sunday and made my rounds. I asked him how he was and remember telling him I was thinking of him the prior day and hoping the surgery went well. When we rounded with the team, we changed his dressings, and despite IV opioid pushes, the pain was so intolerable he broke down into tears. During the dressing change while comforting him, he profusely thanked our team for saving him.
He pointed to me.
As he wiped away the tears from his eyes, he shared with the team about how I told him that I was thinking of him. He told us how good that made him feel, to know someone cared about him. It was in that moment, that all the studying, the long hours in the hospital, those feelings of medical ineptitude, it was all worth it. There was no tangible device that could be worth more to me in that moment. I remember thinking to myself with a lump in my throat, “10:30 a.m. is way too early to cry.”
I am confident that you have also had a moment or moments like this. If not, don’t worry, it will come.
These experiences come when we least expect it, and they can fill us with the vigor we once had. They can remind us of the amazing privilege we have as physicians, and the gift it is to share these moments with our patients. Seek those moments in which you can celebrate with them, whether it is a hug, accepting some homemade dessert or candy from the gift shop, or sitting at the bedside and thanking your patients for letting you participate in their care. Cherish them.
These experiences are the fuel to which our passion’s feed and the humility that reminds us why we were called to medicine.
So, as I started my surgical training, amidst the new responsibility, the complete and utter confusion of being an intern, I looked for these moments. They were there, and they were more apparent than I would have expected.
Don’t lose faith in the process, cherish the small moments, celebrate your successes with your patients and share in the grief. Remember the privilege we have as physicians, and the unique opportunity we have to become an intimate part of so many people’s lives; even if that means sacrificing so much of our own.
Jason Lizalek is a surgical intern at the University of Washington. After moving halfway across the country from the Midwest to start residency, getting married to his high school sweetheart, and honeymooning in Italy, has been constantly reminded why he decided to become a physician all those years ago.