Monthly Archives: April 2013

The Motivation to Heal

“When did you get the call?” A hand shoots up near the back of the room. In seventh grade. And you? When I was a junior. Yes, you over there. About two years ago.

Walking into this conference room you might mistakenly believe this is some type of Pentecostal revival, but there was nothing religious about this particular event. I was here to listen to a sort of pep talk by a local family medicine practitioner/musician extraordinaire (he began his presentation with a bluesy harmonica and a soulful, toe-tapping, off-the-cuff song about personal responsibility). Dr. H was a guest speaker at the monthly staff meeting for my clinical internship. He began with a statement that I’ve since spent a lot of time dissecting:

“You don’t choose Medicine. Medicine chooses you.”

This is quite a bold idea–the thought that medicine, like some act of divine intervention, is a calling. Sure, becoming a physician is not your typical job. It requires at minimum 10 years of post-high school education and training, often closer to 15 years–and placing your patient’s health and needs above all else– before family, relationships, personal problems, sleep deprivation and vacation. Perhaps to be a good doctor, one that lives up to the sacrifice and responsibility required of the profession, one must feel a special calling to serve the sick. How else could you survive?

Indeed, research has found that doctors who view medicine as a calling are more satisfied.

I began to examine my own motives for entering the medical field. Could I think of a specific moment where I felt called to medicine. The truth of the matter is becoming a doctor is something that has interested me since I was a young kid. But how many kids play doctor growing up? Over the years, what began as a mere interest in medicine and the neat tools of the trade, grew into an inescapable feeling of somehow knowing that this is where I belonged–the only place I belong.

It’s tough to describe–but as I entered college to study Journalism, I kept having a gnawing feeling that I was studying the wrong major. I entered the University of Maryland as a sophomore, having taken mainly college coursework during my senior year of high school, which meant I only had three years before I would earn my undergraduate degree. My mind perpetually pondered if I should switch majors to biology. It seemed the universe was trying to send me similar signals. I remember one day walking to class, deep in thought weighing the pros/cons of switching to a pre-medicine major in my Junior year, only to find a flyer on my desk for the Pre-Med Society. I attended the meeting and decided to make an appointment in the Office of Health and Sciences.

The following week, as I sat waiting for my appointment, it was cancelled by the academic advisor.  Instead of speaking to someone about the educational path towards medical school acceptance, I grabbed a flyer listing the required pre-med coursework. My mind fixated on the then required calculus. I hated math. That little course was enough to dissuade me from re-scheduling the visit.

However, medicine continued to stay on my mind. In my dorm, we had weekly Greys Anatomy viewing parties (yes, this show was once watchable!). The biology, chemistry majors and me would religiously watch the show together, dreaming about life as a doctor. I was secretly jealous when they returned to their organic chemistry homework. One of the girls who used to watch with us just matched in an Internal Medicine Residency.

Although I came close to switching majors several more times, I graduated in three years and went on to graduate studies in Public Policy, focusing on International Development. My course work introduced a new concept to me– the idea that health was a fundamental human right. I spent two years studying  the idea of health– its inexplicable link to poverty, health disparities, health policy and economics, ethics, philosophy and Africa as a setting for great opportunities and needs in health.

By the time I was in my final semester of graduate school, the feeling that started as a small nagging thought–I think I want to be a doctor– ignited into a burning desire. I realized my passion for medicine and the profession was not going to go away. Instead, it kept me up at night. At a time when it became even more impractical for me to now not only switch majors, but careers, I decided to finally pursue a pre-med education.

Interestingly, around the same time as this crazy idea that I could actually become a doctor came to a boil, I became sick. Really sick, with a chronic illness that required frequent visits with cardiologists, neurologists and even emergency rooms. Whether I wanted to or not, I was around medicine all the time. It was enough to help me decide to pursue a post-bac program at night.

With each successfully completed science course, the desire to enter the medical profession grew stronger. Eventually, I could no longer think of any other alternative for my future. This was what I was meant to do. I would do whatever it took to get me to medical school.

Although there was no single “ah ha” moment to reflect on–I can’t help but feel that medicine has been a calling I simply couldn’t ignore — as much as I tried. Perhaps, medicine simply chose me. The universe, my genetics, the medical drama ER, my husband’s belief that my dream was not indeed crazy, opportunities to spend time in health clinics in Africa, my own failing health, all moved me towards where I am today–about to start my first year in medical school.

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Choosing a Specialty

Now that I’ve been accepted to medical school a common question I often get is, “what type of doctor do you want to be?” Great question, the answer to which will very likely change as my knowledge of anatomy, pathology and disease transforms from something abstract and superficial to real knowledge. Choosing a specialty is one of the most important decisions a medical student will have to make. In just three years, we will begin the process of applying to residency programs, at which point you pretty much have to know what field of medicine you want to be involved in.

Hopefully, study of the various body systems in years 1 and 2 of medical school will help illuminate this for most students–piquing an interest in the brain or the kidneys or some other specialty. If that isn’t enough, medical students get plenty of help guiding them in this decision through exposure to various specialties via clinical rotations in years 3 and 4, mentors, specialty interest groups and shadowing opportunities.

I recently learned that the University of California Irvine Medical School administers the Myers-Briggs Personality Test to students during orientation to help match their personality and temperament with the residency best suited for them.

“…the Myers‐Briggs Type Indicator (MBTI) has become the most popular and widely used psychological test in the world. Based on Carl Jung’s theory of personality types, the MBTI was designed to analyze personality in a systematic, scientific manner. Where other questionnaires (type tests) only illustrate type, the MBTI precisely identifies a person’s personality type preferences. The test enables you to learn more about how you perceive and judge others, whether in an occupational or social situation. It identifies your strengths and weaknesses and shows whether you value autonomy or prefer interdependence.”

To learn more about the MBTI or to take the test for yourself, you can visit the following site.

In addition, the Student Doctor Network (SDN) has a free online test you can take that helps to match you with the specialty best suited for you: try it here

When I did the SDN test my top five results were: physical medicine and rehab (what?! no interest there), internal medicine oncology/hematology (right on), family medicine (boring), internal medicine-nephrology (hmm interesting!), emergency medicine.

It will be interesting to look back on this time and see how my interests have changed. To date, I’ve had the most exposure to Emergency Room physicians and so it’s no wonder the ED specialty ranks at the top of my list. In addition, here are where my current specialty interests lie:

1. Emergency Medicine

Why I like it: As an adrenaline junkie and someone who thrives on high pressure, high stress jobs, I really enjoy the fast-moving nature of this specialty. Every day is different. It allows you to see a huge spectrum of disease touching on pretty much every specialty (you don’t have to choose just one!). You get to perform really fun medical detective work- typically you have never met the patient and must form a diagnosis and treatment plan based on sound clinical judgement and skills of interpreting results/clinical presentation. You literally have someone’s life in your hands and can have the instant gratification of seeing that person get better. Shift work. No “on call.” Good work-life balance. Great for women.

What I don’t like about it: This is actually something I do like about it, but my body doesn’t. You are on your feet all day and it’s a physically demanding specialty. Although I personally enjoy this aspect, I am worried that because of my POTS, as much as I want to do it- I won’t be able to. It is currently very difficult for me to stand for 4 or more, let alone 12 hours, without feeling extremely fatigued. My heart is in a constant state of tachycardia and there are some as of yet unexplained physiological things going on that cause me to feel weak, sore and tired after this type of  excursion. I am working with my cardiologist to improve my physical stamina so my hope is that in four years I may not have this problem. I do have to be realistic however and it’s very likely I simply won’t improve much beyond where I am today.

2. Oncology

What I like about it: This is a very intellectually stimulating field which would allow me to have a dual role as a clinician and researcher. An interest in cancer is in my blood- both of my parents are cancer researchers focusing on novel drug development. As strange as it sounds, your patients are actually sick and you are able to help them. Often times in the ER patients come in with complaints but no real illness- some of them are just lonely. The field is constantly advancing and there is opportunity to play a role in that advancement.

What I don’t like about it: Exhausting all medical possibilities yet your patient still dies-often. Seeing patients suffer more because of the medicine you give them. Dealing with death that is slow and predictable.

3. Cardiology

What I like about it: I find the heart really fascinating and I have a keen interest in disease states of the cardiovascular system. Partly because of my own experience, I am drawn to cardiology and particularly further research on POTS and autonomic disorders. Same as for oncology, you get to establish long term relationships with your patient and create a continuum of care. Satisfaction of seeing someone improve by making positive changes in their lives to reduce disease state. You get to do procedures (stents, cath lab) and interesting diagnostic exams (echo-cardiograms, stress tests, etc.).

What I don’t like about it: So many of your patients are old. Nothing against old people, but I like a varied patient population. Seeing improvement in patients often requires real life-style changes from the patient and being frustrated when that doesn’t happen.

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