Month: July 2012

Fortune teller


Every now and again we come to a time where we make Big Choices. A career, get married or don’t get married, have kids or don’t get kids, dedicate your life to becoming an astronaut. For a lot of people this happens in a nice linear fashion, go to high school, university, get a job, progress through job, maybe get married, maybe have kids.

It’s come time for me to choose a career path within medicine, except that it’s medicine which at times feels pretty much synonymous with ‘cult’ in terms of how much it takes over your life. Less helpful is the platitudes of ‘you should choose x, it’s good for women’, where x is something like general practice, or psychiatry. Such a loaded statement! ‘Good for women’ automatically implies that you are the primary carer, that it is your responsibility to choose a career, not in something that you’re in interested in, but that is appropriate for your station. Meanwhile it feels like all the guys are becoming surgeons because they feel no such pressure. Never mind the rest of us who really loved their surgical rotations and could really do that job for life, and be good at it.

It’s not the ‘good for women’ part that puts you off in the end though.

Imagine getting up at 5.30am for a 7am start every day. Now imagine that while you’re at work, you’re not allowed to sit down. You have to stand or walk every minute, all day. You might get a sit down for ten minutes at lunch before getting back up again. Now imagine your boss expects you to manage all your clients externally, and attend all the meetings and keep them happy without their input, that your performance is based on this. When you do see your boss for your internal client meetings, he stands over you and questions your detailed knowledge on everything, and consistently points out what you’re doing wrong for the hours that you are together, still standing by the way. Praise is rarely, if ever, delivered.

This picking and testing happens every day, for at least 12 hours a day, along with the standing. After your meeting with your boss, you go and check on your other clients, your patients, where you learn that one tiny mistake in theatre, one moment of exhausted distraction has resulted in someone suffering a surgical complication. Maybe you had an off moment, maybe you didn’t want to be at work that day, that you wished you could chuck a sickie – except that if you did that, everyone else’s day would then blow out to 24 hours and people who’d been waiting months for surgery would get delayed again. Whatever your moment, you’re painfully reminded that there is no margin for error, no room for an off day. And by the way, you’re on call this weekend, for it’s entire forty eight hours, where yes, you will be required to stand, and yes, you will get called in 5pm Friday and not get home until midnight Sunday where your regular working week will start anew. And you have a lazy intern who hasn’t done anyone’s paperwork so as well as checking forty inpatients (think forty client meetings in one day) you have to write a bunch of discharge letters, and get into theatre with your boss where he will lean over you, test your knowledge relentlessly and tell you everything you’re doing wrong. Until 2am.

So maybe you love surgery, would be a great surgeon, but would you put yourself through that for the next 6 years of your life? Forget your future kids, would you want that for yourself? In medicine, things like prestige and money fall away for most of us in the face of what we want from our lives. What we want from our day. We are always told ‘look at the life your boss has’ when choosing, and decide if you want that. Then you have to fit relationships, kids, and friends and anything else that’s important into that.

I read an article a while ago written by a pediatric heart surgeon who said that while it was nice they were so well celebrated and had achieved so much, that in the end it wasn’t worth it. They’d missed out on friendships, relationships, and woken up with all a whole lot of prestige and not a lot of anything else.

These lessons can be applied to any career, not just medicine. I’m still in the process of choosing, of working it out. I have an idea of the direction, but it’s the details, it’s the cult of medicine that gets me. Who knows if it will work it out?

Sometimes you just have to pick something, give it a red hot go, cross your fingers and hope the rest of your life fits in. The universe will always conspire to help the dreamer.