Physicians Don't Make it Alone
This is a column of mine from last year in EM News.
Link is below as well.
Life in Emergistan
Life in Emergistan
Even EPs Can't Make It (Entirely) On Their Own
Leap, Edwin MD
Emergency Medicine News 44(2):p 23, February 2022. | DOI: 10.1097/01.EEM.0000820920.12673.78
My father died last year. It's a surreal thing, to lose a father. Fathers, mothers, and indeed siblings so often become the background of our lives; we expect them there, even when we don't always have time for them, and then, unexpectedly or expectedly, they're gone.
I did not spend enough time with him, but that's the refrain of everyone who loses a loved one. Sadly, in part, I have to blame my career, although to do so is to circle back and blame myself. We all set the priorities of our time, and we all waste more than we like to admit.
Medicine is a thing of enormous momentum; we start rolling down that dark, thorny path from the moment we decide to take it, and it's no small thing to slow us down. It consumes us, from premed classes to the MCAT all the way to specialty boards. It's no stretch, in fact, to say that the process of medical education often makes us into remarkably self-centered individuals, all too ready to sacrifice almost anything on the caduceus-engraved altar of our goals. We too often recognize it in the other professionals we encounter who are completely transformed from human into doctor. We too seldom acknowledge it in the mirror.
It's easy, however, to consider ourselves unique forces of nature, as if we created all the circumstances of our successes by our own dedication, talent, and will. That is true for a few people, but it is unlikely that most of us can say that.
Thanks, Mom and Dad
I sometimes remind residents that their professional triumphs are in no small part related to the support of parents and spouses. The process of medical education is not only intellectually daunting, it is financially, socially, and emotionally costly, and it is very difficult without the support and encouragement of family. Sometimes, that support is money to help with tuition or an apartment or maybe just food now and then. Many parents can't offer much in terms of financial support but can still say, frequently and with absolute conviction, “We believe in you, honey. Hang in there. Come home, and we'll cook dinner for you.”
It may well be that we owe our parents even more as the medical education process becomes more complex and costly. We owe a great deal of our love of learning to parents who passed that on to us, in part genetically and in part by taking the time to read to us, emphasize learning, indulge our curiosity, and guide us into the right classes and schools. We had to do the work, but often they set the stage.
My wife, Jan, and I have been parents for 27 years. We have guided our kids through childhood, high school, college, and beyond. This has been an intense labor of love, and we wouldn't hesitate to do it all over again though we might do it differently (hopefully better) if we had the chance. Parenthood is a thing of great gravity and produces more joy, meaning, and anxiety than almost any other human activity. Those of us who had loving parents were the recipients of that remarkable largesse, its own form of sacrifice on the altar of the future.
We parents only want one form of payment in the end, and that is relationship. We want to remain connected to the ones we fell in love with from the first time we realized they existed. We want to see them, laugh with them, eat with them, watch them thrive, help them when they fall, hold them, and know that wherever they are, the threads of love are ineffable and unbreakable, that the quantum coupling of parent and child never ends.
All physicians whose parents are alive should think about that connection. When your parents launched you into medicine, some knew the cost and others did not, but it was for your own good and so that you could follow your own dreams. Years later, believe it or not, they still desire to spend time with you, hear your steps in the kitchen, vacation with you, and know you as much as ever.
So maybe this year, if you haven't, you can try to offer that gift of time and devotion to those who ached a little as you followed your dreams, but who love you just the same as ever to this very day. You may be a doctor, but you're still their kid.
It’s a tough thing indeed to be working full time in healthcare in any role; physicians have it twice as hard as the rest of us though. You’re in high demand and there are not enough of you to go around. Nice reminder though as you encourage others based on your experience.
I was an only child, so that’s even more fun. When my mother started having memory issues, we struggled with the parent/child reversal of roles. She e fiercely independent to start with, and a very strong personality. I felt like I had broken a promise when we had to have her placed in long term care. But due to my back issues, I could not care for her myself, as she was falling a lot and I couldn’t lift her. It felt horrible. I dreaded visiting her because she often used me as a target for her anger; her memory also became progressively worse very quickly, and for the last 6 months of her life she kept calling me her favorite sister in law. But I dutifully went as often as I could; working 12 hour shifts didn’t help, as I did not go out to see her after I got off work. I’m sure I still broke her heart.
I'm grateful for the opportunity to read this today. I understand - because you explain it so well - how doctors are in some way especially indebted to their families for support. But I must say your point applies more generally. I came of age in the middle class at a time when individuation was emphasized to such a degree that family connections were sometimes not only neglected but suspect. I'm only now discovering that the love across generations is precious.