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Thursday
Mar082012

They Tell Me That Medical School Will Change Me

By Tamara Moores, a fourth year medical student at Loma Linda University specializing in Emergency Medicine.

They tell me that I’ll change.

They always do.

In our first two weeks of medical school, freshmen students are assigned to shadow senior students working in the hospital. When I was a freshman, my senior student’s final comment to me was “Wow. You’re really enthusiastic… That will change.”

Now as a fourth year medical student, today’s version of the story was – “intern year will change you. You may look the same on the outside, you may portray that same bubbly, sunshine personality, but inside you’ll be different – harder, less tolerant, mean.”

They say it with confidence, they say it with authority, brooking no disagreement, allowing no doubt. Attendings, residents, nurses – they all deign to tell me my future – “there’s no way you can stay that energetic, it’s incompatible with a medical career.” Over and over I have heard this. As a medical student, I am supposed to listen and learn - to be guided by these wise elders. This morning when I heard the prediction for the 100th time, like always I politely listened with a half-smile. Yet silently my spirit roared “How DARE you smugly tell me the fate of my soul?! How DARE you justify your own insecurities about your passionless heart by attempting to degrade mine?”

Medicine is a unique environment. In my short foray into this time-honored, traditioned society, I have been buffered and shocked by the rampant negativity that oozes through the hospital walls. People seem to even take pride in their ability to bemoan their situation.

“Oh God, another consult from the ED, think they managed to even do a physical exam before calling?”

“That professor has no idea what’s on boards.”

“I can’t believe we have to be here.”

“This computer system is a joke.”

By far the most common conversation in a hospital is complaining. Tomorrow, try something different - stop and listen to the myriad people talking at work. The ratio of negative to positive conversations will overwhelm you.

Why is hospital culture like this? Shouldn’t a place of healing be full of warm emotions, positive thoughts, and uplifted people? Why is a ‘negative nancy’ the most common type of medical professional we meet? What are we doing wrong? These questions often come to mind during my workday. There is no easy answer. At the very least I know my top goal is to NEVER become that stereotypical cynical physician, and instead be the uncommon doctor with true passion for medicine.

So how do I accomplish this in such a caustic environment? Have no doubt, even at my current bubbly baseline, it is a daily war to maintain my heart for this career. So many physicians before me have fought this battle and lost. How can I succeed where they have failed?

A resident who I highly respect recently told me ‘be careful what you say, because talk patterns become thought patterns.’ This, more than anything, is my first defense against cynicism. It is SO easy to fall into conversation filled with complaints. These tiny conversations seem harmless, but over the course of a lifetime they shape your soul. Now at the end of my medical schooling, and at the cusp of residency, I am awed by the power of the spoken word. It’s undeniable - what we say both molds and reflects what we think.

Overall I believe the best weapon against developing permanent pessimism is to be deliberate in how we react to daily adversity. How do we respond to a floridly difficult, unpleasant patient? Do we moan about how annoying they are? Do we ruminate about how unfairly they treated us? Permit me to suggest a different response. Instead of focusing on how unjustly that patient has treated me, I instead try to feel gratitude. Whether or not it’s right, these difficult patients make me grateful that my life has not put me in their position. They must be really unhappy inside, to so poorly treat the people who are trying to care for them. When I am mistreated by an attending, I remind myself that they are but a momentary discomfort, and soon will be gone from my life. Over and over I find myself fighting to see the positives in my life. It is a deliberate, intentional strategy, which allows me to shine out with joy even in the little moments of the day.

I firmly believe that working as a medical professional can be a path to a life filled with meaning and passion….if we let it. Not all days are perfect, but most days I feel like I’m the luckiest girl in the world to be in my chosen career. The patients are interesting, my skills are stretched, and I feel fulfilled. Beyond these personal reasons, more than any other career, medicine reminds us how short and precious life is. We deal in broken bodies, lives cut short by car collisions, by strokes, by chronic disease. How lucky we are to be able to move our bodies without wheelchairs, to be relatively self-sufficient. Working in the medical field reminds me daily that everything can change in a moment. It is this acute awareness of the frailty of life, which makes me embrace life with so much abandon. It is this knowledge that gives me joy in the workplace, even during the rough days. To put it bluntly, life is too darn short to be grumpy.

So why am I reflecting via this forum? Perhaps because I hope that I am not alone in this fight. Perhaps I hope that by starting a discussion, we might nudge forth a change in the standard hospital culture. Maybe with forums like this, we can shift the caustic paradigm. Here’s to hope.

About:: Tamara Moores is a fourth year medical student at Loma Linda University. She is specializing in Emergency Medicine. https://www.facebook.com/reflectingthelights

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    They Tell Me That Medical School Will Change Me - Uncommon medical school students and residents. - Uncommon Student MD

Reader Comments (8)

Tamara,

Thank you for sharing your thoughts. I found them inspiring and humbling. A great reminder that is all to often forgotten along the journey to becoming a physician. I hope to hear more of you wisdom.

Great article Tamara!! Continue to fight the negative feelings and undercurrent. They are many, many others out there, myself included, who share your same view and positively blessed attitude.

Mar 17 | Unregistered Commenterph8

This is a great article. I agree with your assessment of the negative attitude of many in medicine. I believe it does not stop at work, but the same negative attitudes is part of these individuals' attitude toward life in general. They also complain about their spouses, children, etc.

Maintain your positive attitude. It is OK to be different. Consider a career in academic medicine - researchers and educators, in my opinion, tend to have a more positive outlook on their careers. A mentor once told me that as a clinician, you can affect the care of your patient, which is noble. As an educator, you can affect the care of your students patients, which extends your reach. As a researcher, you can affect the care of all patients the condition you are researching, which extends your reach even further.

Apr 30 | Unregistered CommenterScott

Thank you for writing what seemingly few of us feel. I find myself fighting this battle every day (and I am only a third year medical student!) but I try relentlessly to reflect on my day and assess how I handled situations and how I can do it better. Inevitably it is always easier to respond to something negative with a negative. While I find it easy to see the positive, I struggle to strike the balance between spreading positive energy and being "that girl" who is annoyingly positive. The latter seems to push people away more than help them. So I agree that using positive words to curb a negative conversation can save your happy inner spirit, but to successfully infect others with the positive bug, I think it requires assessment of the situation you are in. Again, I loved your article. I'll soon be joining you in the medical field with a smile in my heart!!!

May 6 | Unregistered CommenterSarah

Great Article!
I'm currently in Pharmacy School and previously worked in a few different pharmacy settings for 5 years before beginning school. My least favorite days of class so far have been rotations in the community because of the attitudes shared by the staff towards the patients they serve. I didn't really realize these constant negative tendencies by the staff (no matter how subtle) while I was working, but when I began my rotations as a student it became apparent that my mentality while I was previously working was headed down the same path as theirs.
It was disheartening to witness the breakdown in how I was being taught to provide patient care in academia while confidently knowing how most patient care is carried out in practice. In short however, this experience has made me eager to explore other avenues of my own profession and your article has further reinforced my motivation to do so. Thank you!

May 6 | Unregistered CommenterMax

Tamara,

Great article! It's always refreshing to see a story of resilient optimism within the medical education system. Without compassion, how is a doctor to help her patients heal?

The only thing that I wanted to point out is your attitude towards seeing difficult patients: "Whether or not it’s right, these difficult patients make me grateful that my life has not put me in their position." I do agree that seeing the effects of illness on the body has the potential to make doctors appreciate the life and good health they possess. At the same time, we have to be careful about making the distinction between pitying patients for our own self-assurance and acting out of compassion for their benefit:

From the Tibetan Book of Living and Dying:

"Compassion is a far greater and nobler thing than pity. Pity has its roots in fear, and a sense of arrogance and condescension, sometimes even a smug feeling of 'I'm glad it's not me.' As Stephen Levine says: 'When your fear touches someone's pain it becomes pity; when your love touches someone's pain, it becomes compassion.' To train in compassion, then, is to know all beings are the same and suffer in similar ways, to honor all those who suffer, and to know you are neither separate from nor superior to anyone."

Just some food for thought as you continue to spread joy throughout the hospital. :)

May 22 | Unregistered CommenterDavid

Really inspiring article! I have studied in medical school, now I work as psychiatrist! I think that this part of life is the most beautiful time for everyone, doesnt metter what and where have you studied! During this years you was growing up as a human and quality specialist in your area! I want to turn back the clock))

Aug 13 | Unregistered CommenterMario

Thank you for your article. Perspective is everything. Somebody is always better off or worse off than another. I hope that I can remember that even the rudest, most non-compliant patient can be a lesson to us and help us treat other patients. When I become upset during work, its usually because I expect too much out of the patient and myself. Patients aren't good at healthcare so we try to help them. They may not listen because they just met us 5 minutes ago. My job isn't to convince but to inform and provide aides to getting better. They will eventually figure things out.

If we spend too much time around complaints, then even the best intentions can't protect us from marketed negativity that prevails in healthcare. My suggestion to anybody is to make friends outside the profession and protect those above any other. We can instantly connect to other physicians but when do we get a chance to meet healthy professionals outside our field (who aren't trying to get us to "invest"). When we see that they have to put up with excel spreadsheets, office politics, and job insecurity, a few crabby patients shouldn't get us too down for too long.

Sep 5 | Unregistered CommenterNirav

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