Last week, I had the privilege of having lunch with a young heart surgeon from Penn. Privileged, because this busy woman wanted so much to impart on me groundbreaking, fresh, and shameless advice on the reality of the medical profession. I wanted to pass her stories along to you.We met in September when I was meeting my adviser for teaching Sunday School. She was in the sanctuary of the church, praying intently to God, after her 130+ work week, that she made the right decisions and prudent actions for her patients. "Seeing medicine as a vocation is so extremely rare these days. Jason, you are in the minority, especially amongst surgeons." Wha??? Let me explain.
Maybe I have been sheltered. Maybe I've just been lucky to have been surrounded by like-minded people. I don't know. But this young doctor, so astonishingly accomplished, was telling me these stories of how frustrated she is being a God-fearing doctor, let alone a Catholic one. To my surprise, in such a humanely focused profession, the spirituality of a person is many times not considered.
Case in point: During med ethics discussion, students and doctors were discussing the worth of medical care. Some care is extremely expensive, and the professor/physician was trying to gear the students towards thinking about how productive the patient will be post-surgery. One's medical decision should also be based on this "calculation." Not to get too political, but this story made me remember Obama's Healthcare forum on ABC, when he was talking about rationing expensive care towards the younger, more productive population as opposed to giving grandma a new pacemaker and costing the hospital thousands for only a few more mostly unproductive years of life. The heart surgeon (back then, a student in an Ivy league med school) stood up and vehemently disagreed. "Who are you to measure a person's worth?" she exclaimed. "We have the resources, the training, and the obligation to provide this care. It is unethical to deny anyone." This is not Uganda, Nicaragua, or Vietnam. This is the United States, where we spend millions on life-saving research and have the capabilities to provide the care. Yes, we spend lots of healthcare. But we can make it more efficient by cutting back on wasteful medical spending. Heck, why don't we extend that to our country's values? Lebron James makes a cool $15 million/year from the NBA alone. Nike pays him $90 million. A soldier in Afghanistan costs $1 million/year, and if he is injured, nearly $5 million/year to recuperate from war-inflicted wounds.
Those aspects of essential care should never be sacrificed due to money. When asked, "If you had a limited amount of resources, would you save your younger brother or your mother?" I think the ethical physician would say, "Lets take out a loan and save them both. Let no one be lost over a question of money." After she told her story, it reminded me of the movie "Schindler's List." A courageous and wealthy German officer risked and sacrificed all to save hundreds of Jews from death. Using his influence as an officer, he was able to "buy" the freedom of concentration camp prisoners. At the end of the movie, when the war was nearly over, he burst into tears. "This pin on my collar...could have saved another child if only I had sold it. My boots, my belt, I could have sold them too and saved a few more!"
After the heart surgeon rebuked her professor, he exclaimed, "Young lady! God has no place in this environment!" "With all due respect sir," she said, "I never mentioned God. You did. These are basic ethical truths that any secular person can understand and practice." After her class, some of her classmates praised her. Some were very faithful people: an Orthodox Jew, a Hindu, a Buddhist. But the flaw of medical school, as I understood from her recount, is the pressure to please those who grade you and the professional politics creating self-consciousness around who you truly are. No one except her was courageous enough to be true to her values, and in her case, her faith. "Its our baptismal obligation," she explained to me, after I said that her actions were very admirable. "But just be vigilant, because as a person of faith and ethics, you will be challenged in this profession."
I agree with her, though, that as a lay person, we can reach a broader audience. As a priest/nun/monk, these professions would encounter like-minded people mostly everywhere they go. As a lay person, differing and even opposing viewpoints will be presented to us. I sure found them at ND, and each one enriched my own perspective. I like to say my view on life is a hybrid of all those I have met. But with these different perspectives, spiritual professionals will be unique amongst their peers. I'm not saying that we should go around converting people, but by living our faith's teaching to enrich the lives of others, I believe people of faith can set that example and reach out to such a wider audience than say a person of the cloak. It is our privilege.
Despite the politics of medicine, and the ever pressing call to excel, she imparted onto me optimistic words of advice:
1) Do the right thing!
- There will be times when doctors in training will be called to perform actions they do not agree with, but most of the time it is prudent to respect authority. Following the Jesuit example, students have the right to voice their opinion once. Yet, our views of right and wrong change daily, and I think it is valuable to be obedient to the seasoned pros and their wisdom. Don't be such a nuisance know-it-all-med-ethics person, but also be courageous to carry out your values even if that comes at a cost to your reputation. The trick is to understand the difference (props to Kurt Vonnegut).
2) Set the example
-Docs are leaders, whether they like it or not. People will notice and take note of your personal actions, even when the culture goes against your values. Setting the right example will change those around you.
3) Don't Complain...all the time!
-If you complain about every little thing, every little routine and uninteresting case or duty, then when it comes time to truly voice an important claim, no one will listen. Going along with setting the example, every little part of medicine contributes to healing, even if that means staying extra hours (or ten hours).
4) Find mentors who you admire.
- The original MC, Voltaire, famously said "Is there anyone so wise as to learn by the experience of others?" Seek out those seasoned docs and nurses who hold treasures of advice that were years in the making. Its better to learn it the easy way....
5) Participate in those activities that remind you of why you are here
- The bulk of med school should be spend studying. But it is also important to make the time for service, mentoring, teaching, being with the homeless or children....any activity that reminds us that we will be the caretakers of society, being intimately involved in the lives of many people.
6) Work hard!
- Another tidbit that I found very hard to believe that in her med school (Ivy League, filled with highly accomplished super-human young people) is that most did not work hard. After all of that work to get into med school, the drive just disappears and the learning stops. Med students must realize that it is a privilege to be passed down and learn the secrets to healing. Work hard and earn this knowledge. It may save a life one day. And the lack of it may end one, too.
7) Live your values
- Competition will never stop in this field. Lets face it: with so limited the number of spots, only the most accomplished (and lucky!) will have the honor to be accepted. I am still in disbelief that I was accepted. I consider myself the luckiest out of everyone this year! Going on: I am reminded of something my friend told me last summer: "I heard about this one high school commencement address where the speaker said, 'every single one of you will become the President of the U.S.' How ridiculous is that!" There can only be 1 "best." We are here to become good doctors capable healing. The competition to be recognized as the best should never destroy our values. In fact, I think it is those values that make the best doctors. No, not the most "prestigious" or "Nobel-contending" docs. Just docs that the community trusts, admires, and turns to in times of greatest need.
hmm....I feel funny writing all of this 1 year before medical school. I wonder how my amigos who already took their first anatomy and biochem final tests would think about all of this. All I know is that I hope to carry on my values and ideals as long as I can. I understand that they will be challenged in the difficult times. They surely were in undergrad. In the meantime...I feel really bad for the ND seniors right now...Our football team again lost their last home-game....Bye bye Charlie Weis. It was good knowing you.
Go Irish!
