Dear residents of all specialties:

You are extremely important.  The futures of many lives depend on you.  I don’t say that to burden you with fear or worry.  I say that to lift you up with a sense of your remarkable place in the world.  Medicine, dear friends, is in trouble.  And you are, and will continue to be, the bright shining hope for untold numbers of patients.

This is important because too many doctors don’t like taking care of patients.  That poses a minor, make that major, problem, since patients aren’t going away and most of us signed up to take care of sick people.  Not wanting to see the sick is rather like being a professor who hates students (an all too common phenomenon in itself), an auto mechanic who hates cars or a vet who would rather be a taxidermist.  It doesn’t make much sense.

The reasons for physician dissatisfaction are too complex for me to relate here.  I’m not entirely sure I understand myself.  But the reason may simply be that physicians have misplaced their, our, sense of mission and of greatness.  We have forgotten the power of duty, the wonder of caring for humanity.  In essence, we have forgotten the calling. You’re residents.  Your calling is hopefully fresh in your hearts and minds.  Granted, you may already be a bit well-done around the edges.  You have already, in your short residency careers, taken care of more pain and misery, done more advanced procedures, learned more science and impacted more people than many of our medical ancestors did in a lifetime.  You have earned a little weariness.  But I’m not going to let you off of the calling.

Rather than try to patch up the system, maybe we need to repair ourselves.  And since, hopefully, you don’t need much patching, what I want to do is prevent you from losing the delight you felt when you first fell in love with medicine, and keep you in love with it for years to come.  But I can’t just do that by being warm and fuzzy about patients who lived, or poignant about patients who died.  I have to do it by reminding you of who you are and what you can do.

You beat the odds.  You ladies and gents rose above the pack.  All around you, from high school until now, other fish of assorted sizes swam in the same ponds.  You out-competed them.  When they went to parties, you read (and went later).  When they shrank from the challenge, you faced it.  When they slept through chemistry lab, you titrated.  When they decided it was too hard, you kept going like muddy Marines, crawling in the flea-infested sand, saying to the DI,  ‘I am full of joy, sir!’

In medical school you did the same.  You worked hard, learned the intricacies of the body, and decided which types of human illness would be the stuff of your lifelong careers.  You did tough rotations, rounded in the pre-dawn misery of surgery rounds, worked up every foot fungus on medicine rounds, performed every infant spinal-tap you could get your eager hands on, and did them all well.  You made connections, stayed late, studied hard and looked at X-rays until your eyes bled and you just wanted to dig ditches.  You then picked a specialty, from pediatrics to neurosurgery, family medicine to cardiology, emergency medicine to radiology, you made a commitment and shuffled off to more work in residency.

During residency you have exposed yourselves to the dangers of infectious disease, exhaustion, depression and violence.  You have opened chests, placed central lines, intubated countless gasping airways.  You have pronounced people dead, dictated charts that made Tolstoy seem like a writer of short fiction and filled out more forms than you knew existed.  Your enthusiasm and dedication has brought life to the dying and hope to the hopeless.  You are incredible people, if only because you come back to the hospital night after night, day after day in order to learn and to do, to give and to heal.  Ordinary humans would take medications just to blot out one day of what you see night after night.

Hold onto that commitment, that wonderful calling.  Before you can blink, you’ll be entering a world of practice where physicians all around honestly think that patients are miserable drains on their time and personal finances, and who will try everything possible to avoid seeing or touching the sick, wounded and dying who inhabit your places of employment.  In the midst of the lassitude of many, go out and remember that you may well be the last hope on earth for many humans.

Try to see your work as a wonderful calling, an incredible opportunity, a great gift.  Because at the end of the day, it is a gift.  If you believe in God, as I do, see it as a gift from him to be able to serve and through service share in his image.  If you don’t, then see it as a gift from humanity to make you more deeply human.  But either way, your practice of medicine will do wonderful things if you’ll open your arms to it.

Many doctors may hate medicine now.  We can’t change their ideas, in all likelihood.  But you don’t have to hate it.  You can rise to it.  You are the hope of many lives, you are the future of medical care, you are the next generation.  Keep your minds on the people who need you.

Don’t let them burn you out; don’t let them abuse you (physically or financially).  But don’t look at mankind as some miserable impedance to your happy practice of medicine.  Mankind is the reason for your practice of medicine. And you have so much to offer mankind!

If you keep your hearts in place, if you keep your calling before you, if you look at your job from the higher perspective of men and women on a mission, you’ll experience some wonderful things.  You’ll care less about money and probably make all you need in the end.  You’ll see the value of every person; even the ones you would (quite legitimately) love to Fed-Ex to China.  And you’ll go home at the end of the day, neither counting money, nor lamenting money; you’ll go home knowing you answered the call you received so long ago, prepared for so long, and are so blessed that you can continue answering.

Be our hope, my friends!  Be the hope of medicine, the hope of the wounded parents and febrile children, the gasping elderly and the poisoned teens.  And learn to see all you do through the eyes of a higher calling.  That perspective, if you can develop it and hold tightly to it, will keep you happier than any political reform or paycheck ever could.

You’re all amazing, and I’m very proud of you!


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