I don’t know why I do it

Most people have a pretty well rehearsed answer for why they do what they do.

I don’t.

People ask me all the time “why did you decide to go to medical school.” I dunno. Cause I got in?

“Okay so why did you apply?”

I dunno. Cause law school and business school and wall street sounded boring, coaching high school kids wasn’t the challenge that I wanted, and academia sounded boring.

“What was so exciting about medicine?”
At the time, I had no idea. It wasn’t really that exciting to me, but it sort of started making sense that this was what I was supposed to do. I guess that’s what some people mean when they say that medicine is a calling. For me, it required the right skills and the right level of maturity at a point in my life when I was still free enough to go down that path.

I liked that the basic interface was still people, not computers or meetings. I liked that there was a horrifically underdeveloped scientific aspect (read: a huge opportunity). I liked the prestige of being a physician (ha!). Well, at least within the hospital that still exists. Mostly, I liked that the cognitive style of medicine rewarded decisive, but ultimately judgement-based (not evidence based) decisions. At the end of the day, medicine in 2010 means that a human being looks at another human being and makes a life-altering decision based on their opinion. That’s both profoundly stupid and pretty damn cool.

At first, I hated the science and hated working hard. Big red flags? Maybe. But as I’ve learned countless times in medical school, sometimes doing things backwards is the best way to understand them. As I learned more and more about the science, and about the hard work, I saw that it seemed to matter. It was concrete in a way that I had never experienced before. To me, science seemed about as useful as ballet or underwater basketweaving. Then after shepherding dozens of patients through clinical trials (cat-herding, really), it slowly dawned on me that “science” was determining the quality of their lives …

This wasn’t a grand epiphany. It was pretty slow and frustrating. But eventually after meetings and meetings and more meetings, and hours working hard (for what? why was I doing this?), either the cognitive dissonance caught up to me, or I realized that this was what I really wanted to do. Or both.

A large part of my choosing to go into medicine has to do with the positive reinforcement and feedback I received from my mentors and supervisors. Without that, there is no way I would have stuck around. For some reason, they thought I was good at what I was doing, and then, so did I. And then, I started to realize that I could be like them someday. And then, I started to feel like I wanted to be like them. And then, the rest is the present (not history … it ain’t over yet).

“Why medicine, though? Why not something else you were told you were good at?”

Yeah, a good question. I was better at debate than anything else in my life, including medicine. Probably would have been better at law school than anything else in my life. But I never had the transitional opportunity to make that happen. I was never really around lawyers, I never was told that I was good at law (who would be? who could be?), and I never saw a transitional pathway to law school. So that part of me has been atrophying for the last 10 years. I doubt I could argue my way out of a paper bag.

It’s funny how skill-sets change. I imagine this is something that I will encounter over and over again in my life going forwards. If the last ten years are any indication …

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