Our elder daughter is in Year Twelve, approaching the final half of her last year of school. Consequently, there’s been much discussion about careers and universities around our dinner table. She’s considering Medicine, which is not so strange given both of her parents are doctors (I no longer practise).
Her father and I thought we should fill her in on a few things, make sure she knew what she might be taking on. People have high expectations of doctors these days, so we sat her down and told her the following…
Doctors are expected to:
1. Never make a mistake.
2. Make an instant diagnosis if someone collapses or bleeds or arrests and act the following instant. And not make a mistake.
3. Possess an encyclopaedic knowledge of every disease and be able to recall it instantly.
4. Be able to communicate with everyone from everywhere.
5. Not show annoyance at the rambling patient. Nor cut them short.
6. Not run late.
7. Listen to a patient describe how they were scratched by a rusty nail that was sticking out of the board they’d been meaning to fix because they knew someone would scratch themselves on it some day, and how it must be a good fifteen years since their last tetanus injection, because they remember the day—it was Ned’s funeral, and Ned died in the July, or was it the August, of ’97, or was it ’98 …
8. Still not run late.
9. Listen to the rusty nail/tetanus story and give the patient a tetanus shot and get them to the door, with their hand on the doorknob, when they turn and say, Oh, by the way, I’ve been getting these chest pains on and off for a while now…
10. Still not run late.
11. Examine the patient while they’re still talking and pick up barely audible heart murmurs and breath sounds.
12. Complete about 300 forms a day.
13. Fix the patient’s problem without pain, and preferably with a pill and not asking the patient to change their lifestyle.
14. Drop everything for the patient who calls at 4pm on Friday afternoon because they’ve finally decided to do something about the cough they’ve had for six weeks.
15. Know which little round white pill the patient is on.
16. Make an accurate diagnosis of someone’s distant relative at any given social function.
Miraculously, there are some doctors who manage to combine all of this into one seamless professional, but those SuperDocs are a very rare breed.
For balance, we thought we’d tell our daughter about the good stuff, too:
1. The joy of studying into the wee hours, filling your brain with encyclopaedic volumes of information about the human body and mind.
2. The challenge of piecing together a group of symptoms and signs, and making a diagnosis.
3. The satisfaction of making a tricky diagnosis and being able tell your patient, ‘I know what the problem is …’
4. Even better when you can add, ‘and I can help you’.
5. The way people trust you just because you’re a doctor. They trust you with their bodies and their secrets. They tell you things they’ve never told anyone else, things they’ve carried with them for decades. They trust you to help, advise and guide them. To be there at their most intimate and vulnerable moments.
6. The honour of witnessing a baby’s birth, the start of life. And, the greatest privilege of all, being there at its end.
I’m so grateful to have been a part of this profession for 24 years. It’s intellectually stimulating and rewarding in a way few other professions are. And it’s more than an honourable career—it’s a vocation. You know you’re helping people—sometimes helping to save their lives; other times, just by listening. It has its challenges, like everything, but it’s worth it.
I just think you would be the most wonderful doctor Louise. People would always want to get you running late because you know how to listen. I have great respect for what doctors do. I think my father gained an extra twenty years of life because of the wonderful doctors he had the privilege to be helped by. Thank you, thank you… all.
Thanks for that, Iris, but don’t put me on too high a pedestal. I tried to be a good doctor, but I did say the wrong thing sometimes. I improved with experience, but I cringe now when I think of some of the ‘trite’ things I said as a young doctor. Even though I said the wrong thing, or it came out the wrong way, I think the patient picks up that you care, and that’s the main thing.
I think I tried to be the type of doctor I wanted for myself. The only people that ever really got angry with me were the drug addicts to whom I wouldn’t prescribe another script. I didn’t have many angry patients and it was usually because of something like running late (!) or a mistake in booking. I remember one patient well. She was angry at me because her son’s ear drum burst a few hours after he started the antibiotics I prescribed. I knew that wasn’t my fault, but I let her vent, and we ended up having a long-lasting therapeutic relationship. The key is, as you say, just to listen.
I think if (when?) you return you will be inundated with a stream of punters, so the running late thing probably won’t get any better. Too much pressure on doctors to get through in unrealistically short times maybe?
I don’t think I will return — I have too many books I want to write! And it competed with my family for my time and mental energy. I couldn’t give either of them the time they deserved. Having said that, I do miss it. Not enough for me to return, though.
Ah well – don’t blame you one little bit. I’m sure you contributed plenty while you were there. Besides, medicine’s loss is our gain – ‘our’ being the reading and writing community. Plus the flow-on effect. Plus, plus… Skills in one area are always used in another, and in a way that provides new perspectives on old stories. Looking forward to the next ‘chapter’.
I wasn’t as devoted to Medicine as I wanted to be, Iris. Like I say, the kids were competing with it, and I wasn’t doing either job — mother or doctor — they way I wanted to. In the end, because I always said that my family would come first, I stopped working. And it was a good decision. Things are much easier for all since I quit work. I don’t feel like I’m on auto-pilot racing from one station to the next, always running late, forgetting things … Like you say, the time as a doctor was not wasted for oh so many reasons, and certainly will be put to use in my writing!
I think you forgot to mention the joy of having infectious patients sharing their foul contagion with you, which may extend to them coughing/sneezing/spitting/spewing on you. Unless this is all an urban myth, not to say wild surmise. I can’t claim to be able to comment from my own professional experience. Trust me; I’m not a doctor. 🙂
I’m curious – what proportion of the ailments that are presented to you as a GP are a) easy to diagnose, b) easy to treat, and c) potentially dangerous to the patient if either diagnosis or treatment are obscure or difficult? Or are my categorisations with this question artificial?
Is medicine just one option for your daughter, or is she really keen on it? I hope she’s not getting too frazzled with Year 12 – thank God none of us have to do that again (not to mention what came after it as well.) What do your other children want to do, or don’t they know yet?
Glen, I laughed at your comments! I didn’t mention some of the other things doctors have to do — that is a whole book’s worth of stories. I have scooped false teeth out of a bucket of vomit, dry-retching as I did. I have extracted all manner of objects from body orifices — I won’t even begin to describe that …
I couldn’t give you a percentage of ailments that are easy to diagnose — probably most. And most illnesses are self-limiting, ie, the patient will improve anyway, independent of the treatment.
Our daughter really wants to do Medicine as a career and has for quite some time. She is coping with Year 12 really well — she has her father’s temperament and is very self-motivated. As for the other kids, they have ideas, but they’re much younger so who knows …
One more question, and I PROMISE it’s not a loaded one: Are you and/or your husband satisfied that enough emphasis is given to the caring aspect of patient treatment, both in medical training and medical practice? Or is perhaps too much emphasis given or expected?
Medical school entry used to be based on marks alone, but these days students have to pass an interview and sit the UMAT, to show they have decent communication skills and are capable of empathy. There is more emphasis on communication during medical training than there used to be. This is all a good thing — communication skills are a craft that can be taught or at least improved. I don’t necessarily think doctors in the past didn’t care — I think they did, very much, they just didn’t necessarily know how to communicate it.
The reason I asked this is because I once read a book that discussed the psychological processes of sickness and healing. On a purely personal level (and excluding possible naughty jokes, of course) the author had a rather striking metaphor for the empathy he thought hospital physicians might aspire to and use alongside their scientific expertise: he suggested that they “get into the sickbed” with their patients. I must point out, though, that the book would now be 15-20 years old, and I don’t know what the interpersonal dealings between doctors and patients were like at the time it was written. But the metaphor has stuck with me ever since.
You’re describing empathy, aren’t you? If you can put yourself in someone’s shoes or sickbed, it always helps. Not just in Medicine, but in life.
Great blog Louise. Thank you! And you’re right in saying that there would be few careers as rewarding, or as hard, as that of being a doctor. Your daughter’s career choice is an excellent one, and not surprising given her background. Overwhelmingly the doctors I know are extremely compassionate and caring people. Curiously, they’re often excellent writers as well! I have a good friend who’s a doctor, and her first novel which is being published by Allen & Unwin is coming out early next year.
Medicine, writing, piano playing…I’m hearing Goldsworthy echoes in the pursuits of the Allan family. Aren’t you??? And who is this other literary medico friend of yours, Marlish? It’s time for you to out them, I think. 🙂
Well, the other outstanding literary medico friend of mine, beside you, is a Moira Mc Kinnon. Moira and I have been friends for thirty-seven years! Most of her working life has been in public health, most notably as an infectious diseases specialist. In 2011 she was a joint winner of the 2011 Calibre Prize for Outstanding Essay. The essay was called Who Killed Matilda.
Her novel, Cicada, is absolutely brilliant, Louise. I’ve read it several times. It’s basically a thriller set in the Kimberley during the early 1920’s. Moira’s knowledge of indigenous culture, language and history at that time is astonishing. As is her knowledge of the flora and fauna of the Kimberley. She’s always been an avid writer and reader, and I have to say, she’s the most humble of people. I’ve always been incredibly proud of her. She’s awesome. You’ll have to meet her one day. Maybe when her novel is launched? She works and lives in N.S.W. now, but the book launch will be here in Perth.
It’s Glen, actually. But thanks for letting us all know. 🙂
So sorry Glen! Trust me, always going at life like a shark in a feeding frenzy, to overlook the fact that the comment was yours! Hope you’re keeping well and that your writing is powering along.
I’d encourage anyone who wanted to do Medicine to do it, Marlish. It is rewarding for all the reasons I stated in the post. For me personally, as I learned about the human body and mind, I also learned about myself. It gave me a leg up and out of a depressing life. I don’t know where I would have ended up if I had not gone into it …
I will look out for your friend’s book and google her essay. It’s great to hear of a successful writer-medico! Mind you, I think Khaled Hosseini pips us all on that!
Glen, there are a lot of good doctor musicians, too. The Australian Doctor’s Orchestra has a pretty good reputation, and plays to packed houses when they do perform.
I truly admire your decision Louise to leave medicine and devote your time to your family and to your writing. My friend Moira was able to write her novel because her husband became the full time house-husband. But that aside, as you say earlier on, pretty tough gig juggling motherhood with a full-time job. Never mind the demands of your husband’s work.
I quit nursing when my kids were little as it was mission impossible to keep a house-hold running, help my husband with his career, and then to work as a nurse on top of it all. Sheesh! But I was floored by the number of people who kept on suggesting subtly and overtly that I go back to nursing. Even had one friend give me a lecture about getting back into nursing, and to give up this foolishness i.e. writing.
No one knows the play like the player. It would have been absolute chaos with me nursing, raising two young children and my husband establishing his art career. As it stands now. I made the right decision.
Gee, your blogs always create such wonderful responses Louise! xx
Perhaps you two ought to check out the work of Karen Hitchcock. Karen published a volume of short stories in 2009 not long after finishing her medical training. I think she also had a novel come out last year. She now works at one of the big Sydney hospitals and does opinion pieces in The Monthly about things like the obesity epidemic and the inadequacies of the public health service.
Oh Karen, thanks for the suggestion, but still flat out assisting Lindsay with his art career – and always will be. The old paradigm of a visual artist exhibiting with a commercial gallery died a long time ago. Lindsay went out on his own in 1996, and due to his illiteracy he really needs my help. He has functioning literacy, but that’s it.
Glen, I will definitely look Karen up — good on her if she can combine writing and Medicine.
Marlish, I’m completely with you about stopping nursing when you had a family and a husband who needed you. Nursing’s another caring profession, where you can run the risk of burning out. I used to walk in the door after work and want ten minutes to wind down, but of course, the kids hadn’t seen me all day and would be climbing up my legs. Not working, I have the day to myself while they’re at school, and when they come home, I’m ready for them … well, I’d still like longer on my own!
Lousie, Glen, please forgive this ole pea brain. So pathetically getting confused between Louise, Glen and Karen. Karen??? Maybe if I was a bit more careful watching about who’s posting I wouldn’t stuff up so.
Hope you both have a good week!
I don’t mind being called ‘Karen’. I’m sure Glen doesn’t mind either!
I suppose ‘Karen’ is an improvement on ‘Lousie’, huh?
I’m getting used to ‘Lousie’ in the digital age!
Personally I love Louise as a name. But for fun’s sake…how about I call Louise – Karen and Glen Karen-Karen or GlenKaren??? And I’ll be MarlyboneKaren. And lets not forget IrisKaren. In fact we could form the Karen Club, or Karen Klub for Kooky Kreators.
If we’re changing our names, I want to change my surname, too. I’ve always liked surnames that start with ‘Mc…’, so can I be Karen McKinnon or Louise-Karen McKinnon? Or Karen McClelland — ooh I like the sound of that! What about you GlenKaren? GlenKaren McClairy sounds good… And MarlyboneKaren McCormack…
(holds head in hands and hopes it will all end very soon…) 🙂
Oh dear, I can see this is going to end in tears. GlenKaren McClairy isn’t coping. Time to stop, for now, put away your toys Karen McCelland and go have something to eat before I call the Karen Police.
It’s easy to see who sits in her attic all day, all by herself, punching away at her computer keys, twisting her brain inside out for the next good plot twist, and going stark-raving bonkers!
Marlish, I have just bought a copy of your novel. You have been warned. I will be watching for incipient signs of madness lying therein VERY CLOSELY.
I’ve just read Moira’s essay that won the Calibre prize, Marlish. Beautiful, intelligent, thoughtful — amazing. How she tied in all the issues she touched on — the rise in infectious diseases, indigenous health issues, indigenous spirituality, monotheistic religion, connection to country, and how she brought it all together. So glad I read it. I will look out for her book.
Oh, and I just bought your book, too!
Excellent. You and I shall compare notes on the MWITA elements (that’s Mad Writer In The Attic elements) that we will undoubtedly unearth in The Bookshop on Jacaranda Street (RRP $29.95 at all slightly strange bookshops.)
No-one expects the McClairy-McClelland inquisition…. 🙂
Oh no! Retribution! The other Karens are ganging up on me! They’ve bought my book. I’m going into a witness protection program.
And while you two Karens are at it, might as well check out my last blog posting, do your damage. Yours MWITA. It’s http://marlish-bookstew.blogspot.com/
Also Glen may I have your email address or are you on Facebook???