One need not search far to palpate a growing dissatisfaction among physicians about the current state of the practice of medicine. Complaints include longer hours, waning compensation, the hassle of insurance providers, direct-to-consumer drug advertisement, skyrocketing malpractice premiums due to growing fears of injury litigation, and a general disintegration of the prestige and respect long given to the title “MD.” While all these claims are valid, a vociferous elite in the published medical community dwell ad nauseum on the shortcomings of modern practice, while often neglecting the timeless virtues of the physician. Medical Economics recently published an opinion piece by a pediatrician who claims that the he has not, in fact, been overcome with the disenchantment that reverberates in the commentary of many practitioners. “Hard to believe, but it’s been almost 20 years, and I still feel the same way,” writes Dr. Lawrence Rifkin. “Being a doctor can be a hassle. But it’s still a joy and a privilege.”1
Although Dr. Rifkin’s essay is a mere 700 words long, he uses the term “wonder” five times.2 The word has many applications, but “wonder” may be most aptly ascribed to the sentiment of aspiring doctors. Medical students and prospective medical students gaze upon the field with a starry-eyed perspective; we mean to do good, and to make humanity healthier. And good for us. For, just as the crabby, nostalgic docs warned Dr. Rifkin 20 years ago, our opinions will likely change. But I say, you have to set out at level 10 on the “wonder” scale in order to accommodate the proposed drop to a disillusioned level 4. Were students to enter medicine already jaded, they might fall off the charts altogether and find themselves practicing, well … plastics.3 But Dr. Rifkin says that his sense of wonder has not left him. It is “reawakened by stepping back and taking a second or two now and again to look at the big picture.”1 His point of view is thoroughly refreshing and encouraging to the newest generation of medical students entering a cynical world.
When I pause and really think about what our profession has accomplished, the sense of wonder rushes in. Since the mid-1800s, life expectancy in much of the world has doubled. It’s as if modern medicine and public health have given each of us a second lifetime. Who among us doesn’t have a relative who was saved by modern science—heart bypass surgery, perhaps, breast cancer treatment, or a C-section? My role may be small, but it still feels good to be a part of such a positive change.1
I hope to thrive off the wonder of being part of a positive change for as long as I can when I officially begin my medical career this summer. And regardless of what truth may lie beneath the seemingly glossy finish, I am sure that cynical diatribes accomplish very little to affect real change, whether in the practice of medicine, or in any profession. But optimism … now there’s a start.
Footnotes:
(1) Still a privilege to be a doctor. Medical Economics. 2008.
(2) Forgive the literary deconstruction of this piece. My undergraduate training involved a good deal of textual analysis, and I cannot help but to count words and to distill meaning where meaning may not actually exist. Nonetheless, I do believe that an author may pen words that arise from a deeper part of their consciousness of which they may not even be aware; the repetition of “wonder” is then seen as an inadvertent, and important, theme.
(3) This comment is, admittedly, a cheap shot. My apologies to the plastic surgeons out there who really do correct horrible disfigurement, such as lifting those dreaded wrinkles that come from the unnatural process of “aging.”