You might think doctors enter the field of medicine in order to get rich, please their parents, or gain status, and sure, there are probably some money-driven doctors who were given only two choices of professions by their parents-medicine or the law. While I’m not saying those things aren’t motivators for some, I will claim that what drives doctors to endure the sacrifices of medical training goes far deeper.
On a teleclass I was leading with Dr. Rachel Naomi Remen for the doctors of the Whole Health Medicine Institute, Rachel asked us, “How old were you when you first realized that the life of another living being mattered?”
We were all less than ten. Rachel has been asking this question to thousands of doctors for decades, and the answers are consistent. We are the children who go out early on rainy days to rescue the worms from the mud puddles so the bullies don’t squash them. We are the girls who nurse the injured baby birds back to health. We are the boys who cry out when the other boys are pulling the tails off lizards.
I was the Squirrel Girl. As I explain in greater details in this blog post, I was the seven-year old who became the nurse to injured baby squirrels in my small Florida town. Between the ages of seven and twenty-two, I raised twenty-two baby squirrels who others brought to me when the squirrels got hurt.
Rachel told one touching story about a male doctor who remembers being only two when he cut his foot on the sharp drain of the bathtub, and his mother warned him not to step on the drain because it was sharp and could hurt him. So every night, as he got out of the bath, he dropped his washcloth over the drain, so the water wouldn’t get cut as it swirled down the drain.
The Lineage Of Medicine
As I wrote about in How To Heal Our Broken Health Care System, doctors are called to medicine the way some are called to the priesthood. Medicine is a spiritual practice. I think that’s why we call it a “medical practice.” It is something you practice, like you practice yoga or you practice meditation, like you’ll never get it fully right.
I know you thought you were helping me when you taught me that the needs of my patients were more important than my own self care. I know you thought you were training me to be an exceptional doctor when you forced me to scrub into surgery when I had the flu, wearing a diaper and an IV so I wouldn’t throw up, pass out, or have to scrub out because of my diarrhea. I know you allowed me to be the victim of years of sexual harassment at the hands of my physician professors, not because you’re evil, but because you’re just asleep, and you mistakenly think “boys will be boys.”
I know you didn’t mean to make me sick. And when I was taking 7 pills by the time I was 33 just so I could keep selling out my body in order to practice medicine, you didn’t realize you were hexing me when you labeled me “chronically ill,” suggesting that I would die in my fifties from a heart attack.
I know that when you expected me to work 72 hour call shifts, you thought it was because someone had to deliver those babies. And when you insisted I see 40 patients a day, limiting me to 7 ½ minutes with my patients, you thought you had no choice because of how managed care insurance executives have bastardized you.
I know you’re blind to how you’re being manipulated by Big Pharma, and you think you’re doing us favors by hosting “drug dinners” funded by Merck and Pfizer. I know you feel manipulated by patients who come in asking for prescription drugs by name because they’ve been duped into asking by ads aimed directly at patients, funded by Big Pharma (a practice which is only legal in two countries in the whole world- the US and New Zealand.)
I know you’re scared of getting sued because of vicious ambulance-chasing medical malpractice attorneys who have left you feeling like you have to be perfect, when medicine is an imperfect science. I know you order too many tests to try to protect yourself from those lawyers, and your greatest fear is that someone will die on your watch, and someone will blame you. But death is an inevitability for all patients, when their times come, and I hate to break it to you, medicine. But you’re not in control of when people die. God is.
Is medicine saving us- or killing us? Are doctors helping you- or harming you? Are you improving your health by taking prescription drugs- or are you decreasing your life expectancy? Are you getting the medicine you really need? Do you even know what kind of medicine that is?
These are the questions I answer in my third TEDx talk, which I delivered live at TEDxFargo, which was organized by Fargo community leader and Whole Health Medicine Institute physician Dr. Susan Mathison.
I had a meltdown on the plane on my way to Fargo because I knew what I would be discussing has the potential to be wildly controversial, and I wanted to ensure that my message was not misinterpreted by the very people I seek to serve- doctors and patients. I reached out to one of my mentors, Brené Brown, and she talked me off the ledge with an email that guided me with exactly the advice I needed. I wound up rewriting my speech on the plane only one day before I gave the talk.
It’s bad enough that many patients leave hospitals with sutures, a bag of pain pills, and a new diagnosis that often carries a “chronic” prognosis. But according to Harvard professor Lucian Leape, something even more insidious is happening that’s leaving patients with a bad taste in their mouth. He says, “Disrespectful behavior - our ability to tolerate it, and not do anything about it - is the root cause of the dysfunctional culture we have in medicine.”
In many of my blog posts, I’ve been suggesting that the only way we’re going to heal health care is to reclaim medicine’s heart and bring love back to the healing process. So I agree with Leape. Disrespect simply isn’t loving - and it runs rampant in hospital cultures.
Disrespect In Hospitals Runs Rampant
In a pair of papers published in July in the journal Academic Medicine, Leape and his co-authors outlined six categories of disrespect prevalent in hospitals. On one end lies the overtly nasty - the surgeon who throws the bloody scalpel across the OR, the four-letter outbursts, the bullying. More common is the systematic degradation and humiliation of medical students and residents by medical school professors, the contempt dripping from the voice of surgeons as they give orders to nurses, and the way some physicians demoralize and disrespect patients by cutting them off, negating what they say, or simply not listening.
But there are other more insidious behaviors of disrespect that permeate hospital culture: passive-aggression (harshly criticizing colleagues with the intent of psychologically harming them), passive disrespect born of apathy and burnout (“I won’t even bother to return this page from the nurse”), and dismissive treatment of patients (refusing to return their calls or answer their questions).
I once wrote a whole book that is yet unpublished called BROKEN: One Doctor’s Search For The Lost Heart Of Medicine. It’s still unpublished, but I now know the real reason - because my role is not just to raise awareness of how broken our system is, but to be a force for healing it.
I’ve known this for many years - 7 ½ to be exact - but I’ve been so overwhelmed by the enormity of such a mission and so traumatized by the system itself that I’ve resisted this calling. Until just recently, when I’ve finally made peace with my calling and agreed to lend myself and my online platform to the service of healing my beloved profession. My upcoming book Mind Over Medicine: Scientific Proof You Can Heal Yourself, as well as the TEDx talk I gave in December 2011 and the one I'm giving in November 2012, the lectures I’ve been giving around the country this year, and many of my blog posts are devoted to being a spokesperson for this vision.
The vision began as fuzzy idea, difficult to articulate and impossible to imagine coming into being. I knew it had everything to do with love and hope and healing touch, but I wasn’t sure about the cursed “how’s.” But over time, my vision has crystallized, the tribe of people who share my vision is gathering momentum, and I already see it coming true, at least in my mind’s eye and small pockets of the world, if not ubiquitous in present reality.
They say if you can’t dream it, you can’t do it. So this has been the first step - getting clear on the dream.