Orientation for new medical students and interns is an informal process that is done every rotation in our teaching hospital. I was glad that the senior resident assigned to me for that two week block volunteered to deliver the introduction to the team of three interns and three medical students. He even submitted to me an outline in advance. It was a fairly routine, brief and detailed account of the daily activities and responsibilities including rounding on patients and lectures and on-call schedules. We were sitting in a small class around a table sipping coffee and munching donuts. At the conclusion he launched into an enthusiastic description of his role; how he so much liked what he did and had fun doing it. It was so heartfelt and sincere that it struck a chord with me.
He and I met on a daily basis for the next two weeks to review the new admissions and go to the bedside to see patients. This could take anywhere from ninety minutes to several hours depending on the burden of new admissions from the night before. Sometimes he was so tired I avoided lingering too long on a teaching point and focused on just getting the work done. Often there were interruptions; beepers, interns reporting updates, angry patients, impatient family members, questions from nurses, discussions with consultants or the unwanted mishap. This is the ebb and flow and sometimes adrenaline rush of the day. It can be especially stressful when the caregiver is sleepless. So I watched my charge strained by the daily toll – was he still was having fun when tired, stressed, or uncertain in making the right choices? And just as a doctor is trained to notice nonverbal clues to a patient’s state of mind I wanted to penetrate his psyche to know of his commitment. I wanted to find a metaphor and query it… was his ‘glass half empty or half full?’, was he ‘stretched to the breaking point and about to snap?’, was he ‘going to become unraveled?’. I needed to answer these questions for him and for myself and so searched my memory- the answer, perhaps left unarticulated in my own training experience over twenty years earlier.
At the completion of his two week rotation, we sat down for a performance review. I’ve watched you over the past two weeks, I said, and I don’t think that your claim to liking what you do and always having fun is entirely true. Sometimes liking or loving something is visited by frustration, disappointment or even disgust and self doubt. What I believe is that you are passionate about what you do. I believe that passion can sustain you when just liking something fails. Passion can sometimes flicker or fade but cannot be extinguished. Passion is the core around which we wrap our deepest desires and it propels us toward our true selves.
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