I think I still believe in saving the world.
During the recent mid-term elections, I stood in line awaiting my turn and shamelessly eavesdropping. A woman, whom I guessed to be an intern, was giving advice to a junior colleague. She had the absolute authority in her voice that comes from never having had a patient die even though you did everything right, or, worse, lying awake nights wondering if there was something more or different you could have done.
She gave advice about fellowships, specialty choices and student loans. They then talked about missionary work. You can do a few surgeries in a week, she said, but unless you create a sustainable system, you haven’t done any good at all. You should found a hospital, she said. Is that true? If I could fix twenty people in a week there, would that be enough?
I am old. I became a urologist early on a Friday afternoon when I looked up from the patient to see that it was evening. I love surgery. I love cutting out the problem and sewing the patient back together. I love the tranquility of manual labor and the reward of delicate stitches healing into a nice scar. You are taught, as a surgeon, never to lift your eyes from the table. You are there with this body, this patient, this problem and no other distractions. And I love that focus.
I am old. In college I dreamed of Nobel prizes. By medical school I wanted to be at the podium of national meetings giving my insights as a leader in the field. In residency I hoped to invent at least a new surgical technique. But somewhere along the way, the goal became more personal. It is not for me, anymore, whether or not my five year data shows this or that success rate. I want to know if I can fix this patient, the one sitting before me in the exam room, who came to me with a problem.
I am not a surgical innovator. I can’t cure all cancers. I don’t have a plan for tort reform or universal health care coverage. I don’t teach in my current job. I battle HMOs daily to get what my patients need, but I am terrible at paperwork. Committees bore me. I will never build that hospital. But when I call my husband, a pathologist, for early results on a patient, he jokingly asks, “Do you think your patients are the most important in the hospital?” The answer is always yes.
I believe that when a patient comes to me, she doesn’t care about sustainable systems. She wants to be heard. She wants me to bring my education and experience to her complaint. She wants to know that I am listening, truly listening. Over my career I am sure that I will treat thousands of patients. But I believe I can only save the world one patient at a time. I hope that is enough.
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