Saturday, November 3, 2012

Life style.

Because I have been working on my residency applications and trying to sort out my future career, I have spent a lot of time thinking about what the concept of "life style" means. Whenever I mention the areas of medicine that I am interested in people always comment on life style. Somewhere fitting in the statement, "You should go into family medicine, it's the best life style."

At which point I want to put 6 inches of duct tape on their mouths.

If I go into family medicine it will be because I want to do primary care and live in the hills, be involved in community and do some extra training in EM, OB/GYN, or sports medicine. It will not be for the life style. Please do not try to sell a career to me based on the merits of how good things will be when I'm not at my job.  I want to choose my career based on how much I will enjoy being at work. Tell me to go into family medicine because you love your work, the fact that you enjoy the variety in your patient population, the continuity of care, the portability, whathaveyou. Not because of the life style.

[Because I plan to take most of this post down before submitting my CaRMS application I am going to be totally honest here.]

I am applying to emergency medicine, obstetrics/gynecology, and family med. I thought long and hard about general surgery as well, but realized that I actually LOVE the surgical component of OB/GYN more than the heavy scope and gastrointestinal component of gen surg. So, at this moment I am not applying to surgery. When people ask, and I tell them my choices, I am constantly told that I shouldn't do OB because of the life style.

Instead of a verbal reply to that from now on I want to hand over the following quote by a pediatric cardiac surgeon, from the book Walk on Water by Ruhlman:

You go through med school and they say, 'Oh, don't be a surgeon--lousy life style'. It's a mantra in med school: 'Life style, life style, life style.' Do you go into emergency medicine or do you go style? I see people doing things that are really hard and uncomfortable, but they do them anyway because they're passionate about their work. I want to do that. I see someone turn off his beeper because it's one minute after five o'clock--is that being a doctor? This is why surgery is the wrong choice for someone like that: no life style. That is what it comes down to, either you go with what you're passionate about, or you go with life style. 
I basically want to stand up and do a slow clap every time I read that passage.

It really is amazing, the responses I get when I discuss my future career aspirations. People will nearly always respond with a disparaging comment. It's reminiscent of when I was in the application process for medical school, actually. I would often get, "Why would you want to do medicine?" or "I almost did medicine but then decided I wanted a life and family instead", "Medicine is so hard to get into", I could go on.

I said to one of the OB's at work a few weeks ago that I was applying to obstetrics. His response, "So, you don't enjoy sleeping through the night then?"

What is the matter with these people? Hellllooooooooo?!

My career will be a big part of my life. If I love my work I will consider myself to be blessed with an amazing life style.

That is, of course, if someone will give me a residency first!! :)


OMDG said...

If that's how you feel, then you probably SHOULD go into Ob. Really, they say that if you want to do surgery (or ob) you need to like it better than sleeping. It sounds like you do. So go for it, already!

Hawkeye said...

As a family doc I can say that the "lifestyle" comment is a fallacy. I think I work hard and while I often don't have as much call as the specialists (although I do OB and emerg) I am emotionally exhausted at the end of my 12-14 hour days. I can't ignore the fact that my patients live on the street, trade sex for money, don't have enough to feed their 6 year old child, etc. The compassion fatigue in family can be overwhelming and exhausting in a different way AND it definitely impacts my "lifestyle."

If you are passionate about what you do, even in family, you can get burnt out. I think you need to do what you love - I'm with you on that - and we call struggle with balancing the things inside medicine and outside medicine. The people who think family is a lifestyle-speciality haven't met those that are passionate about what they do and dedicate themselves to their patients. I don't turn my pager off at 5PM!

Anonymous said...

To be honest, I'm not sure that the lifestyle argument is a fallacy. Medicine (in any field) is very demanding. However, there are fields that can be made more compatible with having an active role in raising your children and there are fields that cannot be made more compatible. This is something that we (a couple both going into the pinnacle of non-lifestyle fields) have often thought about and struggled with. The inflexibility in many medical careers is paid for by a future self with unknowable preferences, probably contributing to physician burnout.

I love your enthusiasm and I share it. But as I did my sub-internships and as I traverse the interview trail, I am increasingly aware of how severe the challenge is. I love my field, and its unquestionably what I want to do with my life, but I understand why it is criticized and even lampooned at times. If I didn't want to have a family, though, things might be different.

Albinoblackbear said...

@OMDG--I am! But, I think the universe (a.k.a program directors) will be deciding what I will be when I grow up. I am ok with that. :D

@Hawkeye--I would like to put your comment on the other side of my Ruhlman quote card. I did a mental slow clap in the breakroom at work when I read your comment. Thank you for your perspective.

@DFTFH--Yes yes yes yes yes yes "...paid for by a future self with unknowable preferences" is the most succinct way I've heard that fact stated. THANK YOU. This was the gist of a recent book I read about finding happiness and the inability of our 30 year old self to predict what will make our 50 year old self happy!

So far, the family equation isn't even coming onto the scene as far as career selection for me. Which does make it a bit easier. If I had a boyfriend/husband pressuring me with regards to that things might be a bit different.

Just Me said...

I agree with all these posters. I'm in family medicine and it is HARD!

You have to do what you love.
Its medicine, it's all hard.
Burnout exists EVEN if you love what you do! Be true to yourself, love what you do and take vacations.
It's even worse if you don't like what you do.

Remember to make sure that you do prioritize yourself. If you want a family, make it happen. When we're all at the end of our days our sacrifices for our work mean nothing - it's all about personal relationships.

I'm still working on my own balance after being in practice for many years. It changes all the time.