The physician as a paradox

I'm taking a class right now called "Personality traits of physicians: How our strengths become our limitations," a super long name for what is essentially two hours of group therapy with a psychiatrist who specializes in physician health. Don't get me wrong, the course is really interesting and it's pretty awesome to have scheduled time for self-reflection, but it's definitely easier to bury your head in a book than to think about what your priorities are in life, whether or not you're truly happy, and if you're living your life right.

To start off the afternoon, we were given a sheet titled, "Personality traits of Physicians," and apparently we (are):
-Need to be needed
-Need to be helpful
-Equate self worth with success (patients getting well) - check
-Over-achieving - unrealistically high expectations - check
-Totally responsible - check
-Self-doubt and guilt - check
-Self critical - check
-Need to feel powerful, perhaps omnipotent
-Perfectionism - always right, in control of every detail - 50% check
-Restricted ability to recognize and express feelings - 25% check
-Underdeveloped capacity to play - 50% check

Whew, what a nightmarish list.

At some point, Dr. Tighe said, "You guys can't keep putting your lives on hold. Oh med school is going to be hard for the next two years, but it'll be more relaxed fourth year and then I'll have time. Oh, intern year is rough, but it's okay. Once I get past intern year, the rest of residency will be better and then I'll have time for you. Soon, I'll be an attending, and then I really will have time for you. And then you're an attending, and you still don't have time because there's new obstacles at every point. It never gets easy and soon 9 years have gone by and life's passed you by."

Sometimes I really wish I was Steve Garcia, with my wife and my two kids, because then I would know where medicine was supposed to fit into my life. But I'm 22, alone and single in Chicago, with the one purpose of being a good medical student. I'm worried because right now, medical school IS life, but is that such a bad thing? It's kind of a fact of life. Is it so unhealthy to think, "If I make a few sacrifices and work really hard for the next 1.5 years, I'll be set and it'll all be worth it?" (I told Kathleen this the other day and she said, "Not to be morbid, but why if you died in 1.5 years?") Sometimes I think that's the only way to get through it all. Two more days until the exam, then I'm done. Four months until the boards, then I'm done. One and a half more years until we're done with third year. How else can you force yourself to sit at your desk for days on end?

Dr. Tighe also said something else that shattered my little 22 year old dreams - "You can't have it all. You can't be the chair of derm at Harvard, and have the perfect marriage with the perfect children and the perfect house." Even though I detest the quote, "Reach for the moon, even if you fall you'll land among the stars," we've been trained our whole lives to think the sky's the limit. What do you mean, you can't have it all??? Of course you can!

The pressure is completely self imposed I know, but it takes a very special person to read through the the Boards averages and number of research papers for each specialty and not freak out. What's turning out to be the biggest blessing and the biggest headache is not knowing where the limits are. The idea of maxing out potential hovers like a huge billowy cloud over my head, because if you work hard and do your best, why shouldn't you have amazing goals? You might kill yourself in the process, but everything's within reach. Right?

There's more than one path to happiness, so I know I sound ridiculous even as I write this. It just seems like getting into the most competitive residency is the new summa cum laude of college, valedictorian of high school, acceptance to Stanford, because it doesn't matter in the long run, and gasp, it may not be worth the added stress.