Dear Medicine, I love you. And, I hate you.

I love you because:

• You fascinate me! The inner workings of the body. How it functions without me even thinking about it. The anatomy. The physiology. It’s all so grand! How the pieces integrate seamlessly. And, how we have the ability to examine life at an intracellular level. It’s incredible beyond belief!

• You give me a chance to serve. I get to help people. Day in and day out, I have the opportunity to help people feel better. I help kids stay healthy. I empower parents with knowledge to support their kids through their illness. I even get to educate them about eating healthy, getting exercise, and how to perform better at school! You’ve given me the chance to travel all over the world to serve. You took me to a Native American reservation in Montana. And, all the way to India, to give medical treatment.

• Through you, I’ve met some pretty amazing people! My best friends to this day are from med school. Even now, you’re introducing me to physicians who are doing wonderful things. All finding their unique way to contribute to the world. Many within the walls of medicine, and many exploring outside those traditional walls.

• You’ve shown me what I’m capable of. You’ve shown me the strength and resiliency within me. Never would I have imagined working 80-hour weeks. Or, staying up for 30 hours straight! But, I did it. Many times over. I didn’t like it. But, I learned a ton about myself through the process.

And so, I also hate you.

• You worked me to the ground. I hit a rock bottom that I didn’t know existed. You didn’t give me the support I needed to find a healthy way through it. I suffered.

• You’re moving too quick. I can’t keep up with you anymore. You’re moving at a pace that isn’t letting me serve my patients in the ways I want to. I don’t get to spend time with them. Or, build the relationships and rapport that I need to feel like I’m making a difference. I mean, I’m still helping them. But, it could be so much better if you’d only give me the time!

• You’ve lost touch with the basics. The technology is amazing. The pharmacology advanced. But, you’ve lost touch with the basics. Empathy. Food as medicine. The power of lifestyle and habits. First do no harm. A subset of us are finding our way back to this. But, you’ve disappointed me, Medicine. You’ve lost the focus on prevention, so now we’re all playing catch up! We’re in a position of putting on the band-aid. The consequence is we’re handing our authority over to other groups to focus on the prevention part. The problem with that is some are valid, and others aren’t. We’re leaving it up to our patients to figure that out on their own.

• You’ve let insurance companies and the internet take over. Yes, two separate entities. But, both dictate how I can practice medicine. Insurance companies restrict the medications I can prescribe to my patients. Low reimbursement rates means my practice needs to see more patients, restricting the time spent with each one. The internet is the new MD. I want my patients to have easy access to information related to their health. But, when parents are in tears because the internet said their child might have a deadly disease, when they really just have a cold. Well, that’s not cool!

• The trauma. The body can do amazing things. But, when it’s not working as it should, it’s messy. When we intervene, it can be disturbing. What I mean is, seeing a child with tubes coming out of his mouth and veins is difficult. Seeing a child who needs more equipment to support her than the actual size of her body seems foreign. I know these are life-prolonging measures. And yet, the experiences and images are burned into my memory. The traumas of seeing the unfathomable. Add to that getting yelled at and scrutinized by attending physicians, and a lack of sleep and food. That all accumulates to a pain like no other.

So, yes Medicine, I love you. But, I also hate you. And yet, I haven’t left you. Call me crazy, but I love you too much to leave you. I know we can get through this. I know we can find a way. But, we need to hit some pretty heavy issues. We need to dig deep into our relationship.

And, like any relationship, we need to apply some essential skills:

• Communication. Girl, we need to start talking. And, I mean really talking.

• Respect. I agree, I need to give you more respect. Somewhere along the way, with all my pain, I lost some respect for you. But, here’s the thing, I need respect from you too. Respect the fact that I’m trying to serve in the best way possible. When you impose limitations on me, I feel controlled and restricted. I need respect and the space to practice the way medicine was meant to be practiced.

• Understanding. While I’m serving others, I need to take care of myself too. You’ve gotta understand this. I need sleep, food, and time to unwind too. I can only take care of my patients as much as I can take care of myself. It’s like the obese physician who’s counseling his patients about diabetes. Or, the doc who smokes and is counseling his patients about tobacco cessation. We gotta be able to take care of ourselves, instead of getting knocked down by the field. So often, we’re left seeking the quickest coping mechanisms, which are also often the unhealthiest! You’re starting to get there with wellness programs for physicians popping up. We need more of that.

So, what do you think, Medicine? I’m willing to give it a shot if you are!

Love,

Dr. Anonymous