As a physician, I realize that my job satisfaction is derived from three sources:
1) My relationships with patients;
2) Specialized knowledge; and
3) The pursuit of technical excellence.
These three aspects of the doctor role continue to evolve and recombine, spawning potentially new “best moments” that continue to thrill and keep me returning for more.
I think most medical student begins their career hoping to experience unfiltered contact with the human experience. Our encounters with patients are totally frank, dealing with issues of suffering, healing, risk, longevity, and the inevitability of death all at once. We share our patient’s vulnerabilities, which often bear the full weight of life’s greatest hopes and fears wrapped up in the unspoken question, “what are my chances?” It is a humbling honor and thrill to be seen as an authority figure and source of hope at such times. These are “best moments.”
During training, doctors develop a tremendous wealth of theoretical knowledge, which is then refined and resynthesized over a lifetime of experience in the clinical arena. One of my professors during internal medicine residency (thanks Dev) would say that “the practice of medicine is not a scientific endeavor, but rather a humanistic endeavor.” That was hard to accept at a time in my formation when I was still working hard to apply my theoretical knowledge at the bedside. However, I now agree, realizing that a doctor’s scientific knowledge base becomes an extension of himself or herself, such that we no longer need to “think scientifically” at the bedside. The focus is now on the humanity, and the opportunity to relieve suffering and restore health and hope. The science comes automatically, and scientific updates in the medical literature are easily assimilated into our conceptual foundation. The doctor is no longer a scientist, but a healer. Emerging as a healer is a source of “best moments.”
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As a doctor performing a high volume of procedures, I also derive “best moments” from my technical triumphs. I perform many of my procedures (such as ablation of atrial fibrillation or ventricular tachycardia) under general anesthesia. After a quick heart-to-heart reviewing what we hope to accomplish, the patient is deeply sedated. Several hours will pass, during which time I am working in earnest. The next thing the patient will know is that it’s all over, and we’re having another heart-to-heart about how it went. I love to perform procedures, which draw on my medical expertise and knowledge of the pathophysiology affecting my patient, allow me to use the latest technology which is thrilling, which requires my finest skill and manual dexterity to achieve. During these cases we take delight in the anatomy, and physiology, in presentations of disease, and in our accomplishments for the patients. It is an honor and thrill to bring the best of my abilities and my greatest efforts on behalf of the patient.
So what was a best moment? It’s difficult to say, and difficult to compare my most valued moments in medicine, because profound moments can be experienced so differently. What I can say is that my goal is to experience high value moments as frequently as possible, knowing that I am adding the greatest value so long as this is the case. In hindsight and in moments of reflection I may see certain interactions as “best moments.” Hopefully it’s obvious that making such distinctions is hardly relevant.
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