Why do we become doctors?

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Another blogger wrote a lovely post recently about some of the challenges of being a medical student, and about her motivations for doing what she does. It reminded me of all the times I’ve wondered the same question.

Medicine is hard. Really, you say? Didn’t we tell you that before you started? Well yes of course, and I knew that and yes, I heard all those doctors who told me not to do it. I’m not deaf. I’m not stupid.

Medicine has been hard in ways I didn’t expect. The work is pretty full on, yes, but not really harder than another degree. Worse has been learning to be a student again, summoning up motivation to study, and exchanging friends for textbooks. And while medical school is one thing, I suspect working life will bring additional…issues. I’ve recently applied for my first Foundation doctor job, a national process that gives final year medical students a vague illusion of choice and autonomy before corralling them into random hospital posts across the country. That’s how it feels anyway. I find myself resenting this process heavily, given that as a… mature… student I would quite like some say in where I settle down for the next few years.

And of course it will continue to be hard. More exams, more job applications, more relocations, less time with partners, friends, children…and of course the sheer hardness of being a doctor at all. Of remembering all the blood results of every patient on your ward in case the consultant asks. Of knowing what to do when you’re the doctor on call and someone stops breathing. Of working out the real reason Mrs Singh has come to your GP clinic and managing her 26 differing needs in a way that is sensitive and appropriate and evidence based.

And to think I used to have jobs where all I needed to do was turn up at 9:30 (9:30!) and switch the computer on.

So why do we do it then? Is it because we “want to help people”? It’s the obvious med school interview answer, but you can help people as a plumber, teacher, hairdresser, kid’s party entertainer, politician – and have more time for your family. Is it to get rich? Better to choose banker, oil company executive, footballer’s wife. Is it because we love science? The thing is, medicine isn’t science, not really – you’d be better off in a lab.

For me, well I’m still not sure and the answer will probably keep evolving. But it probably involves needing some kind of job due to not being an heiress, being nosy about other people’s lives, the rush of a busy shift on call, the amazement of seeing a brand-new baby or someone’s insides, the daily ethical dilemmas, the joy of getting a thank-you kiss from an old lady, the satisfaction of making a diagnosis, the sheer daily variety and, yes, knowing that – even if it was just for an instant, I definitely did make a difference to someone’s day. (It could have been a net negative difference mind, but hopefully not).

It’s interesting, isn’t it, that at the end of the day we often make emotional rather than rational decisions about the most important things in our lives. I didn’t make a rational checklist when choosing my boyfriend – most people would agree that to be weird.

I know that as a medical student I still have a somewhat unsullied view of the daily grind. If you quote this post to me one 6am when I’m about to start my hour-long commute to work having been up all night feeding the baby, you can expect to get a slap. But I will try to thank you afterwards for reminding me.

Is there a doctor on the plane?

Doha to Phnom Penh. We take off in the witching hour, planes waiting on the dark desert tarmac like strange sea creatures. Does anyone ever actually stop in Doha? Second flights always feel like no-man’s land to me: between two unknowns, a stranger to everyone. And night flights, as everyone knows, are the ones that vanish. From an unknown to a mystery.

Anyway, by the second flight I’m often too tired to care. And this one’s half empty, so I manage to lie down and sleep for a while.

I’m woken by a loud thump. To my mind, thumps on planes always = imminent death. Looking round however, I realise that a man has collapsed in the aisle behind me. There are a host of, well, hostesses around him and he’s just starting to move again – looks like he fainted. He’s ok, I think, lying back down to sleep. Also, plane still in air – phew.

That’s when I hear the announcement. You know, the announcement. “Is there a doctor or a nurse on the plane? Can any doctor or nurse please come quickly.”

Me? Naaaah, I think, looking round. There has to be a doctor or nurse on this huge plane somewhere. They’re pretty common professions. Several doctorless and nurseless seconds go by though, and I find myself standing up. I thought this moment would terrify me, but it doesn’t. (I’d be more terrified if I wasn’t pretty sure the guy has only fainted).

“I’m not a doctor” I say, going over to the huddle of hostesses. “But I’m a student doctor”.

They turn. “Oh, thank you doctor”. (Did they hear me?) A case appears containing a handheld sphygmomanometer and a shrink-wrapped stethoscope. Can you check his pulse and blood pressure for us, and write a doctor’s report?

Can I? Well, this is what I’m training for. I put the cuff round his arm, so grateful for those lessons, way back in first year, on how to measure blood pressure by hand with a stethoscope. It’s a surreal moment, listening for the Korotkoff sounds over the roar of jet engines. I take a quick history too, checking there’s nothing else going on.

I’m lucky, the guy is ok and I’m confident to write that down (stating clearly my student status). Returning to my seat, I realise it’s the first time I’ve had to use my skills – however basic – in a real situation, far away from guidance. It feels good.