Advising a potential doctor after a good day in the clinic


I said to a friend of a friend,
Consider the time that you’ll spend
    And the cash you’ll be burning
    For medical learning
And the terms of the Federal lend

I take care of patients and I cannot write identifying information. They are male or female or confused; they do or they don’t work, they are or they aren’t students or teachers or either or neither or both; some drink to excess; many smoke; each is a part of a family unit and has a social context. They all have feelings; the adults all have sexuality. Each has urges to evil and good in various strengths and directed with differing degrees of mastery.

Today I saw patients for colds, coughs, pink eye, sports physicals, sore throats, urine infections, STD’s, hives, ankle sprains, ringworm, and well child checks.

One patient’s family includes three generations of jockeys, one of whom rode the Kentucky Derby three times (I have permission to include that information in this blog).

My patients bore Polish, Hispanic, Irish, Scots, Czech, English and Indian last names; some had mixed Native American facial features.

One parent and child interrupted each other constantly despite a great deal of apparent love.

I gave advice about nicotine, caffeine, alcohol, trampolines, foot odor, ear wax, seat belts, sleep, exercise and diet.

One person, betrayed by a lover, wept.

Two families were affected by alcoholism.

The clinic today opened at noon and we went till eight.

When I got back from work I called a friend of a friend, actively considering a medical career. No matter what you think medicine is, I said, it will not be that when you finish your training; it will have morphed into something we cannot even imagine. No career holds more honor, few have more job security. These things will not change: people will get sick, sick people want to get well and they do not want to see unfamiliar faces; healers will hold a high place in society and they will be fed.

Becoming a doctor requires an investment of two years for premed, four years for med school, and three years for residency; the money invested pales in comparison to the time. Government programs that finance the education demand payback on a year-for-a-year basis, and pay a fraction of what could be earned in private practice.

I had a National Health Service Corps scholarship to medical school; they paid tuition, books, and a stipend.  I worked in the Indian Health Service three years past my obligation because my time with the Navajo enriched my life beyond measure.  When I left my income doubled every six months for a year.

Medical school changes the person who enters. Someone who seeks only riches will either drop out of the program or will change their attitude; the same can be said for those motivated purely by altruism.

The doctor who doesn’t put first things first in his or her own life won’t last in the profession. The doctor who neglects physical needs, such as eating, sleeping, human relations, and medical care, will burn out.

Pick a specialty, I said, based on what you’re good at and what you love. Don’t go into something because you admire a particular specialist.

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