The Yale Guide to Careers in Medicine and the Health Professions, Yale University Press, 2003; Character Counts, p.74-76

A career in Medicine is a lot like life. It is good and bad, joy and sorrow, friends and enemies, known and unknown, connection and isolation. Much of the profession depends on preparation and skill, and much is out of our control altogether. We must rely on ourselves alone and we must leave much to God. We seek self-fulfillment through service to others. We are at once supremely proud to the point of arrogance, and the most humble of laborers. At times, our power seems limitless, and then we face our limits ……

Modern parlance defines us as “providers” of health care. But we are also a priesthood, bearers of a tradition, a body of knowledge, and power. We are authorized by society to levy pain, to do harm, to injure, so that those who trust us may have less pain, less injury, more life.

Our training is narrow, and focused, and removes us from the world. But we bring to our work all we have, and we must remain in the world to function. If we know history, we are better doctors. If we can hear music, we are better doctors. If we have studied philosophy, we can deal with life and death. If we are mature, we can support others. If we are wise, we can heal. If we are connected, loving family members, then we can lean on our family in bad times. We can leave them when the beeper rings, secure that we will be there for them as well.

During my interview for Medical School, I was asked for my favorite reading at that time. I replied that I was entranced by the essays of Miguel de Montaigne. The rest of the interview was a joyous acknowledgement of shared interest. All three of the interviewers had read and appreciated this sixteenth century philosopher whose travail with kidney stones, and life of pain, formed the basis of his approach to life. He was once a patron saint of physicians, I learned.

The best preparation for medical school is the best education we can get. The broader our knowledge of this world, the better we can understand our patients and the lives they lead. The more we bring to medicine, the more we can contribute. If we understand ourselves, we can understand others. If we are secure, others can rely on us. If we are able to call for help, we can hear others call. If we can cry, we can comfort. If we know languages, and can listen and communicate, we can care for patients.
Self knowledge, though, is perhaps the most critical tool a physician can acquire. What level of fatigue limits your ability to function? When have you reached the limits of your knowledge and ability? Can you call for help? Do you know how to tell if a coworker is trustworthy? Can you delegate responsibility? Can you work in tandem with authority figures? Can you work with your peers? Are you generous and courteous to those whom you employ, or those over whom you have authority? Can you recognize, and deal with, failure?

These skills are as crucial as the pages we have memorized, the tests we have passed. We have all known those who are “often wrong, but never in doubt”. They are dangerous.

The best doctors I have known have been good people, are evolved as individuals and good citizens.
One, an ophthalmologic surgeon, has had a sustained interest in government. He turned this interest into a commitment to organized medicine, and to the difficult and challenging effort of bringing the legitimate concerns of physicians to the attention of state and federal legislators. To many of our well-intentioned elected representatives, this surgeon is the dignified, informed, persuasive face and voice of Medicine.
Another, a general surgeon, was long known for his humanistic approach to his patients, as well as for his superlative skill in the operating room. Friends of mine, entrusting their son to his care, remember most of all the picture of their terrified boy falling asleep on the shoulder of this kind surgeon, as he carried the boy into the OR. That he subsequently recovered fully was the most important factor, but that he was cared for and loved while doing so was memorable. This sensitive surgeon began writing about his work and his patients and eventually retired from surgery to pursue a distinguished career as a writer.
One of the most respected internists in our community is justly famed for his attention to detail, and his comprehensive care of his patients. He is also known for his encyclopedic knowledge of classical music. We shared the care of one marvelous man upon whom the fates imposed a terrible burden of disease, pain and disability. I learned along the way that my colleague spent hours at our patient’s home playing computer games with this gallant man.
A gynecologist in our town has published poetry dealing with the joys and sorrows he and his patients have shared, and uses this poetry to show his patients that others have walked the paths life has set for them.
 
I am a Cardiologist, but I was a History major in College. My major has served me well in dealing with the changes society has imposed on the practice of medicine. And, in dealing with individual patients, my medical texts have helped but so have the jokes I have learned, the illnesses that my family and I have encountered, and the life I have led.
Last week, a patient called with a unique problem: his phone service was about to be turned off for failure to pay a bill. This would seem a trivial issue. But he has had several heart attacks, the last punctuated by a cardiac arrest. If this man had no access to a “911” service, it might well be a death sentence. Calls to our local phone company brought no response. But a call to the office of Representative Rosa DeLauro, of the 3rd Congressional District, resulted in restoration of his phone service before the end of the day.

So my advice would be to seek the broadest education possible before joining the profession. The more tools you bring with you, the better tool you will be. In an era when technology is driving the future of medicine, training in the sciences is crucial grounding, and knowledge of informatics and information systems an enabling act. But alone these disciplines will not help you understand your patients or yourself. A narrow, overly focused approach can lead to frustration and a waste of good training.

Failure to understand your patient will lead you to miss crucial information from a medical history. Inability to communicate with the patient will cause the patient to make mistakes in taking medications. Or they will mistrust you, which will lead them to abandon your diagnostic program or therapeutic regimen. 

And there will come a time when you may want to retire. The interests you have evolved will ensure that you continue your connection to life. And this connection will enable you to continue to be of use as a colleague, an advisor, a friend.