Teaching Doubt

Christmas 2009 029Dr. G motioned toward the small upholstered seat in his office.  I obliged and sat down while he walked around his oversized mahogany desk and sat in his black leather chair.  How many patients sat here, nervous, uncertain, looking at their all-knowing doctor sitting in that large foreboding black leather chair waiting for the news.

I wasn’t waiting for anything.  We had just finished clinic and we sat down quietly to discuss the cases.  He told me stories about his time in the Amazon rainforest.  Truthfully, I didn’t believe a word he was saying.  He didn’t look like the kind of guy that would spend anytime away from a hairdryer.  His hair was always perfect.  Too perfect.  He obviously dyed it jet black.  He dressed like Simon Cowell (before there was a Simon Cowell).  Tight black v-neck shirt.  Black slacks.  Black belt.  Very expensive black loafers.

He talked about the time he diagnosed Chaga’s Disease in the jungle, a disease I read about, but would likely never encounter in my entire medical career.  I racked my brain for details, in case he asked me a question, toxic megacolon, some kind of kissing bug.  He sat back in his oversized chair, elbows resting on the arms, hands folded under his chin, looking out into space, and across time.  He wasn’t in the rainforest now.  He was in the city with a clinic full of patients with the typical American ailments; diabetes, hypertension, cancer.

I made certain assumptions about Dr. G after working with him for close to a month.  He was older than he wanted to appear, he was unmarried, never had any children, drove a fancy car, and dated the drug reps.  He wasn’t particularly charming or friendly to the patients, but he was knowledgable, direct, and confident.  He treated me like a colleague, which I appreciated, since I hadn’t yet earned it.

Two things stuck with me from my time with Dr. G.  One of which broke my heart.  As we sat across from each other in his office, he leaned forward, elbows now on his desk, hands still folded, but now in front of him.

If I leave you with anything, Kim, it’s this:  know your medicine, know your diseases inside and out.  You have to know them so well that if you get a call at 2 in the morning, if you are startled out of a deep sleep, you can function, you can treat anything on the other end of that phone, you have to know it as well as you know yourself.  If you can’t do that, if you have fear, you better turn around right now.  You better stop right now because you will hurt somebody.

That certainly got my attention.  It became something of a mantra to me.  Know the medicine.  Know the diseases.  Call at 2 am.  Hurt somebody.  Later, when I was on call in residency, I would remember his words.  I trained myself to wake from sleep instantly, from fully asleep to fully awake at the buzz of a beeper.  Ready to go.  Know the medicine, know the disease, because I didn’t want to hurt anybody.

Towards the end of my time with Dr. G something happened.  His partner obviously irritated him.  His partner was sloppier, friendlier, happy-go-lucky, and lazy in comparison.  I could sense the tension.  Years later, I learned that the partnership had dissolved, although when that actually occurred is unclear.  I think I was witnessing the beginning of the end.  Dr. G even started to look a tad disheveled, which was so unlike him, his black hair rooted in gray, his black shoes a little scuffed.  After a particularly busy day, we sat like we always did in his office.

All the smart people coming out of school go into business.  There’s no money to be made in medicine.  Why would you ever want to do this?  You should go to business school.  This isn’t worth it.  Patients want to sue you, insurance doesn’t want to pay you.  Medicine is not what it used to be.  You should get out now. Medicine is a mistake.

No one ever said that to me before, that I may be making a mistake.  My heart sank.  I never once considered it until that moment.  It didn’t feel like a mistake.  It felt like what I was supposed to be doing.  Going to business school would feel like a mistake.  In that moment, he gave me doubt.  A doubt that once in a while still visits me.  Was it all worth it?  Should I have chosen another way?  Did I do the right thing?  All that money that I owe for medical school…

I wish I could sit across from Dr. G today, me in that small upholstered chair, him in his big black leather chair.  I would sit forward, elbows on his desk, hands folded under my chin, look him in the eye and say, Dr. G, it has been worth it, every minute, every sleepless night, every penny that I have spent for my education.  All worth it.  If I could leave you with anything, Dr. G,  it would be this, to truly see someone, connect with them in their most desperate moments, to bring them comfort, to ease their pain, that is why we do this job.  Not for the money.  Like when you were in the Amazon.  I wish you could see that for yourself before your own doubt destroys you.




This entry was posted in Medical Musings, My Stories and tagged , , , , , . Bookmark the permalink.

2 Responses to Teaching Doubt

  1. Too many good doctors make enough money to retire very early.


    • Many good doctors leave the field too soon because they are burnt out, disillusioned, and frustrated with the system. They open up coffee shops, or join drug companies, or get as far away as possible….


Comments are closed.