Monthly Archives: October 2015

Here’s an article I wrote on a reproductive method that uses DNA from three different people to prevent mitochondrial diseases. The technique raises challenging ethical questions.

http://www.worldmag.com/2015/10/the_nuclear_option

While I feel privileged to practice medicine, from time to time I find myself becoming burned out and discouraged. Spending the time needed to care for a person at their clinic appointment without falling behind in the day’s schedule, angry calls from patients about their insurance no longer covering the medications they’ve been on for years, the sheer volume of labs to respond to and paperwork to review–all of this can leave a physician feeling like Sisyphus pushing the boulder up the endless mountain.  When I feel this way, the writing of Daniel Sulmasy helps me to regain perspective. Sulmasy is an internist, palliative care physician, bioethicist, philosopher, and former Franciscan friar who serves on the Presidential Commission for the Study of Bioethical Issues.  I had the chance to meet and talk with Sulmasy for a while at a conference a few years ago and found him to be kind, gracious, and humble.

Here are a couple of passages from his book The Healer’s Calling. It should be noted that Sulmasy is a Christian and these passages reflect his spiritual tradition:

“For the health care professional, love for one’s patients alone will not ultimately satisfy. Patients can be very fickle. They can bring frivolous lawsuits against those who did their best in love to help them, and this can be deeply hurtful. Patients can be demanding at times. The relationship to the patient will not be a full healing relationship if one cannot see it in the context of one’s relationship with God–one’s spirituality.  If a health care professional is not careful to cultivate a spiritual life, he or she will quickly end up becoming cynical about patients. No physician or nurse will last very long in health care looking to patients themselves for personal satisfaction. Patients can only be the point of departure. They are not the source of satisfaction, but signposts that point the way to satisfaction. Physicians and nurses are really doing their jobs when they see each patient as a precious being swept up into the mystery of God’s love. . . No matter how sophisticated the technology of healing gets, true healing will involve three very simple human elements: compassion, touch, and conversation.”

Sulmasy’s words are lofty and well beyond what I achieve except in my very best moments. Nonetheless, he offers a noble vision of medicine that calls health professionals to strive toward something higher amid the daily stress and frustrations of clinical practice.

Tonight I spoke with UT’s Plan II Pre-Medical Society, answering their questions about what it’s like to become and be a doctor. Here’s some of the advice this old man shared with the youngsters.

Embrace Your Gifts and Passions

Early in his career, the late physician and author Oliver Sacks badly wanted to be a neuroscientist. The only trouble was he just wasn’t very good at it. After a number of mishaps in his attempts to do research, his supervisors firmly told him his future was not in the lab. Instead, he was sent to work with patients with severe degenerative neurological diseases living in a long-term care facility. While his contemporaries saw this kind of work as a dead-end, Sacks found it very much to his liking. At the nursing home, he was able to spend long hours with patients learning their stories.  Out of this experience, he discovered his gift for writing about what it’s like to live with a serious neurological condition. Sacks’ books and articles have evoked empathy and interest in people who would otherwise be overlooked. He has drawn medicine’s attention to the patient’s experience of illness, rather than simply studying and addressing disease. As Nobel Prize-winning scientist Eric Kandel wrote, Sacks “transformed the view of the mind for millions of people in a way that is both insightful and entertaining.” Imagine how much the world would have missed if Oliver Sacks had insisted on being a neuroscientist instead of embracing his gift for hearing and writing patients’ stories.

Be Curious

I recently saw a patient with symptoms I simply could not make sense of.  As I asked her questions about what she was feeling, more and more interesting details about her life came forth. I followed my curiosity and soon we were discussing changes in her most important relationships and transitions that were taking place. And then the cause of her symptoms became clear. Just by following my curiosity, rather than directly trying to figure out what was wrong.

It is also important to be curious about systems, customs, and institutions. Medical students should embrace the naivete they bring to their work. Medicine’s pedagogical method of apprenticeship leads it to honor tradition and hierarchy. It is slow to embrace change and question itself. While students are learning the culture and methods of medicine, I encourage them to also respectfully question why things are the way they are.  This is how breakthroughs and innovation happen. The disciplines of hospice and palliative care emerged when people looked at how patients were spending the end of their lives and asked if there could be a better way.  Was it really necessary to die in an intensive care unit connected to tubes and wires, surrounded by strangers and beeping machines? Or might it be much better to die at home in your own bed with family at our your side?

Seek Balance

There is more to life than medicine Keep up your relationships with your friends and family. Exercise. Take time to do what recharges your battery–music, books, writing, sports, travel, being outdoors. What good is it if you become a doctor, but in the process are transformed into a miserable, boring person?

Anyway. I hope the students gained something out of our time together. I enjoyed being with them and sharing what I’ve learned.

Seek Balance