To shed some light on my very non-traditional career move, I thought I’d share some of the thoughts that went into the whole decision-making process.

Excerpted from my old blog, back in 2005 (was it really that long ago?).  Italics reflect my present-day comments/clarifications.

When I chose medicine over music, I really didn’t know what that entailed. And how could I? sure, I knew about the long hours, the grueling surgeries, the endless nights and weekends spent in the hospital instead of out with friends. I knew billing and insurance was a necessary evil to be dealt with, and I knew that oftentimes patients are grumpy and use you as a scapegoat.

If that were all, I could easily handle being a surgeon. But that doesn’t even begin to scratch the surface.

I didn’t know about the power struggles that would occur between attendings (MD in charge of the team), with quality of patient care falling victim to politics. I didn’t know that callous attitudes are so pervasive, and that even after you spend all night taking care of your patient, the new morning team may not be invested enough to make sure things are followed up quickly… and that buys your patient an extra few days or a week in the hospital. I didn’t know that errors could be so easily swept under the carpet. I didn’t know there were so many @ssholes who value research grants more than a few kind words to the patient who is someone’s daughter/grandfather/best friend/lover.

There are days when doctors labor over a child in the throes of death, lose the battle, and listen to the keening of a mother who has just endured one of the greatest blows she could possibly receive. This in itself does not terrify me as much as looking around and realizing that 2 minutes later, everyone has gone about their business as usual… and physicians are going over the “interesting case” that they weren’t able to save. I don’t EVER want to be like that. Yes, that is a defense mechanism for most of the doctors, and I’m not judging them for it by any means.  I prefer not to put myself in situations that will warrant that kind of reaction, however.

Those who practice medicine as an art end up fighting a losing battle against those who practice it like a golf swing. They burn out quickly, using superhuman effort to bypass the numerous structural and environmental obstacles. And in the end, they are left behind by the inexorable pace of technology, and the “advancements” that encourage physicians to give 16 drugs instead of spending 5 minutes at the bedside.

The future of medicine is not in the hands of medical schools and future physicians– it belongs to the government, to large corporations, to agencies with the infrastructure and resources to effect broad, sweeping, changes. Why are entire generations lost in Africa? We’ve got the drugs… oh yeah. that thing called access. it doesn’t exist. What’s the most common cause of childhood mortality? Diarrhea/dehydration. We have a solution for that, don’t we? Nope, not for 3rd world countries where they can’t get clean drinking water.

Given all this, I was still telling myself several months ago that it was worth it, that if I did surgery, the sheer joy of being in the OR would compensate for all the bullsh*t, and it wouldn’t be a problem.  For a career that truly allowed me to impact people’s lives, I’d readily take it up.

But that isn’t the case today. Medicine is so drastically changed from even 20 years ago that doctors can’t see the forest for the trees. Everything is fragmented and god forbid, if your patient has a problem outside your limited (albeit highly specialized) sphere of expertise, then a consultant from a different field is warranted. I would rather help shape the big picture, instead of blindly toiling inside my little bubble all day long.

The decision point that pits personal ethics against the “prestige” of an MD is inevitable. I’m choosing to address it sooner rather than later, because I know what my answer will be. There’s absolutely no contest.

From the desk of a 23-year-old, no less.

Yes, I was idealistic, and in many ways I still am.  I don’t see the world through rose-colored glasses, and I recognize how lucky I am just to be able to breathe, walk, and enjoy this thing we call life.  However, that doesn’t mean I am also complacent– like most of the hopeful med school applicants, I want to make a difference in the world.  It was hard to make the decision to work for patients’ best interests tangentially rather than directly, but it is the right path for me.  I have absolutely no regrets.

I earned my MD and am now working in a completely different industry.  I miss medicine, but am learning a lot about the decisions that make or break companies.  Ultimately, I want to take the skills I’ve learned in both settings, and use them to run a nonprofit.  Time will tell, but I think I’m off to a decent start.