Why Medicine?


flying cadeuciiCross posted with Quartz.

When I was applying to med school some 20 years ago in the UK, I was advised not to say at the interview: “I want to be a doctor because I want to help people.”

The answer was considered too dull back then. And in any case, I was asked “Why medicine?” only once.

“I’m not sure, but it’s not because my parents forced me.” I hesitatingly answered.

The interview panel giggled at my honesty, and for breaking a stereotype about Indians. I was accepted. But I doubt that this answer would cut it today.

Showing a sense of altruism is practically mandatory today for would-be doctors – one wonders if functional MRI will soon be used to prove empathy. But when I was 17 (the age when we typically applied to study medicine) that wasn’t the case. My curriculum vitae had little evidence that I wanted to help people.

There was no summer volunteering in eye camps in India. No travels to Africa to be indignant about poverty. The closest thing I had done that had any semblance of medicine was a brief stint as a hospital porter to supplement my pocket money: I carried blood vials from the emergency department to the laboratory. And although I waxed lyrical about the experience in my personal statement, I can’t say it was terribly inspiring to stare at cylinders of blood.

I do not recall caring for an ill acquaintance before I became a doctor. I didn’t go out of my way to help blind men cross the road. I didn’t routinely help old women pack their groceries—I still don’t. The most altruistic thing I had ever done was rescue a budgie when I was seven. I did not put that down in my personal statement.

My father, a physician, had little influence. I hardly saw him because of his work, and when I did he hardly spoke about work. I do remember, though, as a child, that he had a full skeleton of human bones in his study. My friends and I would concoct stories that it belonged to a former serial killer.

I watched no medical dramas. There were no medical personalities I admired. I never visited a hospital to shadow a doctor. And although I did fall ill with suspected appendicitis (which turned out to be mesenteric adenitis), it was hardly a life-changing experience.

Some contend that kids do medicine because of the job security and pay. To be honest, at 17, I thought I was immortal and couldn’t have cared less about security. As for money, well I was pretty left-wing.

The reality is that there is no inspiring story I can recount about why I became a physician. If it was a calling, then I didn’t hear it. I don’t think I was the only one in my medical school with the same experience. Over the years I have seen my classmates enjoy and endure medicine. Many are now excellent physicians with impeccable work ethics and compassion. If, back when they were students, they knew that volunteering in Chad during the summer break earned five points, they would have done it just for the five points. But what would it have proven?

Understanding what truly motivates someone to choose medicine, and whether that choice is motivated by noble inclinations or not is a forlorn endeavor. As soon as “I want to help people” becomes objectified as just another criterion for medical school admissions, as it has been, it will be gamed.

I’ve seen an entire generation of medical students become excellent doctors, even though, for them, “wanting to help people” was incidental to simply wanting to be doctors. The best I can garner about why I became a doctor is that it seemed like a good idea at the time. I’m glad I did, though – I have never experienced a dull moment in this profession.

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2 replies »

  1. “Why Medicine” following “The Angry Physician” is too well placed.

    Perhaps the point is that no one should say at an interview: “I want to be [anything] because I want to help people” if there is no resume of caring, no interest in caring or contributing to something bigger than one’s self.

    Though all innocent and innocuous sounding, this expression of professional disinterest, if multiplied by all those “seeking distant involvement and a large pay check,” is the reason that we have an opioid epidemic, that nearly a million Americans/year are pushed into bankruptcy for medical bills, that healthcare eats up 18.1% of GDP, that the primacy of primary care has turned to a quaint but disappearing ideal, that the life expectancy in the U.S. is dropping…that “American College of Hospital Executives” is not just a punch line to a bad joke…

    “An entire generation of medical students [have] become excellent doctors.” Difficult to prove. At the very least, “have become doctors,” since excellence is determined most by insurance executives, er, the American College of Insurance Executives, who ration your good work.

    Caring aside, the lack of defense of the profession and the product is remarkable.

  2. Maybe your wave function was entangled with another Saurabh Jha who decided not to go into medicine at the same instant? Find him and thank him. He could be a terrible writer.