Last day of my Grim Reaper rotation. Two patients died this morning. So far.
I got into a long conversation with a patient's daughter yesterday. I had time. Things were slow. The daughter had been staying overnight with her mother, sleeping in the chair. Just in case her mother needed her. She said it seems too hard to be a doctor, to deal with death every day. I told her it is hard, but you try to depersonalize it, you try to keep a healthy distance.
And then I felt guilty. Because I basically told her I won't be that sad when her mother dies. I mean, I'll be a little sad, but I won't be that sad. I didn't know her when she was well. I didn't know her when she was herself. I didn't know her. And I have a dozen other people I need to have enough energy to deal with.
We released her mother this morning, to go home on hospice. The daughter asked for my e-mail address. I didn't give it to her. I'm not her mother's doctor, I can't answer medical questions over e-mail, it's unprofessional-- maybe-- I don't know-- okay, the real reason is that I don't want to know when she dies. I don't want to get an e-mail saying she died. If I find out, I find out, but I don't want to know unless I have to know. She's going to die. It's sad. But I don't need to know.
I'm actually looking forward to working nights. Two weeks of nights, how can I be looking forward to two weeks of nights? I can't just be a doctor to people who are dying. I want to be a doctor to people who get better. To people who are still themselves, to people who have some life ahead of them. I want to help people, not watch them die.
You're called a doctor no matter what kind of medicine you practice, but I wonder if that's a mistake. There is something fundamentally different between healing people and watching them die. I guess hospice is supposed to be that bridge-- hospice is supposed to be what happens once there's nothing more that a doctor can reasonably do. But it's grossly underutilized, and often too late to matter much anyway. And that's fair enough-- I'd want medical treatment for as long as there's a chance-- but I don't want to be the doctor there at the end.
I should have studied harder for the MCAT, gotten into a better medical school, gotten better grades, and gone into dermatology. Yeah, they're probably sort of boring, but at least you're dealing with problems that you can often solve, and when they're really serious you can pass them along to someone else. Is it really what I want to do? Probably not, but the temptation is pretty clear. Plus they earn three times what I'll ever make. Not that I have anything (or anyone) to spend money on.