* * Anonymous Doc

Monday, October 11, 2010

I saw eight patients in clinic today, and I didn't care about any of them.

I know it's terrible to say that, but it's true. I don't know if I was unusually tired, or these patients were unusually awful, or I'm just a bad person, but they came in, I listened to their problems, I prescribed some medication, made some referrals, wrote some notes, and really didn't care about any of it. Just wanted to be done with it and come home... come home to nothing, really. The Braves-Giants playoff game on TV, I guess. Me and some Kraft Macaroni and Cheese, the Braves-Giants game, an empty e-mail inbox, and very few thoughts about these patients I saw today.

I know I complain about inpatient rotations when I'm on them, and I say I want to do outpatient work, but, man, outpatient work sucks if you don't have a life. If you have a life, it seems pretty great. You go to work, you have appointments, you come home, you make pretty good money and get to live the rest of your life. You're on call sometimes, sure, but you can own the time you're not working, and the time you're working isn't so terrible, it's pretty chill to see clinic patients, you see the same five problems, you refer the rest. But if you have nothing to come home to...

At least the insane hospital schedule lets me forget I don't have a life. How can anyone have a life working eighty hours a week, overnight every x nights, weekends, 16 hour shifts, on your feet, running codes, watching people die. You can't. You can get wrapped up in the work-- you have no choice but to get wrapped up in the work-- you can't have a life even if you want one.

But then I'm on outpatient and all of a sudden there's time to breathe, the days don't run into each other in quite the same way, I have weekends... and I have nothing to do and I realize that this can be my life if I don't do something about it. Go to work, come home, watch TV, go to sleep, do it again, and have absolutely nothing change, ever.

That's the thing about this job. Other jobs change over time. You have business trips, you work on new projects, you have things to look forward to, things to plan for. This job, you see patients. And then you see more patients. And then you see more patients. You see patients, you get paid. You sit on your couch, you don't get paid. There are no special days, there are no new projects, there are no new challenges. There are just patients and whatever they're sick with. And if I'm bored 16 months into residency, what's going to happen in five years?

Doctors don't blog. I can't quite figure out why. There is no community. There's Kevin MD and a few others, but there's not much with any real traction, at least not that I've found. Doctors write books, a few of them, Atul Gawande, Jerome Groopman, but for the most part doctors are not telling their stories. No one at work even remembers their patients from one day to the next. I feel like a lot of my co-residents wipe their memory clean every day. They barely remember each other-- or at least they barely remember me. No one reads the newspaper, no one sees movies, no one else is probably even watching this Giants-Braves game. It was like that in medical school but the excuse was medical school is insane. Now there's less of an excuse. Doctors are boring. I'm boring. Life is boring. This blog is boring. My patients are boring. Two flu shots, a urinary tract infection, bronchitis, and two referrals. Boring.


  1. Dr. Rob http://distractible.org/

    , Vijay http://www.catscanman.net/blog/

    , Ramona Bates, http://rlbatesmd.blogspot.com/

    Greg Smith http://shrinkrapping.blogspot.com/ ..

    Mothers In Medicine: http://www.mothersinmedicine.com/ (this is a conglomeration of bloggers ...links to their own blogs is on it.

    Dinosaur : http://dinosaurmusings.blogspot.com/

    These bloggers each have links to other medical/doctor blogs.

    Scanman (Vijay) and Ramona have been around for years!

  2. Many many many many jobs have the same routine. Start asking people what they do and if they like their jobs. You'll be amazed at how few people enjoy what they're foing. Even when there are special projects, they're still part of the overall routine.

    You've already been given some links to some medbloggers. I'd encourage you to check out the blogroll in those sidebars to find even more medblogs.

    Here are a few more:

    Hang in there! You'll find the right person. Do you mind if I pray for you?

  3. This blog is not boring. Maybe to write, but not to read.

    I would find satisfaction in doctoring the way I do in making plastic. I don't get bored because it's the same plastic. I try to see if I can make the same plastic with fewer moves and less waste. I'd see if I could develop a script to tease a patient history out of a guy. I'd make a little flowchart detailing how to avoid the dead ends in diagnosing respiratory illness. But maybe doctors aren't factory workers because they'd rather be boring than nerds?

  4. i actually find this very very interesting..... and so does my mom. :)

  5. Hey, it could be worse. You could get shot by a McDreamy-hating widower. Or maybe lose your arm to a helicopter blade only to have another helicopter fall of the top of the hospital and flatten you a few weeks later, so a middle-aged newly out lesbian colleague could name an LGBT treatment center after your homophobic ass. (Assuming you're ass is homophobic, of course.) Now that's excitement!

  6. Do you have a friend to have a beer with? all the staff on boston med were close

  7. Lack of a social life can cause depression. Start hanging out with people.

    For example, start hanging out with writers. Many of them have schedules weirder than you do, except they are driven internally. Find several writer's groups on line and in person and show up when you have free time. Offer to help with medical research as long as you can do it on your schedule. Learn to crit other people's work.

    - KrisW

  8. I was telling one of your stories to a friend of mine the other day. He made the comment that he thought it was cool you weren't keeping these stories to yourself. I agree.

    Thanks for the stories. :)

    Ps. You're human. Seriously. Although you may be passionate about what you do, you'll have days where you don't care. I have days where I don't care either. Not often, but they happen. Usually means I need a break. Enjoy your break.

  9. Doctors like him are the reason there is a problem with the health care system - why does he not realize that the patients ARE his "new projects"?
    He needs to either stop complaining and take pride in his profession or find another profession!

  10. I don't think the way the medical profession is set up really facilitates viewing patients as projects. Suppose the doctor was really taken with your suffering and wanted to make a "project" out of getting to the bottom of your problem. Can he stop seeing patients and go Google your problem for half an hour? Can he call you up later to ask more questions about your patient history? Will he get paid if he learns enough about your lifestyle to find the root cause of your condition? I don't think so. All he can do is see you for fifteen minutes, whenever you come in, and maybe forward you to a different department and never know what happened to you. Even if he made you a project he'd likely not know if he failed or succeeded, and that's just not motivating.

    I think doctoring could be made a much more satisfying job than it is today by attending to basic human motivations like achievement (the desire to compete against increasingly challenging goals) and of course, the need for sleep.

  11. On top of the wonderful links posted above, I enjoy http://drgrumpyinthehouse.blogspot.com/ He's a neurologist so it may not be exactly what you're looking for, but he's still pretty amusing.