Wednesday, May 26, 2010

Earning the Name "Doctor" -- Part Two

The Doctor, by Sir Luke Fildes (1891)

The other day, while writing about earning the privilege to be called "Doctor," in the back of my mind I was going in a different direction than the essay itself took me. Madeleine L'Engle has said writing is a matter of following the story and she was often as surprised as anyone else with what came out on paper. I had planned on contrasting those who earn the title with those who do not and I'm glad the essay turned out like it did. But today, I'd like to backpedal a bit and take another look at the subject because not everyone who wears the title has undertaken the task of earning it.

The ones who have, reveal a commitment to taking personal responsibility for themselves and their training. The further along you go in medical education, the more you'll encounter opportunities for failure -- it goes with the territory. It may sound so obvious as to be a waste of space mentioning it, but how we deal with failure and adversity in medicine is even more critical than how often we succeed.

Someone who is resentful about owning up to mistakes or acts as though they are entitled to have them overlooked, has serious problems with assuming responsibility. This is a major thing for me, as you know if you're a regular reader of this blog. It partly stems from the fact that, at age 13, on those rare occasions when my father was ill, it fell to me to run the family retail western store on my own. It was scary, sure, but it was also an adventure in growing up and I learned how to be relied on in a pinch.

So, when a person experiences failure, we want to know they will be the first one to admit it and take steps to correct it. This is one of the primary reasons why we have procedures in place in medical school for helping students cope with failure. We aren't simply trying to help them "pass," we're trying to teach basic principles that can be applied in clinical situations.

For me, one of the defining characteristics of the physician's calling is a sense of yearning. This is more than desire; it's something that comes from down deep producing a willingness to suffer and endure. It turns medicine into a passion, one that my graduating classmates would likely say they'd practice for free (if they didn't have student loans to repay. that is). There are some who just don't have it, though I can't imagine being a doctor without it.

The nature of our legal system permits anyone who completes the requirements to be called "doctor," and that's the only way to fairly approach the matter. But aside from the factual elements, there are other qualities that can't be borrowed, begged, or stolen. They come from within and represent integrity. Passion, honesty, dependability, and devotion to something larger than oneself, in this case the field of medicine, are among the things that distinguish those who've earned the right to be called "Doctor" from those who haven't and very possibly, never will.

(Public Domain image of "The Doctor" by Sir Luke Fildes (1891) via Wikipedia)
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