Hi all,

I just thought since we've been discussing negatives, how about if we hear about some "positives". What keeps you going in medicine? Is it a hug from your favorite peds patient, cookies from the little old lady? Saving a life? What are the little things that add up in your practice???

A difficult question!
I feel I have no choice other than medicine.
Uh, this sounds silly, but there's really nothing else I find interesting enough for doing it every day, for 40-50 years (hopefully I'm a senior medical student now)

I think that many physicians who are dissapointed in their job feel that way beacause they had unrealistic expectations about the emotional rewards of their job. They had dreams about solving difficult diagnostic and therapeutic problems, making changes in people's lives, grateful patients thanking for the efforts of their physician, beind admired by friends, family, neighbours etc
I have these dreams myself, but I try not to let my dreams become my expectations. Instead, I try to appreciate the small rewards of my job. In fact, I often feel job satisfaction when I get a simple "thank you" or when I understand an important fact while studiyng.
I hope I won't loose my enthusiasm for medicine because of the boring daily routine, angry patients, hopeless situations...
I wonder what my answer would be to this question in 20 years.
Anybody here who has been practicing medicine for 20 years? Do you still have your dreams??

One of my favorite stories is about a 5 yo girl that had a both bone fore arm fracture. She had other medical problems so she was accustomed to coming to the mean old white coat world.

Usually in kids I would do a hematoma block if they could tolerate it (or Ketamine), but this girl wanted NOTHING. And she meant it. She was ready for whatever I had to do to fix her arm, but no injection and NO IVs. She knew what was going on. SHe was a regular.

So, anyway, I twisted her little forearm back into position and her only complaint was that I was squeezing her hand. No tears. I was squeezing her hand to reduce it.

That was done with, no tears.

Cast starts going on. I started putting the final layer on...mom had asked if we were about done, I said yep.

Suddenly the little girl BURSTS into tears :weeping: . THere was no consoling her. Nothing hurt. I asked her what was the matter. Between air gulps, she let me know that the cast wasn't pink.

As a neurologist, I deal with a lot of end-of-life and withdrawal of support issues. examples- brain dead teenager after drug OD, unsalvageable husband and father who had an out of hospital arrest with long down time, matriarch grandma with a massive stroke. Although these are not pleaseant situations, I have over the years come to get a positive feeling out of helping families through the most difficult decisions of their lives. I have had nurses say that they were so glad the event happened when I was on call, because I have a way of talking to the families. I have had families thank me for my frankness but kindness. I get so much positive feedback when I can walk out at the end of the day thinking I made a difference. It makes me keep trying harder every time it happens.

:goodvibes:
I wish there was a "pat on the back" graemlin. I just was filled with warm and fuzzy feelings reading your statement, MJBMD. I agree with that driving force and salut you for expressing what I think is one of the biggest advantages to being a female in medicine. (Not to say there aren't some of the men who can do it, too...)

I am an internist who works with geriatric patients, which can be quite demanding and emotionally draining. But I have also found that working with this population is VERY rewarding.

I am pregnant and have only 1 & 1/2 months to work. Last month I had a particularly bad day. I was seeing my last patient when I got a call from the ER about an unassigned admission on a complicated patient and another call about a patient at the hospital that needed to be seen soon. My charts were backed up, I was exhausted and my partner refused to help out. By the time I got off the phone I was a bit upset and just sat there for a minute to collect myself. Before I could get up to go in the room to finish up with my patient she came out to where I was sitting and began to rub my back and tell me it would all be okay. We never finished her visit that day because I was crying and pooped out. I called her the next week and saw her informally to apologize and see if there was anything else she needed. She was very nice about it and never made me feel embarrassed about the incident at all.

I have found that working with the elderly has many rewards. They have provided support to me (in very maternalistic ways) that younger patients could not do. I receive gifts every week for the baby and complete encouragement in my decision to become a stay at home mom. Although I don't think I could ever do primary care full time again (it's just too draining), I will always remember these patients and their kindness. The good days and good patients definately outweigh the bad.