Nice Work If You Can Get It

Years ago, when I was contemplating my choice of future career, I spoke to several doctors to try to get a sense for how much they enjoyed medicine.  It didn’t take long to learn that I shouldn’t talk to doctors any more.

I was a junior in college, majoring in German and planning to follow my father into academics by pursuing a doctorate in comparative literature.  Very subtly, and over the course of months, my father gently persuaded me to abandon my aspirations of the ivory tower and give medical school a try.  He thought I might find it a lot more rewarding (and financially more secure) than a career spent lecturing, grading tests, and begging for grants.

My first run-in came in the form of a radiologist who soundly mocked the idea of willfully entering the medical profession in this age of managed care and diminishing returns.  The year was 1988 and HMOs had just started to change the economic landscape in Utah.  The profession of medicine, he contended, had already been plundered of its most rewarding characteristics (code for “the money’s drying up”).  Indeed that was about the time physicians’ incomes were starting to plummet from previously lofty heights.

Other physicians I spoke to gave me essentially the same advice: Don’t become a doctor—it’s not worth it any more.  One family practitioner in Sacramento had drifted into a state of career depression and longed to give up his day job to become an interior decorator.  The only thing stopping him from living out his midlife crisis was that he still needed the doctor’s income to pay the bills.

Needless to say, I bucked all the advice I received and recklessly enrolled in medical school.  Much to my surprise, I loved it.  I loved medical school, internship, residency—all of it.  And I still love practicing medicine.  As I pondered this recently, I came to the conclusion that my love for medicine developed, in part, from my distaste for doing the other jobs I’ve had in my life.

My first real job came during the summer I turned 14 when I was hired on at $5 a week to serve as a junior counselor at a Boy Scout camp high in the Uintah mountain range of eastern Utah.  I was the youngest of the staff members and my main job was to do all the jobs that no one else wanted to do.  One such chore involved the numerous outhouses that dotted the expansive camp.  In those days the toilet facilities were just holes in the ground covered by small, enclosed structures and their contents were pumped only once, at the end of the summer season.  As the weeks went on the holes began to fill up and, much like the sands of an hourglass, the pungent contents peaked upward toward the seat.  My job was to make regular rounds with a canoe paddle and knock over the growing mound so that patrons of the outhouse didn’t inadvertently take away more than they left behind.

A couple years later, in high school, I was a dishwasher at a local restaurant that specialized in pies.  I hated this job—my clothes always stunk of discarded food, the pewter serving dishes scalded my hands as they emerged from the dishwasher, and tips were divided among all the staff except those of us stuffed in the back—but I couldn’t readily quit because my family and friends had become accustomed to the leftover pies I brought home. Not uncommonly did my legs fly out from under me—slipping on the thin film of muck that coated the floor—causing me to come crashing to the cement along with shards of broken drinking glasses I’d just washed.  The manager always deducted the value of the shattered cups from my paycheck.

I was desperate for a job between my first and second years in college and signed on with a temp agency.  For a few weeks I did odd jobs like landscaping and furniture moving until I settled into a job working in a factory that made herbal supplements. The foreman initially placed me in a room with a handful of illegal immigrants whose job it was to place exactly 21 packets of supplements in a box (to be closed and shipped by another department).  For 8 hours a day I counted to 21 over and over and over again.  1, 2, 3, 4, . . .  Despite the fact my coworkers were friendly enough and spoke passable English we did nothing but sit in silence—none of us had the ability to carry on a conversation and count to 21 at the same time.

Since inane repetition is the mother of all invention, I struck upon an idea when I spied a set of scales in the pill-counting room.  I assessed several boxes filled with 21 packets and found that they were all pretty consistently the same weight.  I then taught my coworkers to just grab a handful of bags that seemed to amount to 21, place them in the box, and weigh them.  Then, we simply added or subtracted to reach the desired value.

Once the manager caught wind of our new system and saw how much more quickly we filled the orders he was elated.  I was plucked from the unglamorous position of pill counter and elevated to the more enviable spot as an assembly line worker.  My specific job was to stuff little cotton balls into each of the pill bottles that came down the line.  I wondered why they didn’t have a machine to handle that job but no one at the factory seemed to have heard of such a thing.  So, there I stood, 8 hours a day for the rest of the summer poking cotton into little bottles, developing blisters on my fingers and calluses on my brain.

At the end of the summer the foreman, who knew I had plans to return to college, approached me with an offer to stay on at the factory permanently.  I guess my innovation in the pill-counting room turned me into a sought-after commodity.  I politely thanked him and went back to college with more determination than ever to get good grades and graduate.

In my final year of college I took a job in north-central Texas, working for a researcher who was testing the environmental impact of a new pesticide.  The job was simple: the chemical was sprayed on a large cornfield and a small army of college students dressed in full hazmat gear would spend their days walking the rows, looking for downed birds.  Why this had to be done in Texas in the middle of summer instead of someplace like Fargo I’ll never know.  The inside of the chemical suits became just short of unbearable as soon as the sun rose over the dusty fields.  We never actually found any poisoned birds but we averaged about one rattlesnake a day.

I view my current job through the lens of my previous jobs.  I spend my days in a climate-controlled building, surrounded by smart and motivated coworkers, and interact on a regular basis with interesting people who are grateful for the service I provide.  I am intellectually stimulated by trying to unravel the mysteries of my patients’ illness and receive a great deal of satisfaction any time I can make someone’s life a little better.  I work in a field that is essentially recession-proof (how many out-of-work cardiologists do you know?) and have a great deal of control over my hours and schedule.

Sure, the paperwork (or digital paperwork, as the case may be) and the bureaucracy of modern health care are a hassle, and I dislike taking night call as much as anyone, but in my view the upside of the medical profession greatly outweighs the drawbacks.

I don’t own a massive house or drive my dream car, but then again I never believed that the practice of medicine would make me fabulously wealthy liked it did for my increasingly disillusioned predecessors.  I got pretty much what I bargained for when I entered medical school two decades ago.  So, while you may hear me complain of irritating phone calls in the middle of the night, you’ll never catch me telling prospective doctors to steer clear of medical school.

Of course, if I ever get burned out on all this, I still have other careers I can fall back on.  After all these years I’m still pretty handy with a canoe paddle.