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.
Well, I have just sat here reading catching up on a number of your articles. You are not only a talented cardiologist, but also a wonderful, entertaining writer. I suggest that if you ever want a second job :-) --- you write. You're wonderfully informative, humorous and entertaining. This site is going on my facebook so don't stop the articles. They are great. You are a miltitalented individual. You're blessed.
Your writing style accompanied by your vast knowledge is always so greatly appreciated. Being almost 40 and still trying to figure out what I'll do when I grow up, your words hit the spot. Thanks
I was a Girl Scout counselor for summer camps and feel your pain. I am thankful you chose your current profession however, as you are one great doc.
I was impressed your foreman was open to a new way of doing things.. You do have a nice writing style...thanks for taking me back to the time in my life I had similar jobs of limited enjoyment. However, sometimes I do opine for the summer job I had mowing the grass at the local University on my riding lawn mower...young, tan and fit..
It's always nice to learn a little bit about our wonderful doctors. We all seem to have something in common, caring for our patients. You do an excellent job, and we are lucky to have you. Thanks for sharing.
Michael L. Aaronson, MD
Dr. VDG, Thanks again for a wonderful medblog. I agree with you. The medical profession is a phenomenal opportunity. I feel so fortunate to have been accepted into the medical profession. Your blog has struck a chord with me in that you, like me, love to care for patients. I view it as an honor and a privilege. Special thanks to Alegent for giving me a place in the sun.
I suspect that your low-paying, low prestige jobs would help any doctor develop a better bedside manner. I know the summer I worked as a gofer getting yelled at by generally unpleasant people taught me a lesson on how to treat those who are doing even the most remedial task that I doubt I'll ever forget. (The lesson, to be clear, was to treat them with respect.)
I loved this blog post. If I, or anyone I love, ever needs a cardiologist, I will certainly refer to you. You are obviously in medicine for all of the right reasons. p.s. loved to hear about your previous jobs - too funny! We all have had those not-so-fun jobs, but your junior counselor job sounds like it was truly terrible. =)
Amy Vanderpool, MA, ACSM HFS
Great article on Winter fitness! It's that time of year when individuals are less active and eat more, not to mention the stress levels rise. I am a Clinical Exercise Physiologist for Alegent Health Cardiac, Pulmonary, and Aquatic Rehab. Looking forward to your presenation at the Alegent Health Cardiovascular and Pulmonary Rehab Conference in December, I am speaking after you that day. Thank you also for your insight on such a wide array of topics.
Until I develop a heart condition that requires me to consult my ever-wise cardiologist brother, I think that your awesome job that brought home amazing chocolate cream pies was the best of them all.