GUEST POST: An Open Letter to Physicians-in-Training: A Response to the blog entry ‘TO BEING DOCTORS-TO-BE’
Guest post by Debra Kriger. My brilliant sister, everyone!
Dear Physicians-in-Training,
First, let me say congratulations and thank you. Congratulations on reaching the levels of achievement you have reached, and thank you for your service. You are an important part of our society, and you do difficult and integral work.
And now, the reason I’m writing this letter: in a blog post apparently addressed to the public (“you”) called ‘TO BEING DOCTORS-TO-BE’, a physician-in-training in Mumbai (India) congratulates himself and all other physicians-in-training for overcoming obstacles in order to achieve physician-hood. In his subsequent blog post, ‘IN MY DEFENCE’, he forms a retort to people who have reacted negatively to his first post. When I read his entries, I feel angry, disappointed, defeated, and hurt.
I found these blog posts through good friends of mine, also physicians-in-training, who had reposted it on social media touting how great a piece it was and encouraging others to read it. (I did.) I respect these people, my friends. Which is why my heart absolutely sank when I saw what it was that they supported. This is also what inspired this letter not just to the author but to all physicians-in-training.
Everyone has hardships in life; they are unavoidable. We each endure and are entitled to our hardships, whatever they may be. I’m not disagreeing with or attacking the blogger’s or any individual’s perceived hardships; they are something only the individual him- or herself can truly understand in context. My problem with this article is that the overwhelming majority of the blogger’s hardships are also privileges.
Higher education (including medical school) is a privilege. The ability and opportunity to be an over-achiever is a privilege. Having a vacation that you need to cancel is a privilege. Having the resources necessary to constantly “trawl for Medical apps” is a privilege. Your parents supporting you (and being able to support you) through your twenties is a privilege. Eventually having ‘first salary’ (in fact, having a job or a decent wage of any sort) is a privilege.
Having the “deadweight of a stethoscope around [y]our necks” is a privilege.
Using this privilege ethically is one of the principles of justice. It’s especially important for people who will be serving the public in a position of power (e.g. you and me) to understand this. You don’t need to be thankful for your hardships (hardships are, well, hard), but be thankful that you have these kinds of hardships; use and react to them responsibly and respectfully.
Would you be in medical school if you grew up in a rural village? If your parents were poor? If you didn’t have access to primary education? One of the tenets of social inequity is the inherent unfairness in not being able to choose into which context you are born. The theory of constrained choices stipulates that we are all limited by our own contexts. Privilege can be seen as the freedom to choose and the different (and possibly fewer) limitations privileged people face. This is important to recognize when we express and deal with our hardships.
Remember that the people to whom the blogger refers as “the dregs of society” are, in fact, people. As you don’t want your accomplishments and hardships to be undervalued, please don’t undervalue theirs. Whether you believe it or not, we’re all in this together (and, believe me, as someone who has worked with and served individual members of the public in all manner of contexts, I know how hard it is to remember or even recognize that sometimes).
So, yes, be proud of your achievement and the bravery you exhibit on a daily basis. But please remember that this pride and the associated congratulations stem from living a privileged life. You do a superb job in difficult tasks, but there is no reason to think that we are inherently better or have it harder than anyone else.
Thank you for your time and energy. I hope this letter sparks discussion.
Best wishes,
Debra (BHSc, MPH, PhD student in public health ethics)
Hey Debra!
Thanks for the very insightful, courageous, and self-effacing post. After reading both of the entries that inspired this letter one paragraph really stood out to me:
We who have befriended no non-medical person since our course began. Who are no longer with our loves from before it did. Who date each other and discuss medicine. Who will advise you to procreate before thirty but who marry after it.
To begin with believe that anyone who has isolated themselves so much within any given community will begin to develop a bit of a persecution complex as the same complaints and problems seem to be common within everyone you know.
I am in the habit of seeing subtext that’s not actually there so maybe I’m crazy but I find the rest of the paragraph somewhat telling. Unlike the rest of the items on this list breaking up with SigOt as you start university isn’t exclusive to med students, its practically a tradition. Even the language begins with love and progresses to dates and then breaks down human relationships to a math equation based on when to get married and when to procreate. I don’t believe this is really a posting about med school as much as it is about a very personal and specific story of regret, lost love, growing up & wondering what lay down roads not taken.
In the follow up entry he states, “It’s never enough. Youthful impulses can be satisfied; Youth cannot.” I think this is just about a crisis every 20-something goes through where we start to realize that we aren’t going to get to hit the reset button and do a second play through to see all the alternate endings when we’re done. Med school has represented the transition period from youth to adulthood for the author & I’m only mildly ashamed to admit that if you look far enough back on my face book you’ll find a similar post only economics themed. Of course I’m probably reading waaaaay too much into a few lines of two much larger posts, but I definitely prefer deep, introspective, melancholy doctor to whiny self-entitled doctor.
Phew! All of that said, while it is tacky to clap for yourself there are a lot of ways to make money that are less germy, and difficult than medicine. It is a long, difficult slog for a pretty selfless career choice so I’d like to take a minute and cheer for the amazing Debra, the author of the original posts, and every other person who wants to dedicate their lives to making sure I live until my consciousness can be transferred into a robot!
Thanks again for the post Debra and hopefully we’ll see more Debra/Sarah (Debrah? Sara? neither of those work phonetically so I’m just going to call the pair of you Dr. House) collaborations in the future
p.s. I may or may not have decided I wanted to make the Dr. House joke first and then scrambled to come up with a opinion to tack it on to (I did)
Hi Tyler!
Thank you for your reply!
I’m sorry – I wrote out a comment, but cyberspace stole it!
The moral of the story is: thank you for your comment.
And especially the post script :)
Thanks again!
best,
debra
Anyone who refers to people as “the dregs of society” needs to re-examine why they’re being a doctor.
Obviously, you live in a bubble and are lucky to never have had to deal with people no one else wants to deal with. There are indeed “dregs of society”: child rapists, violent sociopaths, bums, and assorted miscreants. To pretend otherwise is pure ignorance.
Hi Jess and Anon — thank you both for your comments. I’m glad this guest blog has sparked discussion as its author hoped, and I’ll leave it to her to respond to the content of the comments.
Just a reminder to all that the policy of this blog is to foster a courteous environment for disagreement. Please avoid making assumptions about the experience and backgrounds of others — focus on the issues, not the debaters.
Thanks, and hope you continue your discussion!
Hi Jess and Anon!
Yes, thank you both for your replies!
And thank you, S.R., for the gentle reminder.
It’s an interesting question; who are the dregs of society? One that I don’t have coherent thoughts on at the moment, really, other than thinking it’s a worthy topic of looking into. Thanks for starting the discussion.
And, thanks, both, for commenting.
best,
debra
Hello. Thank you for doing me the honour of composing a reply to something I wrote. When I wrote both those posts, I had no idea they would be read by more than just a handful of people. It’s gratifying to see how far they’ve made it.
I agree with everything written in this post. But I also stand by everything I wrote in my posts; med school in India is very very different from what you probably experience. The ‘psoriasis’ part was in bad taste, I deeply regret including it despite having little or no knowledge of dermatology.
I stand by everything else, because it is the truth, it is my truth, and it is the common truth of everyone I see around me. I hope your readers, and mine, can resolve themselves to believe that, although seemingly unlikely, there are no contradictions between your views and mine.
I do hope this post sparks discussion. I’m sharing it on Facebook.
Hi Mrigank!
Thank you for your reply!
I am, likewise, honoured that you’ve read and replied to my reply. Thank you for your insight.
I do appreciate and respect that your post is your truth, and I hope that that has come across in my post as well.
Thank you for being part of the discussion. It is truly amazing that we can have these kinds of conversations across all sorts of borders (whether physical, cultural, or otherwise).
I appreciate your comment. Thanks again!
best wishes,
debra
Med school in india is about a ratio of one seat to innumerable applicants(the ratio more than doubles for postgraduate seats). We end up with one doctor in a clinic with enless patients(sometimes none). Being a doctor is about fighting or ignoring or participating in (if you are the greedy kind) corruption, from infrastructure to drugs to caste based reservations(when the whole system is outdated). it is about proving all your life you don’t support prenatal sex determination and female feticide(some do it and still claim otherwise). Its about convincing the people that modern medicine has more scientific basis than any other kind of treatment. It is battling killing infections through med school and all your life, some doctors(with intact immune systems) succumb to TB(a disease we consider ‘curable’). But we have those who stick through it all and earn the love and respect of thousands they treat. Coming from a family of doctors since the british raj in india I know it was not easy then, it is not easy now. If you don’t believe me come to the land where female fetuses are fed to dogs and then we will talk. And yes rapists and murderes roam free in this country(so please don’t get me started on that). I know all professions have their problems but all mrigank was trying to say is we got into medschool thinking it was a fairytale but it has become our nightmare. But we still hope.
Hello Whackyprincess!
Thank you for your comment.
I do appreciate the extreme difficulty (an understatement) that being a doctor in India must bring. I wish you all the very best, and echo your feeling of hope. I very much appreciate the insight you’ve shared – thank you.
I also want to take this opportunity to be clear that I am not debating the conditions of which you speak. They are important and serious issues that I do not wish to make light of, and I hope that comes across in my post.
I appreciate you sharing your thoughts and insights.
Thanks again for your post. As in my reply to Mrigank, I think it is absolutely fantastic that we can have conversations like this across all sorts of borders. Thank you for adding your thoughts!
best wishes,
debra