Medicine Is a Calling, Not a Profession

When I was a kid, my favorite show was St. Elsewhere, a show about a Boston hospital that ran between 1982 and 1988. Stephen Furst played my favorite character, Elliot Axelrod, a resident physician at the St. Eligius Hospital. On a show with stellar character actors, I really liked him. He was awkward but also kind–and through his eyes, I saw how hard a life in medicine must be…and I loved it. Even today, I credit St. Elsewhere for showing me what my calling was­­–to be a doctor. Yes, I entered medicine to change lives and to do my best, but I also wanted to be a part of the human experience of illness and of health–just like on TV.

Today, I am what could best be described as a “mid-career” physician. My hands are in everything–teaching, clinical care, research and trials, and now, administration. In my work as a clinical trialist, I am in constant contact with our research staff, which is generally comprised of young men and women for whom MGH is their first real job. For many, it is a stepping stone to medicine, nursing, or another advanced practice profession. Occasionally, one will ask me for advice about their future, or ask me about my decisions to enter medicine and then oncology.

I tell them about the science of cancer, the drive toward precision. The expanding therapeutic landscape of small molecule tyrosine kinase inhibitors, monoclonal antibodies, and immunotherapies making their way into clinic; about striving for cures and turning cancer into a chronic illness–not a fatal one; and about the attention being paid to surviving cancer– managing the long-term side effects of treatment and ensuring quality healthcare for all patients after a diagnosis.

As important, I tell them of the art of medicine:

• The importance of words
• The power of touch
• The fine line that exists between hope and truth, especially when there’s bad news to be delivered
• How important it is to understand that a patient is a human being, not a diagnosis to be treated
• That to understand cancer means understanding the patient–her values, her worries, and her hopes, and those who support her
• That eye contact is criticial to connection

Mostly, I want to impart that medicine, in the words of my friend and mentor, Larry Norton, should be a calling, not a glorified profession. Medicine isn’t done in shifts. It’s a commitment made between you and your patients, to oversee their care personally, even when you aren’t around. It doesn’t mean carrying a pager 365 days a year, or foregoing marriage, a family, or vacations in order to be a good doctor. It does mean a lifetime of learning (and wanting to learn), exposure to human emotions at their worst and at their best, and all the while, the privilege of caring for patients.

And so, as the year completes and many in our research team (like many others) move on towards careers of their own, I wish them luck and hope they will find happiness in the profession they have chosen.