As Doctors, How Can We Reconnect To Our Calling?
Giving to others and self sacrifice are often implicit in electing to enter the healing art of medicine. There is a certain nobility in becoming a physician: years of academic competition, student loans, all nighters, internship, residency, forty-eight hour shifts, specialization, sub specialization, and putting family and intimate relationships on hold, just to mention a few. As a result of delayed gratification, there is both a conscious and unconscious sense of entitlement. Pay back!
But pay back is antithetical to unconditional giving. The repressed need for a return on our investment seeps deeper and deeper into our unconscious. We tend to manage our internal discomfort by becoming more and more aware of our giving, of our specialness, of our contribution to humanity. Gradually, we distance ourselves from those we profess to heal, as well as our family, friends and the world around us. Isolated by our uniqueness, we often become self-contained. In time, unable to receive, needing no one, we suffer from anorexia of the soul.
Yes, it is the physicians inability to receive that is the problem, not his or her giving. True, we receive reimbursement from insurance companies but this money does not rejuvenate the soul. Allowing others into our lives, that is the healing potion.
The creation of health insurance companies adds to the disequilibrium in the in doctor/patient relationship. Until the creation of third party carriers, doctors received remuneration directly from patients. This came in the form of barter. The physician offered his/her skills and received in return, personal gifts or money from their patients and/or their families. And so, the term, Family Physician, was not limited to General Practitioners. There existed an equality of exchange, a leveling of the relationship. Medical doctors became part of extended families. Physicians were intimately aware of the family psychodynamics, which surrounded and often participated in the disease process. These personal relationship made law suits moot.
As a result of third party carriers, there is no longer that personal reciprocity of giving and receiving. Now, physicians receive checks in the mail which are then processed by a business office and dispatched into bank accounts.. The imbursements come with a diagnosis but no human face or outstretched hand or even a thank you. At the end of the month, there is only manna from heaven. Hidden within this system is the realization that our financial survival depends on illness. Pay back of college loans, cars, mortgages, the kids schooling, vacations, etc. all depends on illness. We rely on what we profess to eliminate, disease and suffering. This is the unfaced shadow of medicine. Not unlike the business world, our livelihood depends on supply and demand. Therefore, we owe are patients big time. In a sense they have suffered in order that we can survive. Patients deserve our gratitude as much as our giving.
Giving without reciprocal gratitude establishes a hierarchy and places the giver in control. This one sided game puts the patient in a subservient role of indebtedness, intimidation and fear in response to the physician's god like, savior posturing. The end result of such a patient/doctor relationship is distancing, distrust and resentment.
So how can we reconnect to our personal destiny, to our childhood dreams, to be a healer? And how can we be of greatest service to humanity?
I believe this demands more than a few medical school motivational classes in doctor/patient relationship. Medical school training is so jammed with information and fear of failure that the heart of who we really are is lost or anesthetized. After graduation, our field of specialization tends to further separate us from the rest of the world. Here, we learn to rely primarily on diagnostic technology to do the thinking rather than on hands on, bedside acuity and the intuitive knowing born of patient-centered listening.
Therefore, I would like to propose that the courses in doctor/patient relationship be given after all medical and specialty training has been completed and be mandatory before licensure. The focus of such a class would be to deconstruct our necessary yet barbaric system of training and reorientate us back to why we chose the healing arts as our personal service to humanity.
The seminars would include:
- Journal dialoging with your chosen medical field;
- Patient participation in which patients share their journey through the medical maze and your chosen specialty;
- The hazards of being special;
- How sharing responsibility for care with your patient and patient-centered listening enhances results and diminishes litigation;
- Why you should refer to those who seek healing and health as "clients" rather than as patients since you depend on them for survival as much as they depend on you;
- What is known about the neurophysiology of placebo effect and that beliefs are biology;
- The chemistry of emotions that unify mind and body;
- How and why the mutual giving and receiving between you and your clients not only enhances their healing for but is therapeutic for you;
- And finally, how the acceptance of your ordinariness allows you to more fully connect to your essential self and your clients. Also the acceptance of your ordinariness allows you to find your wholeness and oneness in the mirror of all humanity. Accepting your ordinariness is the closest you can come to touching your godliness.
To paraphrase e.e. cummings, we have all taken a journey only to return once again to the place from which we began but now know it for the first time.