Life in Emergistan: My Name Is Not Doctor : Emergency Medicine News

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Life in Emergistan

Life in Emergistan

My Name Is Not Doctor

Leap, Edwin MD

doi: 10.1097/01.EEM.0000724592.49515.0f
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    I've been thinking about Christmas for a while. Our daughter Elysa sent Jan and me a Christmas list as a PowerPoint in September. This got me thinking about wish lists, specifically about what I'd wish for all of you, who daily and nightly labor for the good of the sick and the dying and to pay for your kids' tuition, health insurance, and all of those mundane things you never considered when you decided to go into medicine.

    I say this as someone who loves to give gifts and often says, “I would love to be Santa Claus when I grow old.” For the cookies, yes, but more so for the joy of giving presents and bringing laughter. What would I give you? My dear colleagues, there are so many things! Here's one: It has been a rough year for our specialty. Who saw this coming last December? We were all planning trips and looking forward to the future when the bottom fell out. So many of our patients and too many of our colleagues were lost to the pandemic.

    We can't sit down over coffee, embrace one another, and say, “It's OK,” so I wish for those hardest hit a reminder that this has always been a hard and dangerous job. It was just harder and more dangerous than usual this year. That people died is not a failure of the profession. It was a worldwide, blind-sided car crash of epic proportions. It reminded us of the hard reality of our mortality, young or old. It showed us in stark relief that our knowledge, skills, and prophetic powers are far more limited than we realized or hoped. Let's call gift number one the belief that you did all you could do. You're not God, and it's all right.

    Next, I would give you power over bullies. Our profession is full of them. Some in our own specialty, many in others. They treat other physicians like mortal enemies, at work and elsewhere. They create division. They suppress voices. They make us dread calls for consults and admissions. They cause us to consider making bad decisions rather than waking the beasts who would demean us at every turn. Well-connected physicians who bring our hospitals sacks of money and as such are impervious to most complaints to the administration. We worry so much about physician depression and suicide, and yet as a profession our treatment of one another is one of our biggest problems. So here's gift number two: the power to take down bullies. Or maybe, just as powerful, the power not to care about what the bullies say.

    The Best Gift

    Next? That you be valued, that those who work with you and those you work for understand the rare treasure that you are. It's so easy for us to be widgets in the medical machine. I know this when I talk to a locums recruiter who tut-tuts my one lawsuit or doesn't return my call after I fill out the requisite forms and send in my CV. I know it when, no matter how busy I am, someone emerges from a peaceful office, puts a file in front of me, and asks, “Is there a reason you haven't signed all of these charts?”

    I know it when the hospitalist once again says, “You haven't finished the workup.” For an obvious admission. You realize it when the administration couldn't care less about your devotion and skill and begins to look for a newer, more lucrative corporation to do the work you have cultivated for years in the community you love. This third gift is everyone seeing you as valuable. It's costly and rare, but when it happens, it is breathtaking.

    I am writing from my living room. Jan is out, and the children are not here now, either in college or working. I am looking out into the vast forest that surrounds our house, which is turning ever so slowly into the reds and yellows that people travel vast distances to see.

    It was in this room that the bizarre months of the quarantine were passed, during which I had no shifts. At first, I was distressed. And then, in due course, I embraced my situation. I watched winter turn into spring in a beautiful place. I was writing and resting, and I slept in the same bed with my wife for far more consecutive nights than ever in our entire married life.

    I realized that someday when I am no longer practicing medicine, I will be just fine because I lived the experience for two months. I was reminded of a wonderful fact: My name is not doctor. The years of training and practice, the intensity and immensity of the work, the frustrations and lives saved (and lost), the exhaustion coupled with creativity, the mixed senses of triumph and futility, all of that is darkly wonderful. But it does not wholly define me, nor does it (or should it) you.

    Gift number four is something you have to say out loud to yourself: “My name is not doctor.” Sometime over the holiday season, sit down and do a thought experiment. Imagine you are not a physician. You are just you, with all your quirks and wonder. That may be the best gift of all. Protect it.

    Now, have a happy season. Rest, reflect, fight back, and accept who you are. Here's hoping next Christmas we have a little less baggage.

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    Dr. Leappractices emergency medicine in rural South Carolina, and is an op-ed columnist for the Greenville News. He is also the author of four books, Life in Emergistan, available athttps://amzn.to/2T60WET, and Working Knights, Cats Don't Hike, and The Practice Test, all available atwww.booklocker.com, and of a blog, http://edwinleap.com/. Follow him on Twitter@edwinleap, and read his past columns athttp://bit.ly/EMN-Emergistan.

    Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
    • mamelrose10:59:40 AMYou ARE Santa Claus. This piece is a gift for us all. Thanks for sharing your kind thoughts and excellent practical wisdom. Hope you have a happy healthy 2021 and a great every day. Warmest regards, Mark Melrose, DO
    • jwpyron7:36:54 PMEdwin, have read your columns for years, and it seems like you can usually read my mind. I think this one is especially appropriate. I retired three years ago after 42 years in EM. The first couple of years were difficult, and I kept wanting to return to medicine. The very things you mentioned are the things that kept me from returning. Administrative and other nonmedical personnel who knew more about practicing medicine than physians, the bullying doctors who refused to take any patient responsibility, the government paperwork, and all the other nonpatient care responsibilities won out. The part about my name is not doctor is especially fitting at this stage. I miss patient care, but most of my friends now do not call me doctor, many don't even know I was a doctor, and it's refreshing to have a life and identity outside of medicine. I am proud of my 42 years in medicine, but at this stage of life, I don't miss all the stress and am really happy to be just plain old me.
    • trineyjr7:58:21 AMThank you. Fantastic!
    • kling408910:36:07 AMEdwin, I have read your stuff for many years. Outstanding conscious thought and reflection. Very admirable and well said. I have to say in all my years of practice, I have contemplated much of my validation, and am very happy with what I have done. I will defend EM to the end to the face of many of those "bullies," etc. After 27 years in public health care and longer than that now in private practice, both at same time in Chicago, I have even more disdain for the ineffective "others" surrounding us with their delusional commentary thinking they know something about medicine and the work we do, both from the danger and education points of view. Such a privilege to hear someone express what I do privately much of the time even in the ED. Always enjoy what you write. Privilege for all of us. Cheers.
    • fcole2:03:41 PMOutstanding column, Ed. I will nominate you for Santa Claus. You always speak the truth so eloquently. Thanks for being a voice crying in the ER wilderness.
    • lbandrew12:16:32 PMOne of your very best columns, Edwin, and that is saying a lot. These gifts should be taken to heart by every EP, and in fact everyone in EM. We are human beings, whose profession is medicine. Although the degree may form part of our purpose, it does not define us.