When I was in training I was the prototypical medical school candidate and student. I attended the University of Arizona Health Sciences Center and felt that in those years we were seeing more “non traditional students”. There were students that had prior lives and families. They were more mature by age and wise by years. I, however, had been farmed from youth and driven had climbed the infinite ladder. I was straight from high school to college and then to medical school like the majority of my class. In those years we still spoke loudly about a “calling” and medicine still had a romance about it. It was the pinnacle of dedication that landed anyone in medical school. It still is. However in the 16 years since I graduate something has changed and I have spent the last 5 years trying to understand the nature of this change. At it’s core is an undoing of the ethos of medicine. It is a distilling of the concept into algorithms and quality metrics. There is less and less emphasis on the notion that patients have important relationships with physicians or that physicians have unique and valuable skills. It is an insidious erosion of an understanding that physicians are genuinely trying to sustain humanity and worked diligently to have this privilege. It is a sad day when help is accused without cause of having ulterior motives.
I know there is magic in the private moments physicians have journeying with patients. I know they occur. I hope these writings help physicians to keep the expectation going that they will continue and for patients to also understand truly what they seek and get by seeing a physician. Physicians are the last lines before priests. They are their to help and to transition a person through life. I hope we always keep this image vivid and alive.