I had a conversation today with a third-year classmate. I'll call him Todd. Todd is a very decent guy; He is considerate and intelligent and will be a fine orthopedic surgeon One day, he revealed to me some of his disappointments about medical school. Before medical school he dreamed of being a physician, of working with a team of dedicated people devoted to helping rescue others from serious disease and early death. 

Instead of this he found a medical system that is built on egos, and days filled with impersonal work involving almost anything but caring for people. He admitted to me that medical school has changed him. Not that he is bitter, exactly, but that he no longer feels the way that he used to. At this point he knows that in the future he is going to just go about his business, keeping to himself, with no illusion as to changing anything much for the better -- except perhaps for what is directly near to him.

At least here he has kept a small spark of life within himself.

I hate to say this, but it is true. Medical school takes life away. It flattens. It poisons it. It takes a young idealistic pure soul and distorts it, rubs it around, and conforms it into an instrument.

It does not have to be this way.

I refuse to give up. I refuse to give anything up, not even an inch. I will not die. I will not so much as wilt. I will take a hit and leave it right there where it came at me. I will look it all straight in the eye and stubbornly plod along my way.

In the end, I will find my way; I will find the people to help me do it the proper way. I will be attentive. I will be present. I will treasure the obligation and the opportunity to care. I will fight every thought to judge or to have prejudice toward people unlike me. I will be personal. I will be loyal. I will be a friend.

I feel humbled to say that I am not one ounce lessened by the ardor and difficulties of my three years in medical school. The commitment, compassion and idealism that accompanied my decision to become a physician is within me today. It is burning deeply within me, as strongly as ever.

I ask you... where are you today compared to where you where when you started medical school? Are you the same person? Are you flatter? Are you greater? What have you done to secure yourself?

If you are on the road to medical school, where are you now? What will you do to make sure that you exit medical school in the same or better place?

If you're in practice today, how do you keep within you your vision?

The truth is that each of us must be responsible for the course of our own growth, through every punch, each challenge and all of the joy. Whatever your school or your professors and deans or your attendings and residents put on you, you can be shed off like loose skin. It is your responsibility to find a way to do that, to find the deep spot within you where your internal compass, your soul, resides.

Thank you all for many things... the Humanistic Medicine community has been a major source of support and strength for me over the last two years. Together we glow and offer each other the flame that is so squarely lacking in our medical school environments.

We are correct.

Compassion and caring in medicine is right. If you don't believe me, just look into your own heart... or ask the last person you know who has been to the doctor. Keep fighting with love.


William Fenster, M.D. University of Florida College of Medicine, 2002
fenster@access-4-free.com