Thursday, May 6, 2010

Medicine, Year 1

I talked with my dad on the phone for 30 minutes last night. 30 minutes. Probably not a big deal to most, but to me, this was something of an anomaly. My dad isn’t much of a talker. Growing up, the vast majority of our conversations began and ended with school, grades, and standardized tests. This has been a trusty recipe for 30-second conversations, especially since I’ve always managed to keep my academics more or less in order. As I’ve gotten older, however, I’ve learned to pick up on my dad’s preferred mode of communication—his actions and his hard work. His “I love you” is an 80-hour work week and his “good job” is a split-second smile and a nod—you might miss it if you haven’t learned to pay close attention.
When my dad learned that I wanted to attend Duke for my undergraduate education, he told me that the price tag for tuition could only be justified if I were to aim for medical school. Otherwise, it simply “wasn’t worth it.” I knew that I really wanted to go to Duke but I also knew very little about becoming a doctor. In the end, I agreed to give the pre-med route a shot and that was my first decision to pursue medicine. I know, not much of a decision.
Despite a general lack of interest in most of what I was learning, I ended up doing pretty well in all my pre-med classes. This didn’t give my dad much to talk about and it was a good thing, sort of. However, I’ve learned that passion-less work will eventually catch up with you in some shape or form. For me, it was burnout. By the time I had finished my junior year at Duke and was gearing up to take my MCAT, I was wiped. I was sick of the soul-draining cycle of stuffing information that I didn’t care about into my head so that I could brain-puke it onto a test, so that I could get the grade I wanted, so that I could go to my grad school of choice, so that 20 years from now, I could perhaps be in a position I wanted to be in. It was all too results-oriented. I realized that I couldn’t embrace the journey because my initial decision to pursue medicine was rather uninspired. I was good at the classes, I liked the idea of helping people, but it felt like I was travelling smoothly, aimlessly down this default path, waiting for lightning to strike.
And then I chose to pursue my medical education at USC’s Keck School of Medicine, at which point my dad basically told me to fuck off. This was after I spent a year working in an ER, and deciding that I really did want to do medicine after all. I think it really forced me to own up to this decision, the fact that my dad hated it—not my decision to go into medicine, but my decision to attend Keck. I was lucky to have garnered a few acceptance letters, and my dad felt that at best, Keck should’ve been my third-choice option. Simply put, he had looked at the U.S. News rankings, and to him it was rather clear. He didn't talk to me for a month. In his eyes, it was love unreciprocated. He had done his duty, working tirelessly so that I would have every opportunity. And now, he felt I was abandoning my end of the bargain, foregoing his love. I have since gained a better appreciation of the cultural overtones that led to my dad's actions and from this I have found forgiveness. But at the time, I couldn't see much beyond the pain and bitterness. There were nights I went to bed with murderous thoughts.
It’s a funny thing when you choose an unpopular stance on anything. You feel added pressure to perform, to succeed, to avoid ever having to hear “I told you so.” And this is how I embarked on my education at Keck. For the first many months, I wavered between an inextinguishable fear that I had made a mistake and an unrivaled determination to make the most of my experience. As the year went on, however, these raw emotions began to dissolve into peace as I found myself enjoying my experience at Keck. And not surprisingly, with this enjoyment came relief. It’s been a transition, a challenge, a fulfillment. But more than anything, it’s been the first time in a long time that I’ve enjoyed the process—the journey independent of the destination.
So I talked to my dad last night and per usual, we talked about school. He had heard from my mom that I was enjoying medical school, and he expressed his pleasure. “You know,” he chuckled, “it’s sort of a relief because I feel like I’m essentially the one who forced you into medicine.”
“Ai-ya, Dad.” I shook my head. “You know if I really didn’t want to, you couldn’t have forced me.”
He hummed to himself in muffled agreement. Then after another brief chuckle, he brought up my White Coat Ceremony, which he had attended at the beginning of the school year. “You remember that—oh, what’s it called—that oath-thing you took?” He was referring to the Hippocratic Oath. “I remember being moved.” He took a breath and his tone deepened. “So, it looks like you are learning quite a bit, huh? I couldn’t be more proud of you.”
I paused to let this translate. In all the years I’ve known him, my dad has only said “I’m proud of you” one other time. Like I said, my dad isn’t a man of many words and tough love is the only kind he knows. But I’ve learned to read between the lines. Here he was, a year after intensely fighting my decision to attend Keck, stating explicitly that he was not only okay with it, he was proud.
I thought back to the Hippocratic Oath my dad mentioned. I remember standing in front of the school my dad never wanted me to attend and pledging a certain loyalty to “the profession of Medicine and… its members” and accepting a certain responsibility “for the good of the sick.” Now looking back, I think the Hippocratic Oath sums up pretty well the fact that our decisions are steeped in the influence of others—friends, teachers, patients, and parents. Our free will is inextricably knotted to both those that come before us and to those that come after. But even as we acknowledge the ways in which our characters and choices have been molded by those around us, we somehow take ownership of our individual paths. The day I stood up at my White Coat Ceremony and recited that oath was perhaps the baptism marking when my journey in medicine—one that began with a little coercion from my dad—fully became my own. And with a simple, rare “I’m proud of you,” I felt my dad acknowledge this fact as well.

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