Out Of The Old Black Bag
OUT OF THE OLD BLACK BAG
Little Things for Little People (Part 2)
Throughout history, it has been witnessed that adverse conditions can sometimes produce remarkable results. Take the raw oyster, for example. When a grain of sand gets into the mollusk’s shell, the irritation causes the secretion of a unique substance (nacre) to coat the intruder. Over time — it can even take as long as 40 years — the process results in the formation of a pearl, one of the world’s most treasured jewels. The medical profession has always been occupied in the transferral of these nuggets of wisdom from generation to generation.
Here are my “pearls” for you:
1. The best advice about work ethic I ever received was from a frustrated senior resident when I was an intern, and it proved to be highly beneficial:
“Just Do Your Job and Shut Up!”
Draconian as it may sound, this piece of advice has generally held me in good stead — and stabilized my mental health. The danger is that when we become “good,” we receive the sought-after adulation of the public; once we are good and know we are good, we change how we view our patients and we judge — and then we are not “good” at all anymore!
2. Over the course of a career, it is easy to lose one’s identity and fall prey to the herd mentality of bureaucracies. However, in the long run, you are your own boss and accountable to your own conscience. Remember the spirit of this quote from Doctor George Sheehan — cardiologist, father of 12, elite runner and author, and guru of the running community who became its mentor and “spiritual advisor”:
“It’s very hard, in the beginning, to understand that the whole idea is not to beat the other runners. Eventually, you learn that the competition is against the little voice inside you that wants you to quit.”
I often had to use this exhortation as an antidote for emerging burn-out.
3. Another irrational, but ironically accurate and well-advised, point-of-view offered by a professor at now-Drexel Medical School when we students whined about the stress of cramming for exams:
“When you are in practice, every day is like final exams!”
I presumptuously chided my own children when they complained similarly, falsely claiming authorship of the wisdom. Now in retirement I know the rub — solving problems on an exam is a simple mental effort; solving even trivial problems in pediatric practice sometimes demands mountains of patience and creativity, especially when the problems do not exist! As Oscar Wilde warned:
“Experience is the hardest kind of teacher. It gives you the test first and the lesson afterward.”
4. When you are angry, do not write anything, say anything, do anything, or even think anything. Your perspective is automatically warped. Angry thoughts beget angry words and actions, which can negatively impact the status of our relationships and our careers. Again, just do your job in life and shut up! At least until you have “slept on” the matter for several consecutive nights (or days if you are a resident on night shifts). Follow the wisdom of Lebanese philosopher Khalil Gibran in The Prophet:
“You talk when you cease to be at peace with your thoughts.”
5. “It’s the little things you do for people that they remember!” This most fundamental and life-changing advice I was blessed to receive was from a community doctor at a neighborhood satellite hospital through which we rotated in our third year of residency. The academic program directors were required to expose us to “both sides” of pediatrics. This included some practical teaching from a harmless “country bumpkin”. The expectation was that he would keep up his knowledge by interacting with the young residents, some of whom would be advancing our careers by taking high-power fellowships and contributing to the pediatric literature by publishing studies in prestigious journals.
Fortunately, for 40 years I TRIED to take his words to heart in every aspect of my life. When he was presented with the “Teacher of the Year” award at the residency graduation dinner, yours truly — being the chief resident and obligated to give the award presentation — received many dirty looks from the program moguls when I concluded: “If I were a child, I would want Lennie Rosensweig to be my pediatrician.”
Unless Doctor Rosensweig has lived to be over 110, he will never read these words I now write, but for us green and anxious residents shaking in our shoes, I hope they have lived on.
6. “BE KIND — and it must follow, as the night the day — as it is, in the long run, the “only thing.” Again, Khalil Gibran:
“Kindness is like snow. It beautifies everything it covers.”
Finally I have the right — and obligation — to pontificate. If I take my arm-chair role seriously, I must conclude after 40-plus years of sometimes needless, self-imposed pressure, of sub-consciously communicating misinformation, of occasional bouts of arrogance and/or a shortage of humility and patience, of transgression of every principle I have itemized above — that it is all about one little thing: Kindness. We must be kind to each other, to our patients and their loved ones, and, in what could be a time of danger to our entire civilization, we must be especially kind to our own souls.
7. Pediatricians are a unique breed. As Sister Sledge sang and the Pittsburgh Pirates agreed: “We Are Family.”
To borrow from the well-known, but humble proclamation of dying American baseball hero, Lou Gehrig, we are “the luckiest individuals on the face of the earth.” Dying men tell no lies. We are not only physicians and sometimes healers, we are the authors who write the novels which often underlie our patients’ lives. Sometimes we even have the power to be “superheros,” to change the trajectory of the fate of an unfortunate child or parent who could not cope without a kind word, a kind glance, or a kind, unsolicited gesture.
I would like to believe that I have “written a few short novels” — in addition to some long blogs. One can do worse than be a writer of these kinds of novels.
PS: Strangely, I never received my diplomas from my residency or chief residency programs. When I returned to the “Mecca” several months after moving to Pittsburgh to pick them up, they had been discarded. However, I was confident that I had already learned all that I really needed to know.
Two fledgling resident physicians “after the same rainbow’s end.” My advice to them: As he lies dying in the movie, Tom Hanks mumbles incoherently to Private Ryan (Matt Damon): “EARN THIS!” He must repeat it several times before he can be understood. Private Ryan spends the rest of his life trying to live up to this.
Dedicated to Joe and Mallory, Kevin and Ashton, Anthony the Psychiatrist — members of a new generation of physicians to whom the “torch has been passed.” I believe that the Golden Age of Medicine will be returning for an encore! Lest I babble on indiscriminately, somebody please tell me to “shut up!”
source http://www.thepediablog.com/2022/03/31/out-of-the-old-black-bag-17/
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