“Doctor, did you see her prom pictures?”

The young woman in the office beamed as she turned her iPhone to show us a group of girls all wearing brightly colored dresses.  ”It was a little skimpier than I would have liked, but she looked beautiful,” her mother continued.

Had you walked in at that moment you wouldn’t have realized that minutes earlier we were discussing advanced directives for the beaming 17-year-old who wore the bit too skimpy dress.  Next week she is going to be evaluated for a clinical trial.  But, as the doctor confided in me after we left the room, she is probably going to die from her cancer.

That is how the whole afternoon went in the oncology clinic.  There was the middle-aged man who had a recurrence of his brain tumor.  The 50-some-year old with renal cancer who decided she was done dealing with chemo and wanted to die comfortably.  The man who had part of his frontal lobe resected and wanted to know when he could wrestle with his young boys again.  Those are just a couple of examples.

I walked out of clinic feeling emotionally drained.  I thought to myself, “is this what my life will be?  Giving people bad news over and over again?  Am I spending all these late nights studying so that some day I will have to be the person telling a 17-year-old she is going to die?”

I wrestled with that thought as I headed home and cooked dinner.  Then I was reminded of something a great doctor once told me.  ”All of the work you are doing is to earn the privilege of being a doctor.”

Privilege.  That is a funny word to assign to a job.  I continued to play his words in my mind…”As a doctor I have been the first person to touch a new life as it was coming into this world.  I have also been the last person to touch someone as they left it.  People entrust their lives to you.  That is the privilege you are working for.”

As I mulled over my day and his advice I realized he was right.  Seeing patients like that, struggling with their impending death, definitely tugged at my heart strings.  But what an honor it was to be part of that.  They trusted me enough to let me be part of that vulnerable and intimate point in their life.  More than that, they put their faith in the fact that the doctor, and I, could somehow help them through it.

I struggle with this part of medicine.  It is hard for me to sequester my emotions.  But I think that doctor was right.  We aren’t working towards just a job.  We are working towards an entire lifestyle.  I won’t have to be the one relinquishing terrible news to my patients.  I will get to be that person. That won’t be my job. That will be my privilege.

I think of things like this every time I’m learning something that I don’t necessarily think will be on the exam… I’m not learning medicine to just pass the course, but to hopefully help someone in the future. They might not know that I slaved over metabolic pathways to try and remember each individual step and how it relates to overall body physiology, but I’ll feel better in myself knowing that i’ve done so, just in case it ever comes up. 

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