Medicine’s dark side: When medicine became meaningless

Taureef Mohammed

I ALWAYS had images in my mind of what the ideal doctor looked like. One of the images was the Hollywood doctor. My favourite was House. I was always fascinated by science and liked how he rattled through the scientific process.

The other images were real-life doctors in my family – granduncles, aunts, uncles, older cousins, my older brother – who were always there at a time of need. They all had a kind of heroic status in our family. And in medical school, just to make sure I didn’t miss anything, I read books written by doctor writers and woke up early on weekends to watch Sanjay Gupta MD on CNN.

The image of the doctor could not be clearer in my mind, and I had no doubt that I wanted to be a doctor.

And then, like a slowly progressing, insidious disease, the disillusionment started to take over, and the images were replaced by strange things – feelings mostly – that I could not understand: an obsession with perfection, fear of making mistakes, shame when I did.

They were replaced by people who I could not stand: the macho house officer/resident who needed to make others feel small to feel macho; the stiff-necked consultant who believed that the only way to be a doctor was to walk the road that he did and to walk it the way he did; and the nurse who seemed to be friendly with everybody else except me, the junior doctor, a fly buzzing around in her space.

How could I have loved this thing so much years ago, and now, that I was in it, despise it so much? Eventually, the scientific process no longer stimulated me, and medicine had lost its purpose and meaning. The images disappeared – and that was the scariest part.

Was I fooled by Hollywood? Were the images that I had in my mind before medical school illusions themselves? Did I wrongly assume that fulfilment was guaranteed by having a Dr in front of my name, some letters after it, and a licence to help? Was I so naive?

Until a few months ago when I heard a talk on physician wellness – the same talk I mentioned in my last column – I never knew loss of fulfilment was a sign of physician burnout.

“It (burnout) eventually starts to affect us at work. We have a reduced sense of personal accomplishment. We start to think: Why am I even doing this? What’s the point of this? What difference am I making here?” Dr Mamta Gautam, a psychiatrist specialised in physician wellness, said.

She added: “This is the stage where a lot of healthcare professionals start to think about leaving – we’ve lost that meaning in the work that we do.”

In the 2021 Canadian Medical Association National Physician Health Survey, 86 per cent of residents ranked their professional fulfilment as low.

The statistic startled me. I found it almost unbelievable that most of us – doctors who treated the sick, the vulnerable, the elderly; delivered babies; transplanted kidneys, hearts, livers; replaced worn-out shoulders, hips, knees; shrank and resected tumours – struggled to find meaning in the work that we did.

“Even the healthiest and strongest of us can become unhealthy in an unhealthy environment,” Dr Gautam said.

Alas, none of us was immune to the toxic culture of medicine, a toxicity that totally enveloped all of us during our junior years as medical students, interns and residents.

A chat with a friend a few weeks ago made me realise that things were better now, more than a decade after starting medical school. We are both in our final year of training and expected to start practising as independent physicians in July 2024.

We spoke about career plans and the paths we could take to find some kind of meaning and fulfilment. That we were able to jump off the treadmill – as my programme director in geriatric medicine describes medical training – and talk about this felt like an accomplishment in and of itself.

After the chat, and in thinking about this column, I picked up a book that I bought in medical school. It is a compilation of stories by William Carlos Williams, who was an American physician and writer. The pencil marks on the pages confirmed to me that I was once genuinely intrigued by medicine. I reread some of his stories; the images pleased me. Finally, I felt some contentment with who I was: I was a doctor.

Taureef Mohammed is a graduate of UWI and a geriatric medicine fellow at Western University, Canada