Remembering = Consciously Not Forgetting

When I entered medicine, I believed I would never forget important experiences or core values. Every clinical emergency was engraved on my mind, every uplifting moment, every unexpected grief. With each key moment in my working life, I believed my commitment to hard work, compassionate care, and intellectual purity would be etched deeper and deeper into my absolute Self. Memory and Identity were thus firmly entwined; without memory, there would be no identity as a doctor. The forgotten self cannot attain enlightenment.

Real life has turned out to be a bit different than the ideal. I remember plenty, but I forget almost as much. Key moments from medical school have degraded into a greyish soup of recollection (was that woman with squamous cell cancer of the jaw Mexican? no, Caucasian. She had photos of her cats in her room....), while those from residency retain some of their cinematic exactness, but are losing emotional impact.

With this inevitable forgetting comes a muddling of identity. When I started my first real doctoring job, I wanted to live the Dream of Family Practice: full spectrum family care, babies, pregnant women, old people, midnight admissions to the hospital, before-dawn births, Rockwellian hand-holding all day in the clinic. I had plenty of memories from my training to bolster up the Dream. Then real life took over, and everyday disappointments, minor triumphs, and sheer exhaustion began to chip away at the Dream. Gradually I removed bricks from the foundation--inpatient pediatrics fell by the wayside, then primary care medicine--and the relief at having found a manageable middle-ground replaced the old key moments in my concept of Self as Doctor.

Since this shift, I struggle with a nagging sense of failure, of having given up on the Dream. Yet the core of identity is still there. The changes I've made will help me deliver the services I still provide with more skill, attention, natural compassion--right? I believe so. I hope so. As I make these transitions, however, I return again to the core of memories that have proven (and occasionally disproven) my idea of myself as a Family Doctor. Perhaps I can't hold onto their every exact detail, but I can prevent their essence from escaping by the simple act of writing them down.

Here they are.

Comments

[Dragonfly]

That is so true. I never would have believed at the time that the names of the first person I saw die, and the first child would be forgotten in time. Particularly with the child, I did think it was burned on my brain forever.

[Bernard Farrell]

Hi

I found you via Dr. A's post.

I don't know whether losing track of details and emotions is anything but normal. Those events with high, high emotional parts are always locked in. Some you can even recall together with all the associated emotion. But I find those are the exception.

I never really considering using blogging as a way to remember these. Thank you for the suggestion, for me this is much easier than keeping a journal.

Best wishes for your new blog.

[Zemi]

Hi there, I just want to acknowledge that you are not alone.

My wife is an internist and is sooo frustrated with the "Real Life" aspect of practicing as an Internist.

She cannot wait to get out of it. Currently she is seeking to go back to school to do another residency where she will have NO patient contact at all.

For her, real life as a practicing Internist has turned out to be a NIGHTMARE!

Your comment below is Right On!

Real life has turned out to be a bit different than the ideal.