Turn This Page

I’ve been doing medicine my whole life — well, more than half of my life, at least. I must admit, it was never my calling, yet I got rather good at it.

I quit. Today is my last day at this job.

It has been an interesting journey. It has been my life, and I don’t wish for another life. I enjoyed it most of the time, and I hope I did my part good — at least I tried to. Some people say I’ll be missed. Some of them I even believe.

It has been quite a struggle for me, all the way. I come from a medical family, and medicine was a natural choice, though I quickly found out I wasn’t really passionate about it. By the end of my time at the medical university I knew I wasn’t really fit for any medical specialty, but there was psychiatry that was at least somewhat different and interesting. Three years later, I was still interested in psychiatry as a field, but I knew I wouldn’t make a good practicing psychiatrist. I’m too impatient by nature, while psychiatry needs time; I later learned to be patient and not change prescriptions before my initial prescriptions even had a chance to cause some effect, but still to this day get bored quickly and deeply by day-to-day psychiatry routine.

Fortunately, I got offered a teaching position at the university where I was finishing my post-graduate training in psychiatry, and that has been a life-saver. Concentrate on figuring out the field and passing this knowledge to doctors that do the actual work; keep seeing the most difficult (hence interesting) cases, use the abovementioned knowledge to figure out the patient’s condition and treatment strategy, but leave the tactics and the actual treatment to the hospital doctors with minimal oversight; do some science in between — what’s not to like? Well, wages are modest, and most of my university colleagues take patients privately to make some extra money. I mostly redirected those who asked me for personal consultations to colleagues who I knew would do a better job helping these people.

I made money on clinical investigations. Most doctors find international multi-center projects sponsored by Big Pharma too challenging, with a whole lot of different processes to learn, extra regulations to comply with, and strict documentation protocols to follow; as much as day-to-day clinical practice is bureaucratic, this is a whole new level, and the differences in applicable legislations don’t help. For me, it all was interesting and fun. I enjoyed finding a way to satisfy contradicting legal requirements while still following the protocols, and setting up processes and documentation practices that would hold against any imaginable level of scrutiny on auditors’ part, while still keeping it practical for a little team to handle. People who worked with me say I was one of the best in the field.

I don’t tell all this to brag, I’m just trying to explain how it came to be that I spent over 20 years doing medicine despite being fully aware that I can not be a good doctor.

You see, to be really good at medicine one needs to care deeply about people — individuals, not humanity as a whole. And the way my psychological defences work is I cut down on the empathy too much. It makes me a good clinical investigator, and a better scientist to quite some extent, but because of that I simply don’t care enough about a patient when the patient needs it the most. Every human is unique, no case you ever treat as a doctor is quite like another (which is why evidence-based medicine is only good to a limited extent), and critical situations demand, more often than not, acting on insufficient information, on a hunch even. In a conservative field like medicine, that’s a leap of faith that requires either caring for and about the patient above all and everything, or being presumptiously sure about your own knowledge and capabilities. I lack both of those traits.

I could go on doing medicine the way I did, of course, but recently several major events in my life changed my perspective to quite some extent. The birth of my daughter, my nothing-short-of-a-miracle COVID-19 survival, my father passing away, the surreal circumstances we’ve all been living in lately — these and many other things eventually put me into this “I can no longer just somewhat passively live on my own life, it’s time I started consciously making every decision to live the best out of it” state of mind. And then I turned 40 earlier this year, and the number served as a trigger: I’m old enough to know who I am, yet young enough to still be able to learn, grow and adapt. This is the perfect age to live, and the perfect time for changes is now. The changes took some time to make happen, but here they come at last.

It’s a relief for me, of course, to not have to do medicine anymore, and I don’t think I’ll miss any of the university or state-sponsored-medicine bureaucracy; but I don’t regret investing all those years into it. I met great people, I worked on awesome projects, and I did some good job I’m not ashamed of. I wouldn’t trade my life for any other.

But for that to hold true in future, it is now time for me to turn this page.