On Wednesday afternoons I am the psychiatrist for a clinic for young people suffering from psychotic illnesses. These young people have serious and chronic conditions. They have a long road of recovery ahead of them, but they are moving forward. It is inspiring to see their efforts and to be an influence in their progress.
It can also be instructive, as I learned several weeks ago. I was making perogies with the group. I have made perogies for many years at Christmas and Easter, thousands of perogies, and it was one of the celebrations that I could share with everyone. As I was holding up a sheet of dough, demonstrating how elastic it is when there is the correct proportion of flour and water, one of the youth said, “I can’t believe you’re making perogies with us, just like a regular person.”
I was literally stunned. I am five feet and one inch tall. I look like a Mom and I’m old enough to be a grandmother, although (I think) a young grandmother. I cannot imagine that anyone ever thinks I’m not a regular person, but there it is. For many people, and even some of the youth who see me all the time, I was surprised to learn that I can seem aloof, perhaps unapproachable, just like many other doctors. If this is true, how does someone feel comfortable enough to speak with me about difficult things?
There is no doubt that doctors have the reputation of doctors to overcome each time they see a new patient. Everyone knows the joke about the surgeon who thought he was God and poor communication is known to be the main cause of medicolegal disputes. What can we do to overcome the impression that we make? Other than cooking on Wednesdays, I mean.
I think that better science and “evidence-based practices” have changed medicine and doctors for the worst. Physicians in the 19th and early 20th century were as much social scientists and philosophers as they were scientists. As scientific discovery improved our knowledge of the science of medicine, there developed a need for doctors to know and for medical students and residents to learn this science that could save lives. At the turn of the 20th century, doctors had to have as strong a grounding in the liberal arts as they did in science but that was no longer the case at the beginning of the 21st century. Here is the beginning of the end of the physician as humanist for, as science requires external observation and correlation with known data (symptoms and signs), the liberal arts demand reflection and the ability to refine one’s thoughts into proper expression. Learning to understand how and what one thinks can be edifying and humbling.
One of the reasons that I chose to be a psychiatrist was that it can be closer to the literary arts, which I first studied in university and which I still love. But even reading and writing are not helping me to escape a doctor’s reputation, it seems. Can the “Doctor” in front of Beck truly be so much of an influence on my reputation?
One of the reasons that I started to write again was to reconnect to a life of reflection, something that I had lost. I found my diaries from medical school and residency. They were so well-written. I was a completely incompetent clinician, but my concern that I would never be a good doctor was so well expressed. Over twenty-five years of practice, I traded one competency for another but now I want both.
I want to be a regular doctor and a regular person.