Family Medicine Vital Signs

By Erika Sullivan, MD

Family medicine is an interesting and wonderful landscape to spend one’s days. Like a good mystery novel, there is an abundance of unusual but endearing characters, treacherous villains (with alarmingly medical names like diabetes and anxiety NOS) and more insidious and unexpected foes, such as poverty and social injustice. When treating patients in family medicine, one cannot help but feel a bit like Sherlock Holmes, using logic and the science of deduction to identify the culprit diagnosis.

 

In fact, the intrigue and mystery that pervades the typical family medicine clinic extends not just to the patients and the diseases we see, but also to unraveling the mystery of balancing work that is meaningful but very time consuming with the rest of your life, which can hold equal parts meaning and challenge as well. There has been a lot written about how delicate this balance is, and the best way to juggle it, and if anything, this first year and a half out of residency has taught me that I’m no expert at balance, and am not likely to give good advice on the subject.

 

But here goes…

 

Although I may not have figured out the secret to the balancing act, what I can say is this: have hobbies that you enjoy outside of work.

 

More than likely, if you are currently working in medicine or thinking of pursuing medicine, you – and the people around you – have had to make sacrifices in pursuit of that goal. As a result, along the way, if you are anything like me, you may have lost a bit of yourself in the process. The first few years after residency, when you are just starting to feel like you aren’t a complete fraud, you may also rediscover the things that you thought you had lost. With a bit of detective work, who knows, you might even start enjoying these things again.

 

In this spirit, and as the holiday season gets into full swing, I am often quite reflective on the things that are important in my life and the things that are not.

 

I think it goes without saying that my family is paramount on my list of that which is important to me, and I need not dwell on it further.

 

On the other hand, picking up every single toy that my two year old daughter strews about the house is not important to me, and so that has fallen off of my list. The juxtaposition of these two things should give you a clear sense of what my living room looks like: messy, but filled with life and love (and lots of toys).

 

I have a similar list of things that regulate my professional life, which is, I think, the crux of the point I’m trying to make here: when you get into medicine, you should strive to dive into your work mind, body and soul. But as with any plunge into a large body of water, know where the exits are and climb out when your swim is done. Staying submerged leads to chills and prune hands, and doesn’t make you a better doctor, just a burnt out one who is tired of treading water.

 

Recently, I indulged a hobby I didn’t know I had, and I wrote and published online a 100,000+ word book. I had not, until the moment I started writing, thought for a second that writing was a particular interest of mine. But I found myself with something to say, and with a supportive partner, I found a way to make it happen.

 

Similarly, I have taken up dancing again. I was an avid dancer in college but lost all but my inherent sense of rhythm in graduate school, medical school and residency. Again, I have hit the partner jackpot in that he is supportive of my long hours at work, which are made longer going to the dance studio three nights a week.

 

As physicians, it is in our nature to make sacrifices in support of our careers. The pursuit of medicine probably begins in grade school, when selecting an AP course over a more interesting elective because it will boost your GPA. It continues in college when the rigors of completing all of the “pre-Med” course requirements prevent you from taking that class in Modern European History that you heard was good. And then medical school, which for many can be a real test of wills, a gauntlet to test you to make sure you are strong enough for your chosen career path. And then the real fun starts in residency, where, in some programs, all of the things that made you a well rounded person are crushed out of you like a carrot in a juicer.

 

The irony, of course, is that for many, it was really those “other” qualities that got them into Med school in the first place.

 

But there is good news. There is light at the end of the tunnel. When you emerge from residency, battle worn and sleep deprived, you enter into a world where you truly do get to decide who you are, what you’re about and what is important to you. You can make these decisions by choosing where you will work, how much you will work, and really start to reestablish your priorities.

 

The work that we as physicians do is important. It is meaningful. It is necessary. And it is very fulfilling.

 

But it isn’t everything.

 

The most important thing I’ve learned in the past year and a half out of residency is that the most important vital signs I check everyday are my own. The days when I am able to do the work that I love, and then leave work at work and come home to my family, to my new hobbies, to my passions, these are my best days.

Erika Sullivan, MD is an assistant professor in the Division of Family Medicine at the University of Utah.