Why Did You Get Into This Business, Anyway?

Why did you go into medicine?

This question will be asked thousands of times this year. Every prospective medical student and prospective resident physician gets asked this in their interview.  It’s just a thing. For those of you who have interviewed applicants (not just medical ones), you know that is not a great question. The applicant has had plenty of time to think up a canned response. In medicine, it’s a rite of passage. If you can’t answer that question correctly, you have no right to be in this club.

Once you’ve been through it you can start to rattle it off quickly, check the box, then go on to the other questions. These students are the top of their class; they know this question will be asked. The answer really adds nothing to the process. Unless you have really thought about it. Unless you really have an answer. Then you can tell them your “Why”.

Sooo…why did you go into medicine?

Since you must know, I’ll tell you. I’ll give you the answer I gave about twenty times and then later to anyone who asked in a job interview. It’s not spectacular. It’s what you’d expect. It wasn’t the right answer:

“I want to help people.”

And here’s what I would say: “I want to help people. I had the tremendous opportunity while in high school to ride along with our local ambulance service. We could sign a waiver, then observe. It consisted of waiting at the ambulance station for hours until a call came in. I had borrowed a book on cardiology and was able to read it. Boring, you might think, but there was a level of excitement, what would happen? Most runs were simply taking a person from home to the ER, not boring either, I was hungry for any patient interaction. Then the day came. We got a call from a person who was buried alive.

“This guy was working inside a trench that had been dug. Whenever the trench was this deep, they were supposed to put in this metal support structure that had two plates on each side and some struts in between. This thing was big enough to hold both walls of dirt on either side. We drove out there ‘lights and sirens’, speeding through town. Drivers would stop on the side of the road and allow us to pass. I felt like Superman.

“We got there and I saw that the support structure was outside of the trench. Maybe they felt they could get by without putting it in the thing. Maybe the worker was going to only be in there for a minute. Whatever happened, they didn’t use the safety equipment. The side wall collapsed in, crushing him from the chest down. I had no idea that much force could be exerted by simple dirt.

“As a high school student, I wasn’t allowed to do anything medical but I was able to help dig this unfortunate soul out. He was in such pain that they gave him a bunch of medication to calm him down and we rushed in to the ER. We handed him off to the doctors. They were getting ready to intubate him and put him on a ventilator when we left. What a terrible thing to happen to the patient. To this day, I don’t know if he survived.

“That was such an awesome and terrible experience. Right then and there I knew I wanted to help people. People in this hurt state. But I was sad that we had to drop off the patient and hand them off to the ER doctors. I have the utmost respect for our Paramedics but I really wanted to be the one doing the definitive treatment. That experience solidified my desire to go into medicine.”

It’s a powerful story. But it was a lie. Well, it wasn’t the truth. Not the whole truth. I’ll venture a guess that every other prospective physician has told a lie like that too. So, are we a bunch of liars? I guess so, but not like you think.

That story actually happened. Those were my actual feelings. The truth was not that I made anything up, but that I didn’t answer the question. I didn’t tell the interviewers “Why” I went into medicine. The real reason is much more mundane. And selfish. Something I would never tell in an interview. Something I’ve only said once. Until now.

Years later, I was on a family reunion and I had a rare moment to talk with my brother alone. He is a great guy, except that he went into law. Just kidding. It’s a great profession, and some of my readers are lawyers. We were talking, and he asked, “Why did you go into medicine?” I asked him if he wanted the interview answer or the real one. He wanted to know both. So, I told him the interview answer. Then I told him the real reason why I went into medicine:

Because I could.

It’s that simple. A terrible ego thing that a lot of us have. I had the ability to study for hours, to ace tests, to interview well, the fortitude to put in the time required, so why not? This was something I aspired to, and unlike a lot of my high school peers, I could.

Don’t get me wrong, those classmates went on to do amazing things with their lives; I don’t think I’m any better than them. Let’s say you want to become an astronaut. There are so many things you have to have in order to even be considered: top physical fitness, vision, psychological profile, mental aptitude, among others. If you need glasses, you are out. Most people simply won’t have everything needed. They probably could do something really cool, like mission control, or build rockets. These are great professions, but if you could be an astronaut, and want to be one, why wouldn’t you? Being an astronaut is not any better than the others, the bar is just higher. In the words of JFK, ”We chose to go to the moon in this decade and do the other things…not because they are easy, but because they are hard…” Take it from Jack: We could go to the moon, so we did.

So, now you know: I went into medicine because I could. The truth is, it wasn’t about making money, I really don’t need a lot. I don’t drive an expensive car. I do have a big house (see my previous posts on that one). It wasn’t just about helping people. I wanted to help people; I love helping people; it just wasn’t the only reason. I wanted the feeling that I get from helping people. Perhaps I’m mincing words here, but it was the ego boost of knowing that I was the one to do the saving. And since I’m being completely honest with you, I sometimes wonder if that is the reason I have my 50-year plan. Will burnout affect me more than others because I got into this gig for the wrong reason?

I had a Why, I just didn’t articulate it to myself. I certainly didn’t when I had my interviews. They would have thrown me right out of there.

I have a Why now: I want to be comfortable with my personal income such that I can do the things I want to do when I want to do them. I want to be able to teach people what I have learned. And, I want to help people. I set a goal to have this done by age 50. I’m doing it through real estate. Medicine won’t quite take me there. My investments will. 

In the end, I don’t care if you tell other people what your Why is, I just care that you tell it to yourself. Truthfully. Let me know if you agree with me.

Dr. Equity

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