Doctor Hat

You reach a point during your second year of medical school where every symptom catches your eye, big or small...

Your neighbor has a cough? "It's probably just GERD or allergies... maybe it's a URI - hopefully he won't get a bacterial superinfection. Maybe it's something worse... heart failure? pulmonary embolism?" Somebody has a stomach pain? "Does it radiate? Does food make it worse? Better? Hopefully it's indigestion or PUD, not pancreatitis or cancer." 

I guess this kind of stream of consciousness analysis is helpful when we're on the wards or in the clinic, but I often find myself unable to turn the it off. Recently I've been in situations where making a diagnosis was irrelevant or inappropriate - where the people around me only wanted to be listened to and given empathy - yet I struggled to suppress the urge to find out what happened, where they were hurt, why the person died. My wife often says to me, "I don't want a diagnosis, I just want to you feel sorry for me." Yet, at this point in my life, it seems like everything I encounter is subconsciously integrated into the pathophysiology of a disease or becomes a bit of evidence for an eventual diagnosis. Sometimes I get frustrated or mad and stop myself, "You're projecting X onto ____; you should take what's making you upset and sublimate it into something good." The doctor logic overrides my thoughts and takes over. F*ck that.

Sometimes I just want to be frustrated; sometimes I need to just say, "I'm sorry your grandmother died of cancer" without thinking "I wonder what kind of lung cancer it was... was it small cell? non-small cell?" Maybe learning how to be a physician is a 24 hour process; that you can't possibly learn everything there is to learn in such a short period of time without it consuming your life. Hopefully, someday, when I'm done with my residency/fellowship/post-doc/whatever, I'll be able to leave my 'doctor hat' at the office and just be a friend, husband, or father when I get home.