What Keeps Me Going on My Longest Nights as a Resident: Medicine as Public Service

Jessica Chao, M.D.'12, with her mom at her general pediatrics graduation in the spring of 2014.
Jessica Chao, M.D.’12, with her mom at her general pediatrics graduation in the spring of 2014.

My four years of medical school were some of the best years of my life. I adored my friends and classmates; I fell in love with the state of Vermont, and I learned all the neuroscience I could ask for. There were endless opportunities to explore our interests both within and outside of medicine. We dedicated hours to memorizing the brachial plexus and to bettering our understanding of renal physiology, and after each exam we threw some unforgettable parties. Looking back, though, it is pretty obvious that medical school was a time for us to be completely, unapologetically selfish. I woke up early; I spent long days (and nights) on campus and I took endless notes – all for my own benefit. I wanted to work hard because I was the one getting the education. If I did poorly, I would be the only one to feel the repercussions.

Then came residency. I matched to my first choice program at Boston Children’s Hospital, and I was beyond eager to start intern year. Just like I did a few months earlier in Burlington, I woke up early, I spent long days and nights in the hospital and I took endless notes, but this time it wasn’t for me – it was for the benefit for my patients. Patients’ lives were at stake now. This was so exciting! The threat of not getting “Honors” in a rotation seemed petty and pathetic in comparison.

And then something happened as we matured as residents and our shifts became longer and busier: We learned to complain. For some, the habit was frequent, for others quite rare. It happened to even the nicest residents at the friendliest residency programs. For me, a predominantly upbeat, light-hearted individual, I was affected only on the occasional long weekend shift with little exposure to sunlight. Suddenly “interesting patients” were frustrating. We rolled our eyes at pharmacy’s request to discuss Tylenol dosing on the twenty-seventh hour of a shift. We were annoyed when a patient misplaced her fifth albuterol prescription and needed another faxed. Who destroyed our bright eyes and bushy tails?

I think the issue is that we sometimes forget that medicine is a public service profession. Our existence as medical professionals is justified by how much we are needed by the people in our community. It is the most significant transition for many of us going from medical school to residency; there is a massive paradigm shift from being an entirely selfish individual, to being completely selfless. And that is the expectation that is defined by our profession.

In the U.S., undergraduate medical education is paid for in part by government funding, at an average of about 50 percent. That funding comes from American taxpayers. Especially for those of us who went to a state university, many of those taxpayers live right here in our home state. These are the same people who show up to the ED in the middle of the night and need our help. Thus, because they paid their taxes to train physicians, we owe them the services they trained us to perform. They deserve to have our attention, our time and our patience.

So, that’s the outlook I try to maintain on my longest, busiest nights at work. I remind myself that (1) these people helped me get here, (2) no one enjoys a grumpy pediatrician, especially the patient, and (3) I have the best job in the world. I get to treat the most fascinating pathologies; I work with brilliant colleagues, and I have the most adorable, hilarious little patients.

Everyone had their own goals coming into medical school, but as physicians we all have the unique opportunity to give back in a direct and meaningful way. So as you start your first week of medical school, keep this in mind. The University of Vermont College of Medicine trained its students to work efficiently and effectively, and more importantly, instilled in us the practice of connecting with our community. For that, I will always be grateful.  (Also, enjoy UVM – you’ll love it!)

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