"Bound together by her luminously detailed and emotionally literate prose, Weir's recollections compellingly portray the challenges and rewards of modern medicine, and the slow and stumbling process through which a physician is formed."
Where Ms. Wood found fault, however, was in my failure to share the decision making process through which I came to medicine and pediatrics in particular. While it may seem naive to admit, it never occurred to me that I should. I might point out that stories must start (and end) somewhere and arbitrary though the decision was to focus on residency only, the world has many doctors. It should not seem outrageous to expect the reader to accept that I had simply decided to become one of them.
The real truth, however, is that I don't think I could have answered Ms. Wood's questions even if I tried. Could I (during those years) envision myself on a path other than medicine? It was not something I could permit myself to think about. If I did - if I allowed myself to wander into fantasies of teaching English or pipetting protein samples into Western blots or serving coffee at our local diner - then why was I trudging the snowy mile to the hospital at five a.m. in the depths of winter? I put blinders on, as I believe we all do when concentrating on finishing some discreet task. My discreet task - residency itself - may have lasted three whole years, but I needed to keep my head down and into the wind just the same.
When I was still in medical school, a friend and classmate of mine left. She was not failing her classes. Rather, she was doing quite well. She liked the material. She thought it was interesting. But she had begun to wonder, during those first two tedious years of medical school where very little if any time is spent on the hospital wards but is instead focused on classroom learning, if she might rather be a teacher. Did it make sense for her to stay on into her third year, do a few clinical rotations, get a feel for the hospital, just to be sure? No, she told me. If she stayed, if she took the loans for another semester's living expenses and tuition, she would be trapped in the debt and never be able to leave. Even with a physician's salary, the debt (mine weighs in at nearly $200K) is not insignificant. With a teacher's salary she would have never been able to survive. So she left a career she may very well have come to love because the risk was that she wouldn't. She might even hate it but would still have had to live with it for many decades to come.
By the time I became a resident at Boston Children's and Boston Medical Center, my husband had turned down a prestigious fellowship at NIST to follow me. He had taken a job he would turn out not to love in order for me to join this particular training program. I chose it because its affiliation with both Harvard and BU was unique and offered, I thought, the best training in pediatrics to be had in the country. And also, when I interviewed, I thought the people were really nice. It was as simple as that. But to question the path that had carried me to that point would have reopened a very tense and precarious discussion that had already been, fitfully at least, put to bed.
Before that, before the question of where, the questions of what and why are more than a little murky still, even with a few more years under my belt during which to reflect. Did I always, like my college roommate Laura, know that I would be a physician? I did not. Until the very end I resisted falling into the clichéd role of premed, one that at Princeton meant you majored in molecular biology and bought books on which activities could be used to best pad your medical school resume. But finally, when I had let more than a few of the experiments for my thesis run afoul because I was distracted by reading War and Peace, I accepted that lab work was probably not my calling.
Was it medicine, then? I didn't know. I had been on surgical rounds once at my mother's insistence, since she believed this was somehow an integral step in deciding if I could "handle it", whatever that means. During rounds the intern removed the staples holding together the incision of a woman who had just had her leg amputated above the knee. She was the wrong patient. The wound had not adequately healed and they spent another several hours trying to put her back together again. Fabulous teaching point, mom, I said, but I won't be going back there again.
Then, several years ago, I was walking over to the pizza restaurant near my parents' old house, the one they left behind to move in with us. My mother had scribbled the order on a piece of scrap paper and when I took it out of my pocket to look at the subtotal and count out the cash, I noticed that there was type on the back. My parents never throw anything away. What I was looking at was a draft of a Christmas letter written the year that I was about to turn ten. In it, my mother described how my brother and I were adjusting to our new schools, having just moved from Western Massachusetts to Buffalo, NY. Then she said that my brother was planning on becoming a lawyer while I had decided to be a doctor.
I have no memory of this. Neither do I remember the conversation I had with my camp counselor years later and of which she recently reminded me in the wake of the book release, when I said essentially the same thing.
Was I sure about medicine? I was not. Have I ever been sure about anything? Generally speaking, not so much. But were other people, many other people who have taken the time to write me the kindest of notes over the past few weeks, were those people sure of me? It seems so. For this, I thank them.
Why pediatrics? Really, I can't pretend to understand the question. Grown ups are cranky and they smell bad. Kids, even when they are throwing up on you, are adorable. How could I have ever wanted to spend my time doing anything else?
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