My first exposure to medicine as a profession occurred when I was around 10 years old. That’s when I started accompanying my father to his internal medicine and dermatology practice in New York City on Saturday mornings. We had to leave early to make our way into the city from our home across the river in suburban New Jersey, but I didn’t mind. It was fun for me to go and help out in the office, although in retrospect, I really didn’t do very much. My dad put me to work filing and handling other minor tasks, but as often as not, I just spent time with him and saw how he went about his work.
My father practiced in an underserved neighborhood in the heart of Harlem, at the corner of 125th and Lennox, and he was one of only a handful of physicians there. His patients were 95 percent African-Americans, and to the best of my knowledge, there weren’t any other Caucasian physicians practicing in the area. He chose to practice in that part of Manhattan because it was where he believed he could have the greatest impact. He went where he perceived the greatest need, and I think his perception was absolutely accurate.
Spending those mornings with my father made a big impression, because patients weren’t very shy about telling me how much they thought of him. If you’re the only physician around, by and large the relationships you have with your patients are going to be remarkably strong and positive. As a child, it meant a lot to learn that my father was doing something that people found valuable.
While in the city, we would go out to lunch occasionally (although this was often hard to do, because he was so busy). Even outside his office, the way people related to him, it felt like everyone considered him family. The role he seemed to play strikes me as similar to that of many physicians in rural areas, where they become woven into the fabric of a community, and most of the local residents know who they are.
Although we didn’t live in the neighborhood, I felt like my father was embraced by the community, and I could sense that the emotional ties were mutual. “Love” might be too strong a word, but I know the people really cared for him, and he cared for them just as much.
When I eventually entered medical school and considered various specialties, one of the things that appealed to me most about primary care in general, and internal medicine specifically, was the opportunity to form long-term relationships with patients. That’s remarkably gratifying, and you find yourself not only caring about patients’ health, but also about them personally. I think physicians who do that are, by and large, much better at their craft.
Of course, I was also intrigued by the intellectual challenge of internal medicine. Having first contact with undifferentiated illness, and taking the initial steps to make a diagnosis, can be very intellectually stimulating and never loses its appeal.
My father stayed in the same practice for his entire career. After graduating from medical school at the age of 21 and then completing his residency, he enlisted in the army and spent five years in the Pacific. When he got back from WWII, he started his practice in Harlem and was there until he retired in 1982. He was in the trenches practicing medicine every day, and he worked hard. He left the house early every morning, generally around 6 or 6:30, wouldn’t get home until 7 at night, and maintained office hours on Saturdays his entire career.
Despite the demands of his profession, and even his frustration with some of the early changes to the U.S. health care system, my father was always thrilled that I followed in his footsteps. At a time when the growth and aging of our population are creating skyrocketing demand for physicians and other health care professionals, and when primary care providers in particular are needed more than ever, it is disheartening—if not altogether surprising—to hear stories of physicians advising their own children to choose a different path.
It is impossible to deny that we face many challenges today, including high student debt, a complex insurance system, and uncertainty in terms of potential reforms, in addition to the demographic shifts underway. Even so, I absolutely believe there is still no finer profession than medicine, and now is still a wonderful time to become a physician. Come what may, medicine will always be a profession in which you can earn an excellent salary (regardless of specialty), have an impact on people’s lives by doing something they need and value, and enjoy variety and intellectual stimulation for the rest of your life. If there’s a better job out there, I can’t think of what it might be.
And I know my father would agree. VS