Monday, January 31, 2011


If wishes were horses, beggars would ride.
If turnips were watches, I'd wear one by my side.
And if "ifs" and "ands" 
Were pots and pans,
There'd be no work for tinkers!

We are back to the "what ifs." What do I wish I'd done that I didn't do.

In my teens, I wanted to be a physician. I loved the idea of learning about the intricacies of the human body, how drugs work, and helping people to be well. I had great grades in high school. I could have chosen the pre-med track at college, but I didn't think I was smart enough, or that I could weather the hardships of internship and residency.

I remember one day when a representative from the 5-year Bachelor's/Doctor of Medicine program at the University of Missouri, Kansas City came to my high school. The room was packed because most of the students at my high school (a day/boarding school) were the kids of rural physicians in Missouri and Illinois. Many of them had plans to become physicians themselves. The representative talked about how hard medical school is,  how only the best and brightest can succeed, etc. He was not encouraging. When I asked a question about the application process, he asked if I had been volunteering in a hospital. I answered in the negative, and he told me that I could forget applying because I would never be accepted. Being the self-hating 16-year-old I was at the time, I took what he said to heart. 

Then when I got to Bryn Mawr and met people in my class who were living and breathing pre-med, and who spent all of their time in the lab, and who talked about the grueling nature of preparing for medical school, I shrank farther from even trying. I decided that my mind could be well applied to non-medical questions in archaeology, and that was that. 

Over the years I toyed with abandoning my Ph.D. and preparing for medical school, but I really didn't think I could make it through. I did meet one very inspiring woman, a medical student at UCSF in the '90s, who was dating one of my roommates. I thought she was brilliant on many levels: she spoke fluent German and could speak intelligently about pretty much anything. She was smart, moreover, without being arrogant or dismissive. She encouraged me to follow her path. She hadn't applied to medical school right after her Bachelor's, taking time off to travel and research. During medical school, she volunteered in women's health clinics in Bangladesh and Nepal. Medicine was her passion, and she was actually helping people, rather than reading in dusty archives and trying to get a venomous, waspish adviser to approve a dissertation.

Time passed, I got my Ph.D., and was still miserable. When Callum was born, I had the opportunity to talk at length with physicians and nurses in the NICU. I thought briefly about preparing for medical school and pursuing the old dream of being a physician, but that would have meant abandoning my newborn, not having a second child, and investing in a completely different future--even though by then, I knew I could do it. Nursing school was a faster path to a parallel profession, and I told myself I would be happy not taking call and working fewer hours.

What I didn't exactly realize is that nursing and medicine are complementary but completely different. Nursing is about providing holistic care and being at the bedside, but following orders and not making medical diagnoses (I refuse to admit that nursing diagnoses are actual diagnoses). [For example: when I see torticollis in a baby, I cannot call it "torticollis" when I am charting, but have to describe only what I see and say something like "Muscles in the neck are not equally developed bilaterally. Head is not held symmetrically at midline and inclines to the right." It's a bit irritating.] Nurses can suggest treatment plans to physicians, but in the end, treatment is the physician's call. Some physicians are more open to taking suggestions to others, and some are more collegial with nurses than others. Medicine is about looking at data, making diagnoses, prescribing treatment, and looking for results. They are extremely busy and focused. They only want to hear the facts. They don't spend much time with patients, and sometimes don't listen well either to nurses or patients. 

I believe that in the big scheme, I would have been happier as a physician, and of course I could have done all of it. I have high school classmates--no offense--who were not terribly bright but who are physicians today. I would have been a physician with nurse-like qualities, like my own primary care physician, whom I love. She listens, doesn't hurry me, considers me holistically, and admits when there are things she needs to go look up, like hereditary spherocytosis and portal vein thrombosis. We discuss her thoughts together and collaborate on my plan of care--she directs, but does not dictate.

If I had my life to do over again, I would have been pre-med at Bryn Mawr, including finding a way to do junior year abroad. I would have been accepted at every medical school I applied to--I might as well dream big! 

The major drawback is that I wouldn't have met some very amazing people in my life--Thomenon, Gale, Nalini, Mark--and I wouldn't have my two sons. I cannot imagine life without them now.

I suppose I could still go back to medical school even now, but by the time I finished residency, I would be 50+. Stranger things have happened, certainly, but for now I am content with my life as it is. It's time to look ahead, not backward.

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