It’s Friday night, and you are finally free, after seeing 20 patients for the day, all of whom have multiple comorbidities, poorly controlled glucose, and a laundry list of complaints to question you about.
You have some time to catch up on your own life. You call your parents on the 5 minute drive from the hospital to the library. The only five minutes you’ve had this week to catch up on what is going on in the world outside of medicine.
Their voices soothe your nerves. But just as quickly as the conversation began, it must end. You’ve got a million things to learn, notes to write, charts to review, medications to reconcile, and a test in two weeks that you must pass to stay in your program.
It’s enough to make any person question their career choice. If you’ve made it this far, you’ve had a million other opportunities. A million other paths that you considered, but ultimately you found that the only way your life would ever be complete was by helping the lives of others.
It’s an honorable choice, but many times during this journey, you’ve questioned what the “easy way out” would have been like. The thoughts have guiltily entered your mind many times during this journey, but it always comes down to the one defining principle that affirms your choice.
You wanted more and you chose more.
You chose the hard road, realizing that living your own life was so much more important than existing in someone else’s.
So, what is it that makes you continually choose the path of difficulty? How have you maintained your motivation when there have been so many times you could have walked away?
Perhaps it is fear of failure or fear of becoming complacent in something that doesn’t make you happy.
Perhaps it is the fact that the paragraph above does not overwhelm you, but in itself is motivation. Maybe you thrive off being stressed and overwhelmed, because you know the end result of all of your perseverance, is something experienced by only those willing to continuously self-sacrifice for the benefit of others.
Motivation in medicine largely depends on the individual, but there are many principles that unite all health care providers. As a student for the past six years with a continuous goal of becoming a clinician, my resources for motivation have continuously changed.
As an undergraduate student, my motivation continued to be the same, but as I became an EMT and actually began to fulfill my age-old goal of “helping people”, it evolved into wanting to change lives on a deeper level.
During my application cycles, it evolved again into not only wanting to get into PA school, but wanting to compete for the best opportunity to engage in patient care. During my didactic year, my motivation was a combination of needing to know things for the exam to the stark realization that not knowing something down the road as a PA could result in harming a patient.
My motivation has vastly changed during my rotations and clinical experience. The things I used to find motivation in, no longer sustain me.
During my didactic year, I found motivation to continue my studying because I was generally interested in the material, needed to learn it for the test, or needed to be able to perform tasks that were crucial to patient care.
The late night and early mornings were vastly sustained by this self-motivation in the hopes that one day I would be able to successfully translate it to good, competent, patient-centered care. The things that now allow me to get out of bed, with a hop and a step, are patients.
As health care providers, we are in a unique position, where we have the privilege of interacting with a multitude of people. We are the last stop for many who feel like the rest of the world has stopped listening.
We are a smiling face on the worst day of someone’s life. We are a smiling face on the best day of someone’s life.
Our unique position allows us to experience human interactions that most people cannot even imagine.
An example of such has occurred for me during my clinical rotations, when I saw a patient who had recently been stung by a bee, and developed a near anaphylactic reaction requiring a frightening emergency department trip, multiple rounds of epinephrine, and a new outlook on life’s fragility.
I spoke with the patient and her husband about the incident and the use of her newly acquired epi-pen. During the conversation and subsequent instruction, it came up that her husband had not been instructed on how to use the epi-pen.
In what seemed like an obvious next step, I briefly paused the interview to teach the woman’s husband, of 60 years, how to use the epi-pen incase his wife was unable in an emergency.
As I explained the simple technique, both of them smiled at me and a look of extreme gratification came upon the man’s eyes. He said to me, “I can’t thank you enough. No one has taken the time to show me how to do this. I’ve felt so helpless and afraid at what could happen”.
I thanked the man for his kind words and the three of us continued to discuss his wife’s chronic medical conditions. Later on that evening, as my focus began to wane from my studying, I thought back to this encounter, and the many others that routinely come up as a health care provider.
Giving instructions on how to use medical equipment, taking medications, or adopting healthy lifestyles is so commonplace for us as health care providers, that can become blinded to how meaningful it can truly be for our patients.
These types of conversations have become the mainstay of what allows me to continue to wake up each day with an instant sense of eagerness to see my first patient of the day.
The intense, emotionally gratifying conversations we have with patients on a daily basis are unmatched in any other profession. This is what makes the endless hours of studying, reciting, practicing, and perfecting so worth the sweat and tears.
The realization is easy.
The bad days come to an end as quickly as they begin. But the good days have the power to stay with us for our entire career.
The patients whose hearts we have the privilege of touching are forever preserved as internal motivators for our perseverance. Medicine by itself is complicated and confusing, but at the heart of medicine, is the same eternally simple principle: you and your patient.
It doesn’t get any better than that.