COMMENTARY

Pandemic Epiphany: Medicine Isn't Worth It

Don S. Dizon, MD

Disclosures

October 23, 2020

When the pandemic started, I worried.

About delays in care for my cancer patients.

About my colleagues who were putting themselves in danger when the entire world was locking down.

And, of course, I worried about myself and the health of my family.

Despite my constant worries, there was never a question of how I would respond. I am a physician and I will continue to care for people, especially those living with cancer.

But as a physician, the politicization of the pandemic and the degree of mistrust levelled against scientists and public health experts have left me gutted. I've been disappointed and saddened by the vocal minority who have chosen not to wear masks, with some even going so far as to call the pandemic a hoax. Meanwhile, those of us in medicine bear witness to the horror: those who have gotten sick, been hospitalized, or died because of COVID-19.

While I've never considered walking away from medicine, I have colleagues who have weighed the option seriously. They have been forced to reexamine their chosen vocation and priorities, and much of it has nothing to do with patient care.

Like me, my colleagues with small children have had to adjust to restricted daycare access and homeschooling. This has forced a change in the routine: We now work from home some days or end our clinic early to make sure our kids continue to learn. Pre-pandemic, we often came home late because of long clinic days or faculty meetings, or we didn't come home at all because of a talk we had to give in Europe. Now, we no longer travel for work. We are home to sit down as a family for dinner. We are around to say goodnight — every night.

For many, it's been nothing short of an epiphany: They love it. It's as if the pandemic has forced them to open their eyes and realize that the only thing that truly matters are the ones you love. Kissing your kid good night beats the plenary stage at a national conference. Writing that next paper maybe isn't as important as making sure your family eats a healthy meal together.

Irrespective of gender, many of our colleagues are grappling with what this means for their professional future. Some are even struggling to answer the most fundamental question: Is my job really worth it?

The 'New Normal'

Recently, I was talking with an oncologist I've known for quite some time who is successfully building up toward promotion to associate professor. With the pandemic, she struggled to find daycare for her kids. She had to scale down her clinic, move half her visits to telehealth, and ensure she ended her day promptly at 4 PM. She needed to be there for her kids and her husband, who was also struggling to balance his work and home life.

With time, however, she has realized how much she was missing out on with her old schedule. She also noticed her parents growing older and recognized that she wasn't being as present in their lives as she had always wanted to be.

With all of her responsibilities, somehow time had slipped her grasp. And now, with shorter clinics and more time at home, she's struggling to see how she could ever go back to the old "normal" — running everywhere, never stopping to take a breath, and continually sparring with Father Time for more hours with her family.

Like many of us in medicine, she was groomed for this "normal." However, the pandemic has forced her to explore something she kept hidden in the recesses of her mind — the idea of cutting back. Or, do I even dare say, leaving it all behind?

Maybe it did not need to be so polarizing: "Succeed at family or succeed at your career — the choice is yours!" Yet, she felt as if the universe had granted a piece of her life back, a do-over of sorts if she wanted to act upon it. The thought of getting to her children's soccer games or being the mom who said "yes" more often became enticing. She romanticized other careers, from cooking to interior design to landscaping, but when she was honest, she knew that helping women through cancer would always have a permanent home in her heart.

Yet, with her new schedule a shift had occurred — her soul was a bit lighter.

Her patients had benefited too. She was clearer, peppier, running on all cylinders at work now that she had quality time at home. Her family dynamic was better, and as a result, so was her professional one.

One of her biggest fears is that as quickly as she was given this balance, the tides can come in and drag her back out to sea. She fears drowning in work obligations again after the pandemic has passed.

At the moment, she is clutching to this COVID-19 "new normal," but realizes the window may be closing if she doesn't choose to make her boundaries known now.

A Seismic Shift

Another oncologist I talked with told me how the pandemic made her next professional step clear: to resign and step away from clinical medicine for a time.

She had somehow managed to maintain the juggling act of being an oncologist, wife, and mother for a decade, pouring her heart into her patients; cranking out grants and manuscripts; learning all the dinosaur names; and coordinating her international travels, her husband's call schedule, and kid's soccer practice, playdates, and homework with a calendar shared among herself, her husband, and a nanny. It was a challenging pace to maintain even at baseline.

Though stay-at-home orders brought on something of a reprieve, there came the added weight of the pandemic: Her patients were scared for their health as their treatment decisions were reevaluated; fearful friends were reaching out for advice on their pandemic-related decisions; and there was discord with her extended family, whose political views felt altogether menacing during the pandemic.

An unsupportive work environment led to further tremors. The seismic shift, ironically, came in the form of a tiny request. After an unusually brutal clinic, she came home to her son's hopeful request to go to the park and fly his remote control airplane. She knew she was absolutely spent. And she was self-aware enough to know that she had nothing left for him. Were he to crash the plane, he would be devastated, yet she would have barely anything left to give. She said no.

At that moment, she realized clearly that this was not who she wanted to be. When her son told his story of the pandemic, perhaps to his own grandkids a half-century or more down the road, she wanted his memory to be one where his mother was always there for him. And with this, clarity came to her.

In the end, the decision to step away from medicine turned out to be not that difficult. Instead of dropping one of the balls she'd been juggling for so long, she took control during these tumultuous times by setting down one of these balls on her own terms. While she sees herself returning to clinical medicine in the future, she did what was best for her and her family right now.

As the pandemic wears on and our ways of life keep changing in unpredictable ways, I know we are all facing similar dilemmas. Most of us will stay in our positions and hold on to our clinical responsibilities. But some may not. These stories are important, because I am certain they are playing out around the world, regardless of location, practice setting or specialty. For those in similar positions, know you are not alone. For those in a position to intervene, I have only one request: Listen.

Don S. Dizon, MD, is an oncologist who specializes in women's cancers. He is the director of women's cancers at Lifespan Cancer Institute and director of medical oncology at Rhode Island Hospital.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....