Cultures of medicine

http://www.theatlantic.com/health/archive/2015/10/the-misery-of-a-doctors-first-days/408004/

I saw this article, "The Misery of a Doctor's First Days," and immediately thought of Byron Good's article that we read at the beginning of the semester. This article describes some very difficult experiences that many new doctors go through, including lack of sleep and breaks. One particularly memorable quote from a doctor about her experience as a resident: "After a few near-sleepless nights, 'I was almost delirious,' she says. She recalls standing in the hallway of the hospital and overhearing a page indicating that someone was coding. If the patient died, she could go home and get some rest. If the patient lived, she’d have to stay on. '[I] prayed that they would die so that I wouldn’t have to stay up for two more hours,' says Gaufberg, now a faculty member in the Cambridge Health Alliance Internal Medicine Residency Program."

From an outside perspective, it's hard to comprehend how or why people would choose to endure such pain and discomfort for their profession. After reading Good's article and thinking about the socialization process in different fields, it's more understandable that people put themselves through this process. The article hints at this as well—"feeling frazzled and helpless just comes with the first year territory, they said. It’s a rite of passage. In his memoir Intern, the New York cardiologist Sandeep Jauhar describes residency as 'brutal, like a kind of hazing.'" This also partially explains why attempts at reform are sometimes met with resistance. Individuals who have already full fledged members of this exclusive community don't want the group identity to change to accommodate for people who don't really belong there—"moreover, some older physicians feel that contemporary medical education lacks the rigor that they soldiered through. “I think the pendulum has swung too far in one direction, toward making the experience too soft,” the Manhattan internist Robert Press told The New York Times in 2009." Good's work would be very helpful if policy makers are serious about enacting long-term change because it's important to understand that these practices are rooted in the traditions and culture of the field.