Clayton Busch, MSIV, University of South Dakota Sanford SOM
Before medical school, I considered finance and research as careers. On my mind was the classic 21-year-old rhetorical question: I get this one life, now what should I do with it? I graduated high school in a class of 38 with the tacit impression that good grades meant becoming an engineer or a doctor. The tide changed in college when even after completing the pre-med coursework and “suggested” extracurriculars, I felt like I had no idea what a career in medicine would feel like. One interest from my coursework was research, where I performed microscopic dissections that caught organogenesis altering its own anatomy in concert with environmental pressures. There was also the opportunity to indulge a naïve interest in finance in a more structured environment through elective coursework. It scratched a curiously similar itch to research. The professor could tell I was engaged, and the former business mogul urged me to consider finance as a field. At graduation, I was still undecided in my commitment to medicine. It entailed too much, and I knew too little. I decided the only way to settle my mind was to find work in a hospital. Initially I was looking for a successful career. After my experiences working in healthcare, I discovered medicine was something more profound.
One short week after graduation, I started my new job as a nurse aid. The unit operated at capacity on a regular basis and was constantly teaching lessons in efficiency. My first day a co-worker looked me up and down and said, “I give him a week.” In the coming months, I was exposed to my first traumas, lost my first patient, and the term “sundowning” became a regular part of my vocabulary. There were moments I became exhausted in ways I did not previously realize were possible. Volunteering, shadowing, and pre-med curriculum could not teach me all I needed to know about medicine. Until you are working in a hospital, feeling the depth of its pressures and rewards, you simply have no idea what you are getting yourself in to.
While gaining novel insights, I still wondered if life in medicine would measure up to a career in finance or research. Both share a unique brand of intellectual satisfaction, but they are rewarded in very different ways. In research, there is a palpable sense of your own responsibilities that nudged out the expanse of human knowledge, while finance knows no ceiling to the monetary potential for those finding themselves ahead of the curve. Medicine’s rewards are different. They can be more complex and often less obvious as demonstrated on one particularly frustrating day where we were short staffed, facing higher acuity, and running at capacity yet again. It was a day where I felt the demands of my job outpacing my personal energy stores. There were days like this before, but this time it was getting the best of my morale. In a fitting twist of irony, this was the day I met one of my most influential patients. She had multiple chronic, degenerating diseases resulting in obvious effects on her quality of life. This woman’s struggles far outweighed my own, yet I was the one feeling sorry for myself. There was every reason in the world for this woman to be angry with her life, but here she was happier than most of the people I know. Over the next several shifts, I watched her strength and outlook on life outmatch my own in increasingly evident fashion. I looked up to her. While taking care of her there was a peculiar ailment, separate from the others that typically plagued her. I watched multiple physicians visit her and felt a mounting frustration in a woman with the patience of Job.
Seeing her stiff with pain, the tone in the room was different. She didn’t want to talk. The act of speaking itself would drain her. Even though I didn’t know the name of her malady at the time, there was no shortage of flashbacks to her hands pressed against her jaw during our medical school lectures on trigeminal neuralgia. I’ll never forget the day the nurse told me to bring her to anesthesia’s interventional pain department. I had never heard of “interventional pain” and my curiosity piqued, but the floor was busy and I couldn’t linger to see her procedure. All I knew was when she came back things were different. This time she had tears of joy. “It doesn’t hurt any more. I feel like I have my life back”—that was when I knew. There was no height in research or finance that could make me feel this way. No amount of money, no scientific epiphany could make me feel the way medicine did.
Medicine takes you places you can’t go on a plane. Over the course of the next year, I performed CPR in a code blue, cared for a woman in her final weeks, and had WWII heroes share vantage points from an iconic period in history with imagery few in my generation are privileged to hear.
Iconic moments in medicine like these are at the height of human experience. Now in medical school I have delivered babies, participated in surgery, and scratched off the meaningful majority of my bucket list.
I remember in our acceptance ceremony for medical school, each of us had a personalized, hand- written note from an alumnus waiting to be found in our pocket after the coating. Mine said this: “Medicine is a wonderful calling. You will be afforded opportunities not many are afforded. You will be invited into people’s most intimate places. Enjoy your time.” He was right. I had found medicine. I had found my home.