The Give-A-Damneter Revisited

The importance of actually caring.

June 23, 2014

I never wanted to be a ‘real’ doctor: an MD who dealt with broken bones, mutated cells, and clogged arteries. I flirted with the idea of microbiology, because my mother said they were the scientists who could find the cure to chickenpox.  I had a horrible case of chickenpox in middle school, which took away the immediate motivator.  Then some scientist developed a vaccine so future generations could avoid the annoying scourge, and my final fragment of medical interest disappeared.

Thus, I think it a supreme irony that I have spent so much time in hospitals the last twelve months. I have mastered - by necessity - the intricate details of physiological, pharmaceutical, and radiological nomenclature.  Now routinely mistaken for a medical professional, a teeny-weeny portion of my not-entirely-subconscious wishes I had formalized my study and reaped its financial rewards.  

Nonetheless, my professional expertise remains in a less-lucrative profession tied to the educational process itself.  I shepherd aspiring medics across oceans and into degrees.

Sometimes I rediscover them looking at me across a loved-one’s hospital bed.  Because I have had the distinct displeasure of confronting medical incompetence as well as the profound relief found under the care of fine physicians,  I have begun to connect the dots between the nascent practitioners who cross my professional path and the fully-fledged, board-certified, MDs I encounter as a patient advocate.

The historian in me thinks she has identified the critical marker between the efficacious and the inept.  Once upon a time, doctors were seen as little better than barbers.  They hawked tonics and removed limbs like so much shampoo and hair.  However, they had to touch, talk, and tend to their customers/patients.  Amputations meant agony for the amputee and a simultaneous tsunami of blood and sound for the surgeon.  Now we herald our doctors as demi-gods, and an attending physician can make decisions -god-like- without ever physically attending the patient.  Only minions see the tears and staunch the blood.

Of course, not all physicians shun their patients’ pain just as not all chaired research professors hide themselves away from struggling students.  The Give-A-Damneter works in the ICU as well as at State U.  I can tell within seconds what sort of doctor has appeared to treat a loved one.  It all happens at the threshold.  Doctors who give a damn enter the room.  They examine the patient and talk to his or her loved ones BEFORE they prescribe a course of action.  Doctors without a damn, stand behind curtains and make pronouncements.  Doctors who give a damn take their residents through the diagnostic process.  They probe bodies and lab results as part of a joint deductive and socratic exercise.  Doctors without a damn review numbers then dispatch their decisions with pompous proclamations - neither patients nor pedagogy needed.

When a student appears in my office and says he or she wishes to be a doctor, I always ask, “What kind?”  Alarm bells ring if they glibly reply, “I don’t have to know my specialty yet.”  That is NOT what I mean.  Those that are likely to spring my Give-A-Damneter into high readings intuit the nature of the query.  They know the populations they wish to serve and the manner in which they wish to serve them.  They need not hear from my colleagues that time working on the front line in clinics is a good idea for admissions purposes.  They WANT to spend time with patients even if their intellectual interests take them into laboratories where they study tiny subsets of cells.  

The parallel experience comes when a student says “I want to be a professor.”  I ask her “what kind” as well, and I don’t mean philosophy versus physics.  When professors were little more servants, even ambitious and illustrious intellects like John Locke paid heed to and their bills by teaching.  Now we think of the chaired professor like the chief physician as among the “one percent” of their respective professions and thus too good to teach or touch the other ninety-nine.  Professors who give a damn, begin as students who aspire and continue throughout their academic ascent to teach.  No one needs to sell them on the value of the exercise.

When I advise, I want to know whose lives my students wish to shape and why.  If someone fails to see beyond the perfunctory functions of her profession, I fear not only for her future but also for those of the people she will inevitably impact.  In short, I want my advisees to give a damn.


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