When did you know you wanted to be a doctor? the pre-med asked. Maybe it should have been an easy question to answer, but it wasn’t. I have friends who have known as long as they could remember that they wanted to be a physician. For them this field has been a calling, and they set their sights on medical school from a young age. Others made the decision in high school biology or during college when they declared themselves “pre-med.” I have always envied those who just “knew” this is what they were meant to do. I believe they are a minority, but a vocal one, that can make those of us who question uncomfortable.
Throughout high school and college, I listened desperately for any inkling of a “calling” and heard nothing but silence. I liked lots of subjects, and was fairly good at most – although calculus induced migraines, so becoming a mathematician dropped quickly by the wayside. I still have a list of careers that I brainstormed around that time and it lists everything from meteorologist to chef to professor. I ended up a Spanish major more by default than out of any real planning – I liked Spanish in high school and continued taking courses in college, gathering enough credits to graduate. To round things out, I completed minors in Latin and English. Very practical degrees.
Diploma in hand but not a clue about what to do with the rest of my life I did what many do at that point – I found a series of jobs; at a horse farm, in retail, as a nutrition educator. It was a period of non sequitors as I searched for something that would satisfy me and pay the bills. Hired for the holidays, I stood at the cash register ringing up a purchases on Black Friday at Macy’s, and had the sudden chilling realization that some people spend an entire career doing this. That might work for them, but not for me. I completed the holiday season and then quietly quit.
Looking for a calling, I seriously considered veterinary medicine and began taking pre-reqs. However, over 100 hours volunteering at a local veterinary clinic, I found myself standing outside in a northeaster, covered in mud and cow manure, and decided maybe not. . . This now puts me in my mid-20s, still uncertain. When did I know I wanted to be a physician? Not then. Then all I knew was I probably didn’t want to be a vet. Crossing that off the list, I began to look elsewhere. I started shadowing a team of cardiothoracic surgeons, following them on morning rounds and observing a handful of surgeries. This work seemed interesting. The surgeons were kind, patiently taking the time to explain to me what was going on – even if I still didn’t understand much of it. So I continued the pre-reqs, thankfully the same for human medicine as they are for veterinary medicine. But, wading through organic chemistry texts, I was no closer to answering the question as to whether this would be the right career choice for me.
Frankly, I didn’t know what being a doctor meant. Yes, I was shadowing, trying to get a sense for what the career entailed. However, even in the best of circumstances, shadowing is like deciding to be a pilot after flying economy class on a few intercontinental flights. Maybe it sounds like a good idea. Wouldn’t it be great to be a pilot? you think. Maybe you like the view out the window, watching as you rise above the clouds. But do you really have any idea what it takes to be a pilot? What it feels like to be responsible for landing the plane and returning all those passengers safely to the ground? Do you have enough information to decide this is what I want to do with the rest of my life? You have no idea. I had no idea. A few mornings a week, a few surgeries, I was only guessing.
Of course, on my application I waxed eloquent about why I wanted to enter medicine and kept up the front during interviews. But did I really know? Absolutely not. This fear lingered with me as I slogged through the first two years of medical school. Is this worth it? I kept asking myself as I put one foot in front of the other. I considered quitting. More than once. I even made pro/con lists – you know it’s getting serious when you’re adding up reasons on each side of the page, trying to decide how to weight each fact and feeling. I reconsidered veterinary medicine. Maybe that northeaster wasn’t as cold as I remembered it. And baby animals are adorable.
Then I hit third year, when many of my friends who had also felt less than enthusiastic about the first two appeared to hit their stride. “This is great!” they would gush. When asked how things were going after completing overnight call on ob/gyn, they would reply, “Living the dream” without any irony. Discussing specialties, they would enthuse, “It’s so hard to choose. I like everything!” Were they joking? Were they attending the same medical school I was? Because I was still fairly miserable. And uncertain. This was a long of time, a great deal of schooling and a lot of resources to invest to remain unsure whether I even wanted to reach the final destination. As a medical student, you are much closer to the cockpit than as a shadowing pre-med, but still have your hands far away from the controls. I’m not sure what the airline metaphoric equivalent would be. An airline stewardess? Maybe, but even they have an actual critical role in the event of emergency. In medical school, your key role in an emergency is more often than not to get out of the way.
It wasn’t until internship, of all places, where I finally decided I made the right decision, where my uncertainty began to melt away. The days are long and exhausting and sometimes the patients are difficult at best. Lots of my time is spent placing orders, answering pages, and writing mundane chart updates (OK, let’s be realistic, almost all my time). But then there are those meaningful patient interactions where you help quell someone’s anxieties or interesting cases that leaves the whole team briefly scratching their heads until a diagnosis is found (or not), and it is a good feeling. I still get a bit of high just from introducing myself as Dr. Riddle. I find that despite the length of the days, when I hand off my patients to the overnight intern, I am satisfied with the work I have done. So when did I know I wanted to be a doctor? About five months ago.
Megan Riddle, MS MD Ph.D., is board certified in both adult psychiatry and consult liaison psychiatry. She attended Western Washington University and received a Bachelor of Arts in Spanish with minors in Latin and English before deciding she wanted to pursue a career in medicine and research. She received a Master’s in Biology at Western Washington University with an emphasis in genetics and then went to Weill Cornell Medical College where she earned a medical degree as well as a PhD in neuroscience. She completed her residency training in psychiatry at the University of Washington, where she was chief resident, before completing a fellowship in consult liaison psychiatry, also at the University of Washington. She is currently a Courtesy Clinical Instructor with the University of Washington Department of Psychiatry and Behavioral Sciences and enjoys teaching and supervising residents.