Who are doctors?

The mythology around the medical profession is as powerful as it is pervasive. For many of us, images of our favorite TV doctors, who are variously lionized and humanized probably have more impact on our image of who doctors are than any reality based encounters. Doctors are as impressed with the mythology as non-physicians, in part because they helped to create it. Doctor as hero, doctor as genius, doctor as savior, doctor as god with feet of clay. The old joke goes, "What's the difference between a doctor and god?" The doctor knows he's a divine being.

The sober reality is that physicians are people like everyone else and vulnerable to the same flaws and weaknesses. One of the most pervasive and legendary characteristics of physician training is its competitiveness. Competitiveness cuts both ways: it may show how tough you are but it also shows how much you care about yourself at the expense of others. Competition begins with the pre-med courses, where getting an A or a B+ may mean the difference between getting into med school and not. Many people are unable to matriculate, and apply and re-apply. Once you are in, the competition begins in earnest. Volumes of memorization enough to blind you and bludgeon your brain into insensibility. Yet emerging from that even stronger! Then the competition continues with equal intensity for the best residency programs, at the best universities, the most prestigious faculty. Years of sleep-deprivation ensue, while managing multitudes of patients simultaneously in your sleep deprived state. Still, they are able to conjure up arcana from the vast stores of knowledge accumulated over years of immersion in medical learning. Then comes the next competition: the most lucrative jobs, the most prestigious university affiliations or medical centers, or multi-specialty groups. Who has the best cases? Who can stump his colleagues? Who can make the most subtle diagnosis? Who's on top?

The downside of this competition, for all of its impressiveness is that it tends to yield (what else) competitive doctors. Competitive doctors are interested in their own advancement above and beyond their other more humanitarian concerns. This problem affected me deeply during my medical training. Because while there certainly were caring people even among the fiercely competitive, and while some good could emerge even out of self-interested doctoring, there was a certain falseness to the myth that was being fostered in the process. The benevolent aspects of doctoring were always being discussed, but the jousting, the self-interestedness, and the competitiveness never were.

When I tell my medical colleagues that I have become a homeopath, it does not surprise me that many of them are uncomfortable. It took me some time to understand this, but I believe that the discomfort arises out of the competitive culture of medicine. The notion that you might have an edge, even by knowing something that other doctors know nothing about, because it wasn't part of their training strikes a blow into the soul of every doctor with an ounce of competition. This may explain the stunned and awkward silence of my fellow doctors on finding out that I have something I know that I feel confers an advantage to me over what they do. It probably explains the hostile reception homeopathy has had over two centuries from mainstream medicine. In the world of medicine, I regret to say, defeating the competition sometimes seems more important than being a good doctor.