It took me many drives to work to realize what bothered me about this billboard. At first, I thought it was because I could not for the life of me figure out what object was in the background, next to the stark words the bank was blaring out with their advertising dollars. At first glance the image looked like an upside-down weed-wacker, that long handled electronic tool designed to cut hard-to-get weeds and grass in places unattainable by a lawn mower. The second time I passed the billboard, allowing myself only a second or third glimpse to keep my eye on the road and not end up a patient at the hospital where I worked, I thought it was one of those Mt Everest climbing ice axes, though strangely with a long red ribbon on it.
What was not difficult to discern was the billboard’s main message, shouting out in large black letters, DO WHAT YOU LOVE AND THE MONEY WILL FOLLOW. This is what really irked me about the advertisement, not the mysterious image I couldn’t decipher, but the implications of the message. I thought of all the people in my life that struggle to survive and put food on their table. A family member that works as a special education teacher, loving her kids with autism and behavioral disturbances, yet unable to make enough money to pay her student loans or fix her car when it breaks down. Another family member who loves to decorate both inside and outside of homes to make them gorgeous and inviting, yet who still works for minimum wage at the age of 78 to pay her bills. And another friend who loves to write and paint, is a skilled poet and a burgeoning visual artist, yet must work on an assembly line during the day or a pizza joint at night to support his love of art and desire to share it with the world.
That billboard’s proclamation is a first world privileged viewpoint, not surprising as it was a bank advertisement, but it did get me thinking about my own life. About what I love and how it supports me, not just financially, but spiritually, the currency that is so much more important than the green paper that seems to run the world and the practice of medicine.
Like the many drives to discover the enigma of the billboard’s image, it has taken me some time to realize how I can be happy at work. Happy at a place that is full of so many things outside my control, yet that significantly affect my workday. I started by imagining my life if I was not a doctor. Say, if I was a full-time writer, sitting at home at my desk writing, taking breaks to play with the cats, walk in the wetland, photograph the birds tending their babies, before returning to my desk for more writing. Or say if I was a full-time chef or caterer, pouring my love into creating nourishing meals for family celebrations. What would that be like? And would the money follow?
Two things about those other possible sister lives, one as a writer, the other as a chef, would be challenging. I would feel lonely without significant physical connection with other humans, a need that even four cats, phone calls with physically distant friends and a lovely husband cannot fill. But the hardest part truly would be missing patient care. I really love my patients, even the ones that challenge me to figure out a complex medical problem or navigate a sticky psychosocial web with their families.
So that’s what I love. Patient care. When I made the decision so many years ago to switch careers from massage therapy to medicine, the driving force was how much I liked taking care of the patients on my massage table. It wasn’t for the intellectual challenge, the prestige of having the title of doctor, or the desire to make more money, that caused me to start medical school at the age of thirty-five. It was and always will be the patient.
So, how could I increase the amount of time I spend with my patients, from within a healthcare system that functions as a business? How could I get more patient time without taking on a higher patient load and leading myself back to burnout and depression, a dark place I never ever want to visit again?
I am so fortunate to be working as an inpatient rehabilitation physician. I do not work in a clinic where I have patients waiting in their little rooms for me and my limited 10 or 15 minutes of focused attention. I work in a rehabilitation hospital and can see my patients any time of the day, in one of many locations: their room, any of the multiple gyms we have, outside if the weather is cooperating that day, in the hallway on their way to and from their therapy sessions, or even in the cafeteria as they are just starting or finishing their meals. Obviously if there is something acutely medical going on, I will see them in their room to give them privacy, but often they are stable, and I can evaluate them in the gym. I so enjoy watching them do their therapies, seeing their functional improvements as well as their setbacks. Not only that, but I am also more available to staff as well as families, now that COVID restrictions have lifted, to answer questions and update to their loved ones in real time, rather than with a phone call back in my windowless corner office.
I used to round or see all my patients as efficiently as possible to get back to my office and finish my documentation quickly, a goal to avoid spending all afternoon and evening doing the most dreadful part of medical care these days. After the billboard’s message had been swirling around in my consciousness for a bit, two weeks ago, I decided I would try something different at work. I would take a computer on wheels with me while I rounded, seeing patients wherever I could find them, and after I completed that, park myself in the main gym to do my documentation. I have been completing my notes and placing orders at the same time I am out in the main gym, available, surrounding by co-workers, and most importantly, patients.
I have found a way to do what I love the most, patient care, and a way to make it a greater part of my day. This has brought me so much more satisfaction and joy with my work. Yesterday as I drove into work, singing and thumping my fingers on the steering wheel to the rhythm of the dance music blaring from the speakers, I focused a little harder on the billboard’s image once again. I finally figured out what the elusive shape was: a red strapped high heeled sandal atop a stack of white boxes, the top box’s lid askew with a red ribbon dangling over the side, implying doing what you love would bring you money and the ability to buy or consume your heart’s desire. For me, the love of patient care will be enough.