Some Thoughts on Medicine and Altruism
I had a pretty interesting conversation with my husband the other night.
You see, my husband is pretty set on spending most of his waking hours, for the rest of his life, in The Saddest Place on Earth…otherwise known as the children’s cancer ward.
Now, physicians could probably argue all day long about who has the more difficult specialty, or the more physically exhausting specialty, much like New Yorkers debate the details of Manhattan apartment listings. But I feel confident in saying that life as a pediatric hematologist/oncologist is not always going to be sunshine and rainbows, simply because…LITTLE KIDS. TERRIBLE DISEASES. Am I not-so-secretly proud of my husband for this specialty? Well, yes! Bursting with pride. But I also have really serious reservations about it (please, please, husband, don’t get seriously depressed), and these reservations were the focus of our discussion.
My husband, in the past, has argued, in something of a throwaway manner, that pediatric oncology is “happier” than adult oncology because the survival rates in peds are higher. He has also said that he switched from pathology to oncology because he genuinely enjoys patient interaction much more than he thought he would. But last night he confessed that he’s not as motivated by altruism and a need to “save all the children”. He likes problem-solving, nuance, and complexity. His motivations are, essentially, much more cerebral than emotional. (If it helps paint a more complete picture, my husband is an MD/PhD, and he completed his doctoral degree in genetics research. At this point he’s even more of a scientist than a doctor.)
I wasn’t taken aback by this. In fact, I drew a parallel between his words and my own experience. As a high school English teacher, I too must confess that I am drawn to teaching more out of a love for the subject rather than pure altruism. And the moral pedestal that teachers are placed on by the public (well, this doesn’t always happen 
but often) can feel oppressive, as though I’m faking it when somebody compliments me for my contributions to society. Am I making contributions? Well, sure, I hope so. I love my students and love the connections and relationships I’ve built with them. But if we’re being honest, I really just love talking about books. In education, it’s about the kids…but it’s also about the teacher.
So I wonder if my husband will encounter a similar tension between the inherent altruism of the medical profession and his obsession with science. And I have to wonder how The Saddest Place on Earth will augment or ease that tension.
What about you? What are your thoughts on altruism? How motivated is your doctor spouse by it?
Photo from www.savagechickens.com, which is hilarious and always helps in times of sadness.
4 Responses to Some Thoughts on Medicine and Altruism
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I am the proud, happy wife of J., an MD/PhD at the University of Virginia. As of Spring 2013, we are closing in on MS4 after completing a very successful PhD, and I am beginning the slow-burn freakout that anticipates residency interview season, Match Day, a big move, and our first home purchase. I always try not to define my path in life by my husband's unforgivingly rigorous career; I have a Masters in Education and left J behind for three years while I kickstarted my own career. I'm happy to report, though, that we now live together in the same household! I work full time as a curriculum writer and travel writer. Expect posts about the twists and turns my career has had to take to accommodate the medical school mistress, as well as personal finance for medical couples. 
I think it is important to love the complexities of your field itself along with the altruism. I agree with amgray and have heard similar ER stories from Sommy…I think the altruism is innately there and exercised when it should be. However, this is real life and every waking moment isn’t going to be wholly altruistic and that is o-k. Thank goodness in those moments that you know that you love your field and work to do your best and succeed.
Thanks for your comments, guys! Sommy, drug seekers would drive me nuts. They drive my husband crazy too, though he’s so great at not judging and treating addiction as an illness (it’s another reason he likes working with kids–the challenges those children face are unrelated to diet, exercise, and other lifestyle elements). If I may draw yet another parallel between medicine and teaching, it’s somewhat akin to the balance I have to strike when helping a child improve a grade. It’s my job to help them, but personal responsibility needs to be taken too. I just felt compelled to write this article because it seems like a lot of people have pitchforks out for doctors and their high compensation (in the context of “doctors are bankrupting the system”). Often, one of the major justifications for high salaries is the contribution they make to society. And YES, the contribution is hugely significant. But there’s more to it than that.
I don’t think you (or your husband) should feel guilty at all about balancing his selflessness and selfishness (though those terms may be a bit extreme). Many careers are touted as altruistic in nature and lead people to believe that individuals who enter these careers are entirely devoted to the humanitarian effort. While that may not be wholly untrue, I think it’s ridiculous to suspect that there is no interest in personal gain. Being able to balance the two is what keeps us sane!
My husband is in the glorious ER where he deals with a lot of drug addicts with “back pain”. It’s really hard for him to be sympathetic and altruistic with these types of patients since they will make things up for the sake of getting their pain medication of choice. My husband is very strict and doesn’t give in to them. When there is a real emergency, such as a heart attack or stab wound or a drowning, etc, his altruism kicks and he will go out of his way to care for the patient. Something needs to be done with our healthcare system though. Great article that gets us thinking about what really matters. Thanks for sharing!