22 November 2007


Thanksgiving actually starts the major holiday season around most undergraduate, medical schools and residency programs. As an undergraduate, you realize that the fall semester is heading for a close as there is very little time left before semester finals. As a medical student, Thanksgiving means a welcome respite from the intensity of coursework and as a resident, you know that you are going to get at least one day off from working the wards.

In residency, you quickly learn that either you are working the actual holiday or you are off. Everyone can't be off and your administrative chief makes sure that holiday time is equally distributed among the staff. Sure, you want to be there to sit down with your family but it just isn't possible for everyone to have every holiday off as people get sick on every day and at any time during those days. Sometimes you will not be able to go home for a holiday visit to be with your family.

I never particularly minded working on a holiday as long as I had one day to sleep in late. My idea of the perfect holiday is sleeping until 7am; getting up and drinking my coffee in front of the telly as I watch CNN. I know this sounds boring but residency taught me to appreciate the days where I can just do nothing (or a few things and at a very slow pace). I now appreciate going to places like Cancun or Key West where I can lie on the beach and appreciate the sunrise or the sunset. Before residency, my idea of a vacation was to head down to Belize and spend a week diving with friends or spending a week playing tennis. Now, just lying around or clubbing in a new city are my ideas of great ways to spend time off.

My other favorite vacation activity is to catch up on my reading or get ahead in terms of reading. As a physician, I make sure that I read at least 30 minutes each day and one hour on the weekends. I always have a journal with me to read as I am waiting or on those call nights when I just can't fall asleep. I have a monthly check list of journals that I definitely read such as Nature Medicine and New England Journal of Medicine (in addition to my specialty journals). Like exercise, if you make journal reading a habit, it become part of your life. I make notes on articles that I will use in my teaching or articles that I want to incorporate into my practice.

As a medical student, I made sure that I read every review article in New England Journal of Medicine and every case report. My faculty advisor encouraged this practice on our first meeting as we became acquainted during orientation week. It became as much a part of my life as brushing my teeth each morning. I also found that I acquired the "language" of medicine more quickly as I kept up with my reading. No matter how much studying I was doing, my journal reading was a welcome change of pace from the daily grind of mastery of coursework.

As an undergraduate and graduate student, I read journals regularly. This was a means to become a participant in departmental meetings and discussions. As an undergraduate, we had regular journal discussions in our laboratory research meeting. As a graduate student, I was expected to lead those journal club discussions. In short, as a pre-med student, you need to make sure that you learn to read and critique scientific literature. If you anticipate a career in medicine, you have to be able to evaluate journal articles and keep up with the literature of your practice. This is not something that you learn to do overnight but a skill that is developed with practice.

Once you become a medical student, gone are the days that you can just sit passively and regurgitate information given in course lectures. You will be expected to question information and make sure that information that you give out to patients will be accurate and up to date. Most of the information that finds it way into textbooks is already dated by the time the textbook is published. Those of us who write book chapters scan scientific literature regularly and include updates but there is a time-lag between the completion of a book chapter and the publishing of a text. It is up to you, to make sure that you are caught in that time-lag as a practicing physician.

Holidays spent in the hospital are usually break-neck busy (the time passes rapidly) or very slow. If I was having a slow day, I took the time to read, rest and socialize with the staff that was working. This is just my way of spreading some "good will" around the place. In short, someone has to work and I generally didn't mind working a holiday. My family wasn't going to vaporize if I missed Thanksgiving or Christmas dinner and I saved the calories so that I could splurge on New Year's Day. This was always my personal preference and my colleagues continue to appreciate this.

Part of being a member of a health care team is realizing that the world does not center around you. There will be times that you will miss family gatherings to take care of your patients. If this is something that you can't do without getting a bad attitude, then medicine is not for you. There will be times when you "draw the short straw" and have to work on an important holiday. Sure, it's not your preference but grumbling all day and whining all day will not help your attitude or your situation. Make the best of it and get your work done. For me, I never forget that it is a privilege to take care of people who need my help. I can certainly acknowledge that the situation is not my preference but that's the end for me. I set about the task of going merrily about my job and spreading some good will. After all, I chose this profession and I knew going in, that there would be holidays that I would be in the hospital the entire day. It is part of the life that I happily chose and I alway remind myself on Thanksgiving to be thankful that I have been allowed to practice medicine every day not just on non-holidays.