I didn’t get the job I wanted…

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I didn’t get the job I wanted.

And it rocks.

When I was three years old, I told my family I wanted to be a doctor. My grandparents gave me one of those plastic doctor’s kits – the kind with the flimsy plastic stethoscope in a little white bag with a red cross on it. I’ve told people I wanted to be doctor for as long as I can remember. Aside from brief flirtations with the idea of a killer music career and dabbling in astrophysics (!) it would seem as though it’s been a straight line for me.

But, as any medical student or resident can tell you, it’s not quite that simple. What is classified as “a doctor” varies tremendously. I used to think it meant the doctor I saw for my regular childhood checkups, but then I discovered the exciting TV ER dramas and saw a different side to things. My first “specialty” decision was to be “a heart doctor” – and by that I meant a cardiac surgeon I suppose. My rationale for that was simply that while neurosurgery was more complicated there wasn’t much you could actually fix doing that. It was just cutting things out after all 😛

Then I went on a medical student career conference….and loved the idea of pathology. Sorting through disease causes, an intimate understanding of pathophysiology and anatomy…and really yucky cases. Yeah, that sounded cool.

And then I hit medical school, and somewhere along the way I fell in love with viruses. Bacteria were ok, I guess, but I had a real problem remembering all the damn antibiotics and what they did. My categorization for the cephalosporins consisted of “Cephalo-kill-a-lot”, “Cephalo-cost-a-lot” and Ceph-du-jour”. It was pretty pathetic. I also realized that while surgery was indeed incredibly technical and cool…it consisted of a lot of standing up or running around…and I liked to sit down. I also had difficulty putting things back together after I had taken them apart, something which I understand is a prerequisite to being a competent surgeon. So…medicine it was for me.

But then what kind? Kids didn’t like me – I would walk down the street and make them cry. Maybe I had some kind of weird expression on my face – I never figured it out. But old people didn’t get better, at least in the hospital. Each admission added another diagnosis to the list, and the slow downward spiral was a constant reminder of my own mortality. A selfish thought perhaps, but a valid one when it comes to job happiness. I was in a bit of a quandary.

And then what about teaching and research? Well, I did like teaching, so that would be nice. I had some practice at that during my PhD years. But I had been told that “Those who can, do – those who can’t, teach.” I wasn’t sure I wanted to get lumped in with that.

And as for research – well, I really like bench research. Don’t ever call it “basic science”. It’s not “basic” – it’s actually quite complicated 😉 I remember several people telling me that with the mix of PhD and MB I could go into clinical trials. I pooh-poohed the idea, since I didn’t want to work for the evil money-grubbing pharmaceutical companies. I wanted pure science.

I gradually found myself gravitating to an outpatient office-based way of life. General Practice or Psychiatry interested me – treating the patient instead of the disease (but wait, didn’t I like pathology…? How did that happen..?) Maybe I just liked to talk a lot. I dunno. In any case, at some point when I was planning on moving to the US I sent an email to a pediatrician here – a contact of my wife’s family. He replied that he couldn’t help me with psychiatry or family medicine (as it is called in the US) but I could come over for an elective.

I rather cunningly selected Pediatric Infectious Disease as my rotation, since I would get to work with him. It turned out well. At the end of it I was offered a research job with him for a year, while I worked on the USMLE exams. His boss, the division chief, asked me if I wanted to do clinical trials work. Torn between my thoughts about Big Pharma and my future job prospects…I said yes.

Fast forward 7 years. What did the medical student who didn’t get on with kids, hated antibiotics, didn’t want to do clinical trials and who loved bench research end up doing?

Here I am, an Attending in Pediatric Infectious Disease. In charge of, of all things, an antibiotic stewardship program. I have taken part in over a dozen clinical trials for pharmaceutical companies, and not done any real bench research since I left the UK. I have created a new curriculum and won awards for teaching. My first week on service as “the real thing” has been at times stressful, busy, fun frustrating, but at every step of the way IT FEELS RIGHT. This is what I feel I am meant to be doing.

The bottom line is that whatever you think you want to be, you never can tell where life will take you. Keep your options open and give things a try. Even a couple of years ago the idea of heading up a stewardship program wasn’t on my radar. Who knows what the next 5 years will bring…

Oh yeah, and kids smile and wave at me in the street now. I still don’t know why.

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  1. #1 by Arun Mathews, MD on December 3, 2011 - 16:33

    Nicely worded! I think that being open-minded in general speaks of an adaptability to new experiences. This in turn often leads to success, IMHO. Keep up the great writing!

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