Wednesday, July 20, 2005

"Why I became a physician"

And not just any type of physician. Here's Red State Moron:
I was four or five when my brother died in-utero. I remember that my mom was pregnant. I remember she went to the hospital, and then came home, but without a baby. And I remember that she and my dad were really, really sad. Traumatized. And they couldn't have any more children.

I told these stories to my friend the psychotherapist the other night; my daughter's only child lament, my parent's trauma. His eyes lit up in some sort of psycho-therapeutic orgasm, and I knew, immediately, what was coming next. Why I chose medicine; why I chose obstetrics, especially high risk obstetrics. Almost seems too obvious, doesn't it? Only child pursues career in which he deals daily with the trauma of high risk pregnancies, and the trauma experienced by the patients and their families.
Now, why the hell would I do that?
We can't discuss our patients easily in these blogs (unless we're constantly saying, "My colleague from another city told me about this case," before proceeding.) But we are certainly talking about ourselves. This is self-disclosure that many would hide from psychiatrists. (Many would hide it from their blogs!) And whatever we think of Freud, his ideas can still resonate.

Doctors are sometimes thought to have "repetition compulsion," when they've had a childhood trauma that involves illness. The anxiety of that trauma didn't simply go away. The theory goes that, as doctors, they're still - unconsciously - trying to fix that original trauma, and relieve that anxiety. Does it work? Not always. Google yielded some articles on this, and a joke:
Final Exam, Item 12.
Define Sigmund Freud's theory of repetition compulsion.
Wrong. Try again.
My colleague from another city told me about a blogging psychiatrist whose parents had a very, very sick baby when she was young. Mom was frantic, dad was screaming, and everyone was terrified, including the future blogging psychiatrist. It was the most frightening thing she had ever seen. Ultimately she went to med school, and actually did a few years of internal medicine...learning about medical emergencies and treatment. And then she switched to psychiatry, and learned about treating anxiety, and coping with trauma.

Sounds like repetition compulsion?
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