Memo from the Editor

May 6, 2005

Who am I? Why am I here?

We've all asked those metaphysical questions at one time or another. Usually with a hint of despair or exasperation in the midst of a stressful day. I've urged you before to write down the reasons you went into medicine on a slip of paper and keep them near-tucked in your pocket, maybe-to be pulled out when things get bad and you can't remember what defines you or what made you choose medicine.

Well, about six months ago, we received a manuscript from Susan Melton, a young, third-year family medicine resident. Just 28 months a doctor, she acknowledges a need to remind herself sometimes why she wanted to be a doctor. Like when she has to admit an alcoholic, "saturated with the stench of alcohol, sweat, and urine." Or when she's asked to fill out, again, an appointment request for a mammogram or a colonoscopy because the patient didn't show up for the first one.

Dr. Melton does reach into her pocket for those reminders, and they're valid for all primary care physicians. Here's what she finds:

"I consider all that I love about medicine, and know that a career in family practice is the only one that will offer me these things on a daily basis. So it is that I am here, with health maintenance and continuity of care my phrases of passion.

"I smile at the thought of encouraging exercise, healthy eating, and smoking cessation and discouraging binge drinking, unsafe sex, and teen pregnancy. I smile at the challenge of a difficult diagnosis and at the experience of caring for a grandmother who shows the same pictures of her grandchildren at each visit. I smile at my desire to make alcoholism, depression, and sexual abuse less stigmatized and more treated.

"Whether a physician for 28 months or 28 years, I'm sure we have all asked ourselves why we do what we do. My answer makes my muscles relax and gives me the strength to contract them again. I am able to ask about smoking and encourage cessation, again. I am able to ask about alcohol and other drugs and offer treatment, again. I am able to fill out the referral slip for the mammogram or colonoscopy, again."

I join my own wishes for you-whether you've been in practice 28 years, or 38, or 48-with these of Dr. Melton: "May each of you revisit your own motivation for your service in healthcare. Renew your joy and gain strength to treat your patients as you would colleagues and family, because life and its circumstances unite those as one and the same."