changes

What's so fascinating about medical training is that in some sense, we have completely stepped outside the normal cultural and societal norms. The body, as one of my friends puts it, no longer has taboos. We learn to ask people - complete strangers! - intimate details of their personal history; touch and examine them in ways and places no one else might; and participate in the most emotionally charged moments of their lives: birth, sickness, disability, and death.

No longer is sexuality, digestion, or defecation off-limits conversationally, but a normal part of the work-day. We learn about rare and peculiar diseases in class and find ourselves fascinated by information they reveal about our genetic and biochemical makeup, rather than saddened by the terrible nature of the disease and the personal impact it has on the family.

We will cut apart the bodies of the dead in order to better help the living; examine dispassionately and non-judgmentally the afflictions of age, lifestyle, and upbringing; encounter death and disability on a daily basis, and sometimes be completely helpless to change them; and yet through it all maintain some semblance of normality.

I am still grieving in a way the loss of sensitivity that accompanies these changes. The walls are going up, however tremulously, that the patient is "other" than me. As time passes, I think those walls could become barricades.

We could be swallowed up by pain if we didn't, but I fear that I will lose the ability to be affected by the smaller things, but the ones so important to friends and family.

Everything has a price, and for me the price of medical school is to learn how to contain my empathy. Whether that can be done in a healthy way or not - that remains to be seen.