hidden curriculum

I realize now that what I am being taught in clinic is to be a good body mechanic: diagnose problems, prescribe treatments, send patients on their way as efficiently as possible.  My attending physician is teaching me to be more focused in my history taking, and that really is something that I need to learn. 

The problem is that much of what I'm learning about being efficient in clinic is directly contrary to everything I know about good conversation: interrupt frequently, make assumptions, pre-categorize patients, and keep the conversation focused on what I care about as a physician-in-training, not necessarily what they were concerned about.  In particular, try to avoid engaging with the human complexity of experience, and instead focus on the disease which has discrete action steps.

I know I need to be more efficient, but I came to medical school because I was interested in becoming a healer, not solely a body mechanic.  I'm interested in how people experience disease - possibly even more so than treating the disease itself - and I know that sometimes what is needed is not our engagement with merely the physical problems, but with that very complicated, energy-intensive human-ness.

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I fear that what I'm learning as a physician will seep over into my personal relationships - that in my social relationships I will find myself tuning out the "extraneous information" as I mentally sift for the things I am interested in within a conversation.  Yet I don't think I have the emotional resources to connect deeply with the number of patients we would be required to see each day.  Ho w does one modulate empathy and connection?  But without that husbandry of energy, I will drain myself dry in a few hours, days, or weeks.

Many of my friends who are physicians confess that they just become robots after awhile - too many of the same problems, too many patients, not enough time, not enough energy.  And I want to go home too at the end of the day.

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The expectations are so high for physicians.  I keep reading articles about how we're supposed to be better diagnosticians, better listeners, better this, better that.  We're not omnipotent, you know!  Just people. 

I accept that my training is going to shape me in certain ways.  But I don't know that I like what I'm being taught, even if it is necessary.