Medicine has always been a part of my family.
My father’s father was Suk Ki Hong, a doctor and pioneer in renal and environmental physiology, well-known in the medical community for his ground-breaking research on the effects of breath-holding and high-pressure systems on the diving women – or “Haenyeo” – of Korea. As a major figure in both renal and diving physiology for over 35 years, he authored or co-authored nearly 190 articles for scholarly publications and more than 40 textbooks and other writings. Nothing short of a celebrity in Korea, my grandfather was a humble but notoriously hard-working man; the many awards and titles he earned over his lifetime are too numerous to be listed here. He married my grandmother, Kyung Im Kay, the top student in Ewha University, which was the first and only women’s college in Korea at the time. Her father was Dean of the prestigious Yonsei University in Seoul; he was also the first Korean surgeon to learn surgical techniques in America and bring them back to Korea. The former Head of the MD Anderson Cancer Center is my grand-uncle, Waun-Ki Hong, whose work established a new paradigm in cancer prevention of the head and neck through the use of personalized biomarker-driven targeted therapy. My father has had a long career as an emergency room doctor and he is currently the director of the ER department in a Texas hospital. My sister, an aspiring surgeon, has just begun medical school and is one of the top students in her class.
And then there is me.
In the shadow of these great men and women, I have spent much of my 25 years rebelling against my “destiny” as a doctor. Truthfully, I have never been passionate about medicine. I came to medical school out of love for my family, and I have persevered for 3 years out of duty, but I have long since abandoned any hope that I will find fulfillment as a doctor. After wandering through rotation after rotation of my clinical year and observing every variety of physician, I can’t help but be vaguely reminded of the biblical Book of Ecclesiastes. Disappointed as he systematically seeks out all the riches, pleasures, and glory that the world has to offer, the King of Jerusalem exclaims with exasperation, “Vanity of vanities; all is vanity. What profit hath a man of all his labor which he taketh under the sun? I have seen all the works that are done under the sun; and, behold, all is vanity and vexation of spirit!”
A little over-dramatic, yes, but it has taken me years – and I am still learning – to accept the fact that there is more to life than just making myself happy and getting what I want. It is more than simply seeking pleasure and avoiding suffering. I was raised with the idea that true love is an action and not an emotion, and so I strive every day to find satisfaction in medicine even though I don’t enjoy it. Every day I choose to love my work even when I don’t like it. But don’t feel too sorry for me just yet! It has taken me a while, but I can confidently say that I am satisfied with my lot in life. Medical school has made me tired, but not burned-out or bitter. Indeed, it is a strange and miraculous phenomenon when sacrifice and duty can bring contentment and peace; knowing that you’ve made your family proud is a wonderful thing. I am also fortunate: although it will never be my passion in life, there are many good aspects to medicine. I am grateful that I have been trained in a way that very few people in the world will ever get to be trained, and no one doubts that medical school builds character and discipline. I personally take pride in working faithfully and enthusiastically in every one of my rotations – even the ones I dislike – and being a student that all the residents can rely on. And while I am not the best student by far, I like to think that being disillusioned with medicine enables me to work harder than most in tough times. Lastly, I am grateful that medical school is not nearly as demanding as it was in my father’s time (in which students were essentially on call every 3rd night)! Basically, medicine will never be anything more to me than just a job, but honestly, as far as jobs go, medicine really isn’t so bad.
But there is another, darker side to medicine that I did not anticipate.
Every student has seen it: the head surgeon who screams at her nurses and makes cruel comments toward her residents. The exhausted and passive-aggressive intern who is impossible to please and always writes scathing student evaluations. The overconfident third-year student who offers unsolicited advice to second-years, and whose head swells after a single compliment from his attending. It is the feeling that you are excused from moral responsibilities and from acting like a decent human being because you tell yourself that you are “saving lives.” It is the part of medicine that feeds your ego and makes you feel self-righteous because you believe you are part of something greater than yourself. It is the part that strives to be your spouse, your life, your religion. It is the idea that you are somehow a better person when you put on the white coat. That you are no longer you. That you are a god – no – a doctor.
It is the danger of finding your identity in medicine.
Now, for 3rd year medical students, this is actually a pretty big temptation. Of course, I am not trying to say that every student who enjoys medicine is a raging, egotistical lunatic. Some may even argue that devoting your entire life to medicine is not a bad thing at all – even a goal worthy of attaining. Obviously, this is a perfectly fine goal, and I am not trying to pass judgment on people who think this way. However, the basic idea is that any level of devotion requires sacrifice, whether it be your resources, your time, or your relationships. We have all witnessed the attending who stays late for work and is never able to see his children. We have all been that student who becomes so consumed with studying that he or she no longer makes time to call home. Human beings are finite creatures who are not capable of infinite love; when we give our love to something new, we must take it away from something old. Passion is not benign – to love one thing is to hate another. And so, for those of us who have even a little bit of a life outside of medical school, the greatest danger is not falling away from medicine, but falling in love with it. As the popular song goes, “I hate that I love you.”
In all honesty, my greatest struggle this year has been remembering who I am and why I came to medical school in the first place. It’s funny because as much as I complain about medicine, I can’t help but be attracted to it. Most people don’t realize this, but medicine is a belief-system. I always chuckle to myself a little whenever I hear a doctor make fun of religious people, because medicine is a religion too – almost cult-like, in fact. Its message is extremely seductive because it offers a sort of “earthly salvation” to those of us who are slaves to our dreams, convincing us that we can be happy if we only continue to be faithful and pay our dues. Medicine promises that we can control our futures if we work hard enough and “believe in ourselves” – perfect for us medical students who will do anything to satiate our inner control-freak and maintain the illusion that we are somehow the masters of our own destinies. But perhaps the worst aspect of the Church of Medicine is all the praise: all the people who are constantly patting us on the back just for being part of the medical community. Eventually we start believing the myth that we must be good people because we save lives, forgetting that there are plenty of downright rotten people in the world who save lives too. As physicians-in-training we are especially susceptible to the infamous “god-complex”, but unlike the Roman conquerors of ancient times, we don’t have a servant to constantly whisper in our ear, “Memento mori. Memento mori.” – “Remember, you are only mortal.” There are a few people – only a very few – that I know of who truly don’t care what others think of them. But for people like me who are painfully dependent on others’ approval, medical school can do a lot of damage to the psyche.
My biggest fear is that I’ll wake up one day and realize that medicine has become my surrogate family. As a large part of the Hong legacy, medicine has been trying to win my heart for years. I can’t speak for everyone, but my heart has always belonged to the ones who have loved me from the very beginning: my true family, especially my father and sister. I have had to remind myself every day that I did not get into medicine because I love what medicine can give me, but because I love my family. I made a personal choice long ago that my mind, body, and soul will never belong to anything else, including medical school.
In the Game of Thrones series, the Starks are admired for their intense loyalty and sense of duty. After the honorable Ned Stark is unjustly executed, the rest of the series focuses on the journey of his children as they struggle to find their own identities. They all end up taking separate paths in life, but they never forget that they are Starks. In the end, they remain loyal to their father’s name and his teachings. And, fittingly, the Stark family emblem is a Direwolf – a reference to the unbreakable bonds between members of a wolfpack.
These are themes that resonate deeply with me as a medical student. They are reminders that I don’t have to surrender my identity to medicine, and that I am not a victim of my surroundings. I love my family; medicine will always be a part of my life, but my true allegiance belongs to the ones who have loved me from the start. Thus, I am proud to be a Hong, and I am especially proud to be a part of my father and sister’s legacy. I will forever be grateful to them for being the reason I have been able to survive in medical school – they are truly a breath of fresh air in a seductive, but suffocating, alien world.
It has been a long 3 years, with many more years to come. But like the Starks, I am a Hong and will always be a Hong. Medicine will never change that.