Life is full of hierarchies, whether you are the oldest brother in the family, the supervisor of a company, a chief of medical residents. There is always a hierarchy. It is a hierarchical order that keeps our society organized. You know where to look for guidance. Who is the person above your title who can help you with a challenge you are facing?
Even within surgical specialties, there is a hierarchy. Doctors or patients may think that a neurosurgeon is more valuable than a pediatrician, which may reflect why society does not value the reimbursement they do.
A neurosurgeon can easily earn ten times more than a pediatrician. But why would that difference in value be placed?
Is the pediatrician, who is astute, the guardian who keeps his children safe and realizes that something is wrong with his son and works him to diagnose an aggressive cancer, not have the same weight as someone who operates on his brain tumor?
It’s what the pediatrician did for your child or whatever “value” less than what a neurosurgeon did for a brain tumor. If you are the father of the child, you would not agree. You would donate your kidney in appreciation for a doctor who was able to care, listen, diagnose, and take action to do what it takes to save your child.
Interestingly, even within a surgical specialty, the same principles apply. If you are a urologist, which in itself is a very competitive specialty, it is as if “only” being a general urologist carries a stigma of inferiority by default.
You may not be able to “hang” so you can do grueling 8-hour cystectomies (bladder removal and reconstruction). Or maybe you just don’t have the technical knowledge to perform a two-hour prostatectomy. There is always an unspoken value that is lower for those who are general urologists. As if what we do is the defect of not being “good enough” and not a conscious decision.
I will say that although others may have thought this or said it out loud, I have never had this thought as a general urologist. Being a general urologist and truly outpatient surgical is not a default or unconscious choice.
I consciously decided that I wanted to do surgeries that were less lengthy and easier to recover later. Not because I don’t have the stamina or skill to do it, but because it doesn’t serve my goals in life, I’ve chosen it for myself. My ego is not driving what I need to do to prove myself to others. My worth and merit are within me and are not due to an external achievement.
What’s important to me is taking care of my patients 110 percent, but then going home and doing the things that serve me: rushing, driving 58 minutes, and changing clothes in a parked car to get to yoga class during the residence. my sanity. Or rushing home at 5:02 pm with all my notes done, ready to go to see my kids. After all, he had spent the whole day working and the time from when they got home at 5:10 pm until they went to bed was short.
I want to be present for my life, my health, my husband and my children.
For me, start my clinic at 8:30 a.m. Instead of 9 a.m. M., What will not allow me to take my daughter to school is worthless for the extra money it will bring to see two more patients.
The value for me is spending time with my daughter, helping her when she’s nervous by leaving her, giving her a big hug, and putting her together with her friends from school as they read her morning story. Yes, it is a 13 minute drive to school, but those 13 minutes are priceless.
Now when I share stories like these, others always start to feel uncomfortable and react angrily to tell me that they love their children, that they like spending time with them, etc. My opinions and the choices I make do not reflect anything that you are doing. or not to do. Or maybe it is? Perhaps unconsciously, it makes you angry or uncomfortable because there could be some truth to the priorities you’ve been placing and when you see that it is someone else, anger flares up.
Now, I never said that others should do what I do. I never said that 8-hour surgeries were absolutely not worthwhile, but I did say what works for me and what I find value in. However, there is still this awkwardness from others when I say it.
If something I wrote or my priorities makes you uncomfortable, then I ask you to think about why.
Why did you feel anger right away?
Why did you feel resistance inside your body?
Did your muscles tense, did you clench your jaw a little when you read it?
Maybe it wasn’t, and that’s okay too. Actually, both reactions are fine. I don’t want you to change them, I just want you to explore why, and you might find some amazing answers during your introspection.
So challenge your reactions, your emerging emotions.
Challenge the hierarchy and the unconscious choices we make on a daily basis.
Challenge the value you are putting on things in life.
It can transform you.
Diana Londoño She is a urologist and can be contacted on the site that bears her name, Dr. Diana Londoño, On twitter @DianaLondonoMDand about her Blog. She is one of the 10 percent of American urologists who are female and the 0.5 percent who are Latina and female.
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