On the meaning of purpose

I’ve been spending a lot of time in Africa thinking about what to do with my life. Lately, I’ve been reading some of the blog writings of a Buddhist physician (happinessinthisworld.com), which has been giving me a lot of interesting food for thought. In one of his posts, he discusses the importance of finding a mission in life, and how we might not even realize what sort of core mission we have, but there is something intrinsic that guides our movements whether we have actively selected it, or whether it is unconscious. I thought about these words all day, and during my run, I tried out his mind exercise for finding your mission. Strip away all of your explicit statements about your purpose in life, one by one. Determine your emotional reaction as you lose them.

In my last big effort to determine what I wanted to do with myself, I had come up with my personal philosophy: I want to help others achieve their goals, whatever those are. I believe (and I still do), that you are not able to pursue your personal goals if you are impeded by health. Cure the disease, and you free the body to follow the mind. These statements give me theoretical and philosophical motivation for my life. But do they give me that day to day purpose that he was speaking of? Not really. It’s hard to get up every morning motivated by a goal that is achievable only through years of work. So, what does get me out of bed? What will be enough of a push to believe in my work every day, when I’m tired, when I feel like crap, when my (hypothetical) family needs me? As I jogged along (don’t judge me, but listening to Shakira’s Waka Waka, which has been stuck in my head), I was forced to admit that what gets me going are two things. The first is an interest in other people. Understanding them, hearing their stories, becoming a part of their lives. After all, I was an anthropology-cum-psychology major years before medicine. Not in a voyeuristic sense, nor dispassionate observation, but directly related to a feeling of empathy. The “why” of a life is of great importance. Secondly, I believe in completing things (and doing so well). I find great satisfaction in this process. I feel this in medicine when I see patient through a visit through a hospital, when I write a paper, or when I finish a painting. It’s all the same sense of, “I played a role in that, and I made it better than it was before.” Self-centered? Maybe. But it works for me.

What do I take away from this? Well, I’m deciding on residency in a few months. I know that if the above are true, I need to hear your story, and I need to take an active role in your care. So, that rules out most of the surgical subspecialties, ER, pathology, radiology (stories being hard to come by in those departments), as well as referral-based care (e.g. family medicine or general primary care), neurology, and psychiatry (as seeing an illness completed and being active in care throughout is not as likely).  I have a feeling that either a medical or pediatric (or med-peds) subspecialty is coming my way. Anyone know of a job opening for a med-peds endocrinologist who does global health?