On Being a Physician: A day in the life

Over the years we have received numerous requests from high school and university students, who are in the midst of choosing a career, asking what it is like to be a physician. Here is Dr. Greene’s reply

It was a bad hair day.

Two hours earlier, I had been dreaming happily of flying over the beach at Cabo San Lucas — without an airplane — when the harsh ring of the phone burst the scene into quickly forgotten fragments. It was a call from the hospital; they needed me for an emergency Cesarean Section. After a blizzard of activity, the emergency was over, and a picture-perfect little girl had been born. Still awash with the glow of the miracle of birth, I glanced at my watch. The emergency had come at that awkward time when I would normally be home showering. Instead, I shaved in the on-call room (no time for a shower), rushed through the cafeteria line, and ate breakfast while walking to my office. I am a pediatrician.

I arrived late, harried, and wearing part of my breakfast. I know that it’s a very minor inconvenience, but the feeling of wearing a stained shirt or having unkempt hair embarrasses me. I was not looking forward to the rest of the morning.

The waiting room was jammed. The first few patients I saw were delightful children I already knew, who had come in with minor complaints. I sped through the morning, pausing to smile at each child, but hurrying to get back on schedule.

The next chart in my in-box had an unfamiliar name on the cover. I stepped into the exam room and saw a nine-year-old boy. Large clefts marred the middle of his face. Although a scar suggested that his cleft lip had been repaired, he was still left without nose or eyes. He did wear glass eyes in an attempt to make his visage more presentable.

“You must be Stephen,” I smiled, “I’m Dr. Greene.” I reached forward, took his hand in mine, and shook it warmly. The hand at the end of his shortened arm was missing three fingers.

I recognized Stephen’s condition as the Amniotic Bands Sequence, which affects only about one in 25,000 otherwise normal children. When Stephen was still waiting to be born, his forming face fused to the membrane lining of the amniotic sac. Normal development arrested, resulting in the large clefts in his mid-face. Part of the amniotic membrane ruptured, and the sac that was supposed to protect him, instead entangled his developing limbs in shriveled, fibrous, amniotic strands. Decreased circulation to the limbs caused multiple deformities and amputations. Normal intellect and normal emotions were framed in a twisted, blind body.

“I’m glad this sweet boy will never see his own face,” I thought. Thumbing through his chart, I looked up to ask a question, and saw tears making their way down the crevices of Stephen’s face. Mild surprise that his tear ducts functioned gave way to genuine concern over what had made him cry. I placed my hand gently on his shoulder and asked what had provoked his tears.

“I’m just happy, Dr. Greene… you smiled at me!”

This boy with no eyes had felt my smile, just as he had felt the averted gaze of many passers-by. And the smile had touched him deeply.

How striking that a gift as simple as a smile could be so powerful. When we see someone afflicted, whether emotionally or physically, it is easy to turn away. What an important act of humanity to look in the eyes (even if there are none), and see a person, not just a problem.

But it’s not just the disabled who need reassurance. In our mobile society, our moorings both to place and to people have been loosened. We are adrift in a rolling sea of humanity. By looking with fresh warmth and compassion at the people who surround us each day, we create new connections. By seeing beyond surface appearances to the unique miracle of each individual, we are all buoyed.

As I stood in the exam room with Stephen, the two of us beaming at each other, we both felt beautiful, bad hair day and all.

P.S. Stephen went on to have plastic surgery on his face, despite others’ objections that he did not need it, since he was blind. He is an absolutely delightful young man, and I am honored to count him as a friend.

Last medical review on: March 31, 2011
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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