About a year ago, I had an interesting encounter on my way back home to Texas after visiting my parents. I was casually chatting with an older female acquaintance as I got situated on the plane. She asked me what kind of medicine I practice. This woman is in medicine, not a physician, but knowledgeable about the varying specialties. I told her that I was an internist working as a hospitalist in Texas. “Oh, you’re just a hospitalist, that’s OK.” Ladies and gentlemen, I was given permission to feel validated about being a hospitalist … kind of! I stood there, in the aisle of the plane, much too early in the morning, 35, married with two kids and pregnant with my third. I remember at that moment I was glad I had no quick or witty responses. I feared that since being caught off guard with this statement, a quick response may have come across harsher than intended. I smiled, and despite my fatigue, reflexively started to justify my career choice. My first thought when these kinds of interactions take place is, would this happen to my husband? The answer is no because he does not have these types of encounters with people. We went to medical school together, trained together, and work together. I like to think women are sometimes more personable, and people feel more comfortable sharing their opinions and stories with us. I know this is naïve, but it is what I like to believe mostly to justify the ridiculous commentary I have to endure. As much as I enjoy feeling like I am a special person, I know I am not so unique, and most of the thoughts I have, others do as well. I am likely not the only person that would be bothered by being referred to as “just a hospitalist.” No one enjoys being “just” anything. But I still wonder, why did I feel compelled to justify my career choices? I am not ashamed or embarrassed about my job. I love what I do and the freedom it allows for. I work very hard for 84 hours or so, and then I have a week off to pursue hobbies and spend time with my family. I enjoy hospital medicine, helping take care of people at their sickest. I have an incredible quality of life. Are their what ifs? Yes, of course, but to me, that is a normal part of any decision you make in life. Something about the nature and culture of medicine cultivates this automatic defensiveness. As much as many deny it, there is a hierarchy in medicine, the more specialized the field, the more allure there is to the specialty and, therefore, for some, more respect given to that field. In my personal experience, amongst colleagues, I felt this most noticeable in academia and notice this culture less in community-based medical practice where there is a more collegial, collaborative effort to treating patients. In an environment of respect, there is naturally less defensiveness. To this lady on the plane, Hospital medicine is not an impressive field of medicine. This is fine for her to comment on because I am a woman, and I am in a field of work that most feel open and often compelled to comment on. Why does anyone think their input on my career choices is valid? And who decides which medical field or specialty is more important than another? If only she knew the thought and stress that goes into deciding on a field of practice. As physicians, we are drawn to our specialties with either a passion or a combination of passion and practicality. We do our best to find a specialty we feel we can stick with long term, be able to pay back our student loans, and be able to spend a reasonable amount of time with our spouses and children. This is no easy feat. The home/work balance is almost impossible. So much so that at this point, I have joined into the belief that there is no such thing as balance. You incorporate different aspects of your life together as you are able. You have to be realistic about the amount of support you have or can afford. All that being said, as a parent, you have to decide how much time away from your family is acceptable for you. The parent guilt is real; how much can you tolerate? The spouse guilt is a reality too. For a successful marriage, you have to take your spouse into account. What did they sign up for? Were they planning on staying home with children all day while you work, or were they expecting you to perform the majority of the childcare duties? This is an oversimplification, but you get the point. Not one of us arrived at our fields of medicine without a great deal of thought. I am confident in my abilities as a physician. But for a brief moment, my world and identity were rocked by a person I barely know and her opinion. The insecurities from the past, medical school, and training resurfacing for a moment until my rational mind took over to clearly reveal to me a truth that I sometimes forget. Despite some thinking, I am “just” a hospitalist. I am a hospitalist and I love my job. Jazbeen Ahmad is a hospitalist. Source
