First Decisions

When I set out on my career path many years ago I had very little comprehension of what I was actually doing. I did not have a step-by-step guide or a mentor to help me avoid the pitfalls. With this in mind, I offer some observations and thoughts from my own experience of surviving the “doctor factory” of medical education. This is not meant to be a comprehensive treatise, but hopefully it will be useful to those who are considering or preparing for a career in medicine, and at least entertaining and uplifting for the rest of you.

This article is the first of a six-part series:

  1. First Decisions: Deciding to become a doctor
  2. Apply Yourself: Undergraduate studies
  3. The Academic Eating Contest: Medical school preclinical years
  4. Academic Vertigo and the Identity Crisis: Clinical rotations and specialty choice
  5. Keep Your Nose Above Water: Surviving residency
  6. Living the Dream: The transition from training to practice

Choices, Choices

The only career advice I remember getting from my dad went something like this: “Alan, you can do anything you want. Just don’t become a geologist.” So I didn’t.

When I was a little kid I wanted to be an astronaut, but then the Challenger exploded and I lost interest while NASA was grounded for 3 years. When I was in high school I wanted to be a rock star, but thankfully that didn’t work out.

Serving a mission for two years overseas was an incredibly useful and well-timed life experience for me, as I personally met hundreds of people languishing on the dole for various reasons. I saw what a soul-crushing situation that can be, with little hope for a brighter future and none of the excitement or energy which come from ambition. “Education is the key which will unlock the door of opportunity for you,” taught Gordon B. Hinckley, who was president of The Church of Jesus Christ of Latter-day Saints at the time. So when I came home from my mission I was ready to work hard on my education, and I signed up for classes at my local university.

The admissions process went something like this: I walked up to the table where a lady was sitting and I said, “Um, hi. I would like to enroll in classes.”

She asked, “Are you a state resident?”

“Yes,” I answered. Then she reached out for my wrist and felt my radial pulse for a few seconds.

“Okay. You’re in,” she announced.

I was ready to work hard, but I still didn’t have a specific plan or even a clue of what career I might choose. During my first semester I took classes that I thought would be generally useful or interesting, including mathematics, computer programming, and a humanities class about the history of jazz music.

The Calling

The beloved textbook, still found in my collection.

But the class that really hooked me was about the anatomy and physiology of human language. This was taught by a speech pathologist, who brought in videotapes of his own patients to demonstrate the clinical findings of various language disorders. We started by learning about the language and motor areas of the brain, then surveyed the brainstem and cranial nerves before moving on to discuss the muscles and cartilages of the larynx. Every lecture was fascinating, and every page of the textbook held me spellbound; I even read the chapters which weren’t covered in the course. Comprehending the connection between structure and function in the human body, and seeing a glimpse of how that knowledge can be applied to help real people, awakened in me the desire to become a healthcare professional.

Taking this class felt like pulling the sword from the stone; I had discovered my destiny, my calling. It was more than just suddenly wanting or deciding to become a doctor. In a way that I can’t describe and which does not seem entirely rational, I felt like I had been chosen. This sense of being called to the profession is common among doctors.

Another lure which attracted me to medicine was the promise of good job security. That was the whole reason my dad counseled me against his profession. I reasoned that even if there were a total disruption of the healthcare industry, I would still have a job, and they would still need doctors.

Around this time I attended a devotional talk given by Russell M. Nelson, a pioneering cardiothoracic surgeon who later became a member of the Quorum of the Twelve Apostles. I told the story in a previous post:

“Early in my undergraduate studies I attended a meeting where President Nelson was the guest speaker. He spoke about his many years of education, and mentioned how some people had questioned his chosen career path because the training was so long and demanding. As I recall, his reply to them went something like this: ‘Yes, it will take 8 years of additional training for me to become a cardiac surgeon, but those 8 years will come and go whether I do the training or not. And at the end of those 8 years I want to be a cardiac surgeon.’ This comment had a powerful effect on my attitude, and soon after this meeting I decided that I would also study medicine.”

Not Knowing Beforehand

It honestly never occurred to me that there were other careers available in health care. I could have been a dentist, optometrist, nurse, radiology technician, chiropractor, physical/occupational/speech therapist, physician assistant, or any number of other things, but none of these options even crossed my mind. At the time I was making my decision I didn’t even know that osteopathic medicine existed. Truth be told, I didn’t even really know what doctors did, aside from what I had seen on television and movies. If you had asked me at the time to list the job duties of a doctor as compared to those of a nurse, I could not have given you a reasonable answer. Fortunately, despite this breathtaking ignorance, I somehow stumbled into the right path for me.

I say “stumbled” because I didn’t have a master plan, or even a backup plan, and because my progress wasn’t always very graceful. But I was moving forward with some confidence because I had faith that God would show me the right way even if I couldn’t see which way I was going. “Thy word is a lamp unto my feet, and a light unto my path,” says the psalmist (Psalm 119:105). Like Nephi of old, “I was led by the Spirit, not knowing beforehand the things which I should do” (1 Nephi 4:6).

If you are considering important choices in your career, I encourage you to make it a matter of prayer. Ask the Lord to guide you and help you. He will not lead you in the wrong way.

A Transfer Point in Life

During my second semester I enrolled in a full schedule of pre-med classes. After a few weeks I became friends with another pre-med student who was in most of the same classes. We also rode the same city bus, and often met at a transfer point along the way. One day she asked me why I wanted to be a doctor.

“So I can help people,” I said.

She gave an exasperated sigh, looking upwards. Her negative response perplexed me until I learned the back story. Ever since childhood she had been haunted by a persistent and inexplicable desire to become a doctor. She had mostly resisted this desire because what she really wanted was to become a mother, and she thought that the time requirements of being a doctor would prevent her from being the kind of mother she wanted to be.

But the thought would not leave her, and eventually she followed the prompting to enroll in pre-med classes. Although she was confident that she was following inspiration, she still struggled with her decision, and she struggled in her classes. “Do I really have to do this?” she prayed. “Is it okay for me to just be an art major?” About 6 weeks into the semester, for the first time in her life, she felt that old nagging desire leave her, and it has never returned to this day. God’s answer was, “Yes, you can change your major. It’s okay.”

By this time it was too late to change her schedule, so she stayed in all of her classes for the semester. We continued to see each other every day, and then on weekends too, and pretty soon our friendship turned to romance. The two of us were engaged before the end of the semester, and married before the next one began.

Our first Christmas together.

Her sister said, “Did you sign up for pre-med classes just so that you could marry a future doctor? That’s genius!” But my wife insists that this was not her plan. She believes that God gave her this longstanding desire to be a doctor just so that she could be in the right place at the right time to meet her future husband, and she was released from that desire as soon as its purpose was accomplished.

What is the moral of this story? “Trust in the Lord with all thine heart; and lean not unto thine own understanding. In all thy ways acknowledge him, and he shall direct thy paths” (Proverbs 3:5-6).

Move forward with faith, and follow the promptings that come from the Holy Spirit. God will lead you in the right way if you ask him to, even though the journey might not make sense along the way. I was doing the same thing my future wife was, trusting that God would show me the way to go and stop me from making any really big mistakes. So far he has proven to have a better sense of direction for my life than I do.

Alan B. Sanderson, MD is a member of The Church of Jesus Christ of Latter-day Saints and is a practicing neurologist.

Related Posts

Apply Yourself

Part 2 of a medical education memoir: Thoughts and memories about undergraduate studies and applying to medical school.

The Academic Eating Contest

Part 3 of a medical education memoir: Thoughts and memories about the first two years of medical school

Academic Vertigo and the Identity Crisis

Part 4 of a medical education memoir: Thoughts and memories about medical school clinical rotations, specialty choice, and applying to residency.

Keep Your Nose Above Water

Part 5 of a medical education memoir: Stories and memories from the dark days of internship and residency

Living the Dream

Part 6 of a medical education memoir: Adventures and lessons from my first years in practice

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