My 12-year-old self believed some things that I don’t believe now. My unmarried, non-parent self understood things that I understand quite differently now. My medical student self knew some things that turned out to be crazy mistaken. I think it’s pretty cool that what I think will change over time. Thinking and mindset have the amazing capacity to evolve; they’re not fixed like the brain of a formalin-soaked cadaver. If my thinking is fixed, I might as well be a twig in a river.

I’m posting this on my blog for a single reason. I’m making a big change in my approach to communication and it’s uncomfortable for me. I’m compelled to publicly share thoughts that may turn out to be dead wrong through the retrospectoscope. When that happens, and it undoubtedly will if I’m courageous in my quest for understanding, then I’ll use this post as a short hand “defense” to which I can link should it seem prudent.

Experiencing the toxicity of medicine: a brief wandering thought

Writing this post transports me back to my clinical days and spotlights a harsh reality. The harsh medical panopticon drives physicians into a defensive mindset that’s personally destructive and erodes some of the most sacred aspects of the doctor-patient relationship. The fear of enduring one of the ugliest experiences in the clinical realm plays in the background of most physicians’ minds pretty constantly. It doesn’t take a leap of imagination to believe that the habit loop of defensiveness in clinical relationships can influence relationships outside the clinical environment. Maybe it contributes to the high divorce and suicide rates among physicians. It’s a serious topic that opens a big bucket of thoughts for me, but exploring those thoughts will wait. Perhaps I bring it up now as a sort of apology and a request. I apologize in advance if my writing feels stiff. Some might call it sterile. I know it to be defensive. In my habit that demands precision and conditional, qualified, referenced underpinning for any assertion that I make, my writing can get cumbersome and tedious.

Finding my voice: my request and my promise

Nine and a half years ago I performed my last operative case. I remember the day well. As I walked away from my career as a clinician, it felt surreal. The next career chapter required me to transform my writing style and unbind my defensive mindset. That remains a toughie, let me tell you, but I’m working hard and choosing to be vulnerable. I’m taking risks. Like starting this sentence fragment with the word “like,” for instance. I’m a veteran rules-follower, literally. Military family. Active duty military career. Surgeon. Hypervigilant follower of grammar rules. Until now, of course. Just look at the last 36 words. My high school English teacher, Mrs. Purbaugh, would probably have a heart attack if she were to read this.

Here’s my request: please trust that when my tone seems distant or sterile, it’s an artifact of a long exposure to institutional toxicity, a lingering defensiveness spilling into new relationships. I trust that it will happen less often with time. I hold human connection to be one of the most sacred aspects of life and I strive to always connect authentically and intentionally. I promise to listen and speak and write with care. I will share “what I think now” openly and honestly. If what I think changes in the future “now,” I’ll share that, too. Both will be true in context, although they may be opposite in reality. I’m okay with that and I hope you are, too. Peace.