I went to medical school with a woman who wanted to fix things. As a fourth year medical student on clinical rotations when confronted with chronic conditions she would bang her fists. ‘Just fix it,’ she would say with frustrated urgency. ‘I want something I can fix.’ She wanted the quick hit of making things better. So she became a surgeon under the illusion that she could avoid the most difficult elements of the human condition.

Since first meeting my classmate I’ve worked with a handful of ‘fixers’ as I call them. Doctors who think they can shelter themselves from the chronic afflictions for which there is no quick solution. The ones who show up to feed their sense of personal accomplishment.

…

This is an awkward disclosure for a physician, but I fix fewer children than you might think. When I look at what I do from day-to-day I’m in the business of helping manage the lives of children and families. Disease takes its course and I either keep it at bay or help parents and kids work with and around its course. I’m not a fixer. Sometimes problems fix themselves when we nudge things in the right direction. Or parents fix themselves as they adapt to a world with a child different from what they expected.

And the chance to cut isn’t always a chance to cure. I work closely with a wonderful pediatric surgeon, for example, who has dedicated his life to the care and management of children with inflammatory bowel disease. He fixes some. More often he palliates.

The reality is that despite our bluster over precision therapeutics and even the ability to cut, fewer patients than we might expect are fixed by the targeted cures we often read about. Increasingly I see myself as a docent: A technical guide helping patients and parents along the path they’ve been forced to walk.

I had no idea that this was what I was getting myself into when I left medical school. But with a longer world view, I’m fine with it. It’s difficult but rewarding work.

I wonder how my classmate is doing.

Modified photo by Andrew Neel