• Rosalind Kaplan, MD

Right Where I Need to Be

By Rosalind Kaplan, MD

Haven't posted for months. I thought about this- should I just stop blogging, since I can't seem to get myself to post? But I don't think that's what I want to do. In all honesty, I wasn't posting because I was writing a book. And I think it's pretty much done now, if 'done' is even the appropriate word. I've found that I never feel done, because I could just keep revising and revising and revising. But there is a point when too much revision ruins the integrity and the freshness of what is written, so I have to stop myself. I've sent it out for proofreading and formatting.

I've written a series of essays about life in medicine- from med school to training to practice; the essays span the 40 years from the time I began applying to medical school (and it's hard to admit that it's 40 year, and even harder for me to feel like it's been that long) until the present. The essays are intended to give readers a view of the world of doctors-- the anatomy lab as students, the craziness of hospital training as residents, the electronic medical record, the shift over the decades to what is now a corporate culture, the ways that covid has changed things- both in day-to-day practice of medicine and patient care and also in the way we look at healthcare, the way that all the cracks in our crumbling, creaky system have opened up into chasms in the face of the ongoing medical crisis, and an assortment of other issues. Of course physician burnout is a big theme; these days I can't think of a single doctor I speak to who isn't fried. The reasons for it differ, as 'frontline' doctors who are in direct contact with covid patients are just overwhelmed, while other doctors can't do their jobs because of covid disruptions or find that their patients have fallen through the cracks in various ways because

of the resources that have been shifted to pandemic care.

I'm soon going to work on getting a publisher for this essay collection. It will likely take a while, and I don't know if it will happen. I'm trying not to listen to the writing pundits who say 'essay collections don't sell.' I buy essay collections! But some of these essays are already published in journals- take a look in the 'published short works' section of my website!

Despite all the burnout and the stress, there were more medical school applications in 2021 than ever before. This tends to happen when the economy is tight, as young people look for 'secure' vocations, but there are probably other reasons, like the wish to be needed, or to be a part of the solution to problems. Some of the reasons are good, and some not so good. The number of spots in medical schools hasn't changed much, so there will be lots of disappointed applicants. I just hope that those who do ultimately joint the profession know what they're getting into.

It's what I talk about in the essays: medicine is an amazing profession. There's so much to learn, so much to be excited about--great scientific advances and so many opportunities. But medicine is also a hard culture to be part of. I think there is an acceptance now that burnout, stress, and depression are real problems amongst doctors, but I still don't see real action being taken to address it. Institutions are touting 'wellness programs' that don't actually improve physician lives or well-being.

Something else I'm considering is becoming a life/career coach for other doctors who could use some help or direction navigating all the stresses and finding ways to preserve their own well-being and sanity within the profession. I wish I'd had such a person early in my career; I made decisions- some good and some bad- without much guidance. It was especially hard to find mentors as a woman in medicine when I was finishing training. A coach is different from a mentor, because coaches are trained to keep their own opinions and interests out of the mix, while mentors are often consulted specifically for their opinions. Coaches were unheard of when I started my career but are now pretty common, and there are training programs specifically for physician coaching. I will likely join one of those programs in the near future.

When people ask me now what I 'do', I tell them that I'm a 'dilettante.' I'm making fun, but there's truth in the jest: I teach a little, I write a little, I practice medicine a little. I might start coaching....Yet for me, all of these endeavors are connected and I feel like I'm meant to be right where I am right now.

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