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Editorial MARCH 2006

DonÍt ñJustî Do Your Job

Vivian M. Dickerson, MD

One of my favorite features in The Female Patient is our new column ñMy Most Memorable Moment,î in which we invite our readers to share outstanding or meaningful experiences from their careers. It encourages physicians to think about the positive encounters, poignant moments, rejuvenating interactions, humorous events, and learning experiences. Such an exercise may also help to save our specialty.

John Gibbons, Jr, MD, assumed the presidency of the American College of Obstetricians and Gynecologists (ACOG) in 2003. In his initial address, he pointed out that the specialty had reached a crisis point, and had to act accordingly to save itself.1 In 2004, OB/GYN match data were disillusioning. Fewer American medical-school graduates were choosing the specialty, with many gravitating toward emergency medicine, ophthalmology, dermatology, radiology, and anesthesiology. This was largely due to the influence of faculty and comments overheard in locker rooms, operating rooms, and conferences. Fearing that our own frustration was deterring the current generation from considering OB/GYN, ACOG launched a national competition for residents entitled ñWhatÍs Write About Obstetrics and Gynecology?î The ACOG junior fellows deserve most of the credit for this essay contest, as they have been enthusiastic and creative in promoting the positive aspects of what we do. The winning essay was originally published in May 2005,2 but the 10 district winners were later reprinted in a publication entitled What Obstetrics and Gynecology Means to Me. These short works by residents or fellows in OB/GYN do not represent memories, but rather reflect experiences that are recent and fresh. Reading these vignettes was variously uplifting, amusing, and a matter of smiling through tears. It reinvigorated me, making me realize that I was often too busy, cynical, or frustrated to notice the wonderful things about my chosen lifeÍs work. We are often admonished to remember why we entered this specialty, but we rarely examine why we have stayed the course, and what core values and experiences are central to the profession.

There is abundant discussion today about living in the moment. For OB/GYNs, ñthe momentî too often translates into the ongoing liability crisis, the encroachment of managed care and insurance companies on the decision-making process, the cost of doing business, and the metamorphosis of medical practice into ña business.î Maybe it is old-fashioned, but I believe that caring for women is more than an 8-to-5 vocation, and that we often overlook the many high points we encounter in the course of our work. The individual experiences are often overwhelmed by paperwork and professional angst, so that we fail to take note of the magnitude of priceless moments, thereby creating a ledger that has more minuses than pluses. Is this really what we wish to communicate to future physicians?

The ñMy Most Memorable Momentî column is a way to share a bit of meaning, and jog the memories of our colleagues as they reflect on their careers. I often recall the patient who finally conceived after 10 years of infertility, only to experience intrauterine fetal demise at 38 weeks. I was in my second year of private practice, and was the physician on call who had to tell her the horrible news. I will never forget the sound of her screams. And I will never forget that when she became pregnant again a year later, she came to ask me to deliver her baby. I thought she would have wanted to eradicate all memory of her loss, but she said, ñI think that having you deliver my baby will be good for me—and I know that it will be good for you.î This pregnancy became a healing journey with a very happy ending. Her profound and insightful gift will always be one of my most meaningful memories.

What about you? I doubt that you have to think very long before you are awash in memories of the joy and healing power of your ñjob.î Please share your memories with us—for yourself, your colleagues, and the future of our specialty.

Vivian M. Dickerson, MD
Editor-in-Chief

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References

1. Gibbons JM Jr. Springtime for obstetrics and gynecology: will the specialty continue to blossom? Obstet Gynecol. 2003;102(3):443-445.
2. van Dis J. What obstetrics and gynecology means to me. Obstet Gynecol. 2005;105(5 pt 1):1123.