Do I Really Want To Quit?

     This is a tough question.
     I think about medicine and my patients all the time.  When I quit, what will fill all that mental space?      Physicians don't give up their medical affiliations just because they stop practicing their trade.
     My brother, David, went to medical school, then did one year of internship.  After that, he decided to work as an emergency room doctor for a few years to pay some of his debts.
     In his first year out of school he got sued by the family of a patient whose daughter, a hospital nurse, had stopped him in the hospital corridor and asked him to check out a mole.
     "You'd better go see a dermatologist right now about that," he said.
     She died a year later of malignant melanoma, not having taken his advice.  She hadn't been his patient, so he didn't have medical records documenting the "hallway visit" or his advice that she seek immediate medical advice.  It was his word against the unfortunate woman's family's word.
     The lawsuit dragged on and on and my brother, discouraged, stopped practicing medicine forever.  That was thirty-two years ago.  He worked for the pharmaceutical company, Wyeth, for many years, then retired.
     He had been a practicing doctor for exactly one year, and never again felt the desire to work as a clinician with patients.  Nevertheless, every two years for thirty-two years he has renewed his medical license, paid the fees, and continued to belong to the club.  He still reads medical journals, and when the conversation turns to medicine, he joins in with so much erudition and enthusiasm you would think he had been practicing medicine for decades.
     It's a hard identity to give up.  The dues we pay to become physicians--many years of nothing but studying; a decade or more of sleep deprivation; living, thinking, breathing medicine; making crucial decisions that have dire consequences; drawing to ourselves people who look up to us and stake their lives on us;  constantly living with the uncertainties of ill-health, difficult diagnoses, and inadequate research;  faced with death, constantly, the prospect of death, death, death--these factors cement our perceptions of ourselves, permanently.
     I will quit practicing medicine, but I can't quit being a doctor.  The choice to attend medical school and identify myself as a healer was one I made for life.  What it will mean for me to be a doctor once I close the doors of my practice and stop treating patients--that's not easy to imagine, not easy at all.