I am often asked the age old question: How did you know you wanted to be a doctor? I wish I could say that all my life I dreamed about going into medicine- but I can’t. Why did I become a doctor? I don’t know exactly. When I started college I was planning to enter law school with an accounting degree, but somehow at the end of my sophomore year, that no longer seemed like that right thing to do. There was no specific event that changed my mind, nor did I dislike what I was learning in college. I just started feeling that I wanted to do something that involved helping people and being involved with them on a personal basis. I viewed medicine (and still do) as more than just a profession and a way to make a living, it allows me the opportunity to be there for people at difficult times of their lives and stand as a source of support. That all may sound hackneyed and trite, but nonetheless it remains true. (By the way, I still did get my accounting degree as an undergraduate.)
The next question that I’m asked is: OK, so now that you became a doctor, how did you know which field of medicine you wanted to go into? That question is a little more complicated to answer, especially since I have multiple specialties. I did not know exactly what I wanted to do until I did my clinical rotations in the hospital wards, during third year of medical school. Again, there is no event that I can point to that convinced me what I should do, I just had a premonition. I always enjoyed getting to know people and having a relationship with them, so I wanted a specialty where you became “a part of the family”. I also wanted to be intellectually challenged by interesting cases and have the ability to work up the patient and arrive at a diagnosis. I therefore chose internal medicine as my primary specialty. Internists, also known as doctors for adults, have to act as detectives, taking individual symptom complaints and putting them together to determine what is ailing a patient.
That explains my primary specialty, but I also have three sub-specialties. A sub-specialty means that you have to first be trained in a primary specialty as a prerequisite and then continue training in a more “specialized” field. (Many people don’t realize that their cardiologist, pulmonologist, endocrinologist, etc. are all trained internists who pursued further training.) My subspecialties are pulmonary, critical care, and sleep medicine. The main reason I chose my sub-specialties is because as a resident, I really liked working in the intensive care unit (AKA ICU- this is where a critical care doctor works) and I also enjoyed working with the doctors who ran the ICU. Pulmonary medicine and critical care medicine training are often combined because so many of the patients in the ICU are on respirators. It was only at this point that I discovered sleep medicine.
Sleep medicine is also related to pulmonary because a large proportion of sleep problems are related to breathing, such as sleep apnea. But sleep, as I quickly found out, is a lot more than just sleep apnea. It combines parts of pulmonary, neurology, and psychiatry and is such an important part of our life. After all, we spend approximately one third to one quarter of our lives asleep. Many people are shocked when I tell them that I am a sleep medicine specialist, because they didn’t even realize that there is such a specialty! What is especially exciting about sleep, is despite what we already know, the specialty is essentially in its infancy, only about 20-25 years old. We are constantly gaining new and vital insights to the process, importance, and underpinnings of sleep as a necessary biological process that every animal in the world needs to engage in.
It is probably obvious to you that your doctor is very busy and often does not have the time to spend explaining every disease and its implications to you. This might leave you disenchanted with the state of healthcare in the year 2006; however it also should be obvious that we now have advantages, such as the internet, that allows you to have access to a wealth of pertinent information that will make you an educated consumer (my apologies to Sy Syms). This information will help you ask direct and relevant questions to your doctor, so you can feel more at ease with what is going on. Doctors appreciate a knowledgeable patient, because they demonstrate awareness of their health issues and can also help in taking care of themselves. Too often I find patients who are passive and fail to get everything they can out of the healthcare system. Always find out what each medication is for and why each test is being performed. Stay educated and informed and you can be an active participant in your overall health.
My hope is that in future installments of this weblog, I will be able to get you educated on certain topics and help you remain on top of your healthcare needs. I also look forward to hearing questions and comments from you. I would be glad to be assistance in giving you insight to a problem that you can then address further with your doctor. Obviously, since this is an open forum and I am not privy to all your other health issues, please keep your questions more general, dealing with a recent news item or a specific disease and/or complex symptoms. This forum is designed to give you a better idea of how to help yourself, but it can not take the place of a private doctor. In this way we stand to gain from one another, as students of sleep medicine.
Published On: June 14, 2006