I

t was the talk of joy that surprised me most during my first week of training as a resident physician.

Most of orientation was devoted to priming me and my fellow residents for the dual responsibility of being both learners and employees of the Cambridge Health Alliance. Then one of the senior physicians started talking about finding joy in medicine.

Medical school and residency are rigorously challenging, and sometimes all consuming. It didn’t take me long to learn that medicine is a profession of delayed gratification; sacrifice now through multiple years of training, and reap the fruits of your labor later. But as I prepared for my residency, I’d started to wonder: When, exactly, does the gratification come? And from where?

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I have friends training in a variety of specialties, from emergency medicine to neurosurgery, who fear the light at the end of the training tunnel is dimmer than they once expected. “I realized that I didn’t want the life my attending [physicians] lived. So many of them seem miserable,” one friend explained. “Their lives look like more of the same.”

It’s unsettling to think that many physicians delay being happy, only for the promise of more unhappiness.

That’s why I was so intrigued by the mention of joy.

The very concept of joy in medicine was foreign to me, because I’ve rarely experienced it in the pursuit of physicianhood. The most common positive emotions I’ve experienced in medicine are much more cerebral in nature. For example, I felt proud when I was admitted to medical school, relief when I got a question right on rounds, satisfaction when I learned to suture properly, and awe when I helped deliver a baby. I’ve been happy for my patients, and feel purposeful when I’m able to help them heal, but when I think about the totality of medical school, I’m not sure I was happy for myself.

A good day was one where I didn’t leave the hospital or clinic feeling dejected because a self-serving medical student threw me under the bus, or a senior resident used me to deliver a subtly demeaning message to a nurse, or an attending physician berated me for making a mistake while learning to communicate a patient’s progress.

I’m embarrassed to admit my standards for a good day are so low — but my experience is not uncommon. I recently stumbled upon a portrait of a medical resident collected for the documentary project Humans of New York. “There’s a strange culture in medicine. People are less friendly to each other than I imagined,” said the resident, who had lost two resident friends to suicide. “… the stress just erodes people. There’s a lot of tension and anger.”

Knowing what my soul was up against, I was conscientious in choosing a residency training program where the residents seemed genuinely happy, because happy people were less likely to be unkind. But I didn’t think about the possibility that the program itself could be a source of joy; instead, I was looking for programs where the residents seemed able to build in time for enjoyment outside their medical work. I knew no other alternative. Throughout medical school, it was the activities I did outside of medicine that sustained me and gave me the grit to keep fighting for my dreams. I was preparing in residency to do the same.

Now, here was this senior physician telling me and my fellow trainees that the practice of medicine itself could be joyous, and we could help sustain each other. This joy is an extension of a collaborative workplace culture that puts people first and fights to preserve the humanity that allows all of us — doctors and patients alike — to feel fully alive.

One of our chief residents told us a story about the fear and apprehension she felt on her first day as a doctor three years ago. Her senior resident assured her that she would be OK because the other residents would look out for her. And sure enough, they did. In this supportive environment, she not only learned how to take care of her patients, but also her teammates too.

On the last day of orientation, all of the interns read and reflected on a poem, composed of prophetic words spoken by Hopi Elders. The last line of the poem reads: “We are the ones we have been waiting for!” It was an answer to all my questions about gratification. We don’t need to wait to feel the warmth of the light at the end of the tunnel, or hope for a better tomorrow, because we can all be better today. By cultivating a community of compassion, we can help extinguish the culture of unkindness.

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For the first time in a long time, I feel energized and excited to live the practice of medicine rather than compartmentalize it. I’m only a few days into my training, but as far as I can tell the Cambridge Health Alliance seems like a special place. I’ve been introduced to the radical idea that there can be joy in medicine, not just in the spaces we occupy away from it.

I don’t want to just get through the next four years, I want to experience it in a way that aligns my purpose with the delight you should feel while pursuing your passion. I’m cautiously optimistic about this new beginning — and I’m open to the joyful possibilities.

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  • The journey itself is satisfying for being a servant is what medicine is all about. Many of us found satisfaction in knowledge and scientific truths. Get into orbits with discoveries and inventions. Small miracles happen daily. Do not look for joy in rewards and compensation for that is flawed. Somehow burn out is the result of anger tension and frustration not satisfaction of getting a job well done. In the end, we are judged by how much love we put in our work not by how much we are loved.

  • I’m so happy to hear this! I’m an upcoming second-year medical student and I always try to find joy and happiness in what I’m doing because I’ve worked so hard to get here and have also had a ton of support. I figure that if I wanted this life so much, there’s no point in hating it. I fully intend on enjoying the ride. This article makes me optimistic of the future and of my residency experience waiting ahead of me. I can only hope that I will land a spot in a residency program with a similar atmosphere as yours!

  • I fully agree with this smart and warm presentation on how medical activity should always be.
    Franck Sturtz, MD, PhD

  • I am very glad that you have found such a wonderful place to do your residency! If only this idea of mutual support could spread throughout the medical community.

  • The National Patient Safety Foundation’s Lucian Leape Institute has cited restoration of joy and meaning in work as a fundamental key to improving patient safety in our health care system and released a report on this in 2013 that includes a number of recommendations for hospitals and health systems. Great observations in this piece, and I wish Dr. Adaeze Okwerekwu much luck in her career.

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