“And It Took Me Back To Something, I’d Lost Somehow, Somewhere Along The Way”

Last week, I began teaching my first class at the University of Texas at Dallas. I am teaching an undergraduate seminar to premedical students, a seminar on the healing power of narrative. It was a thrilling experience meeting these young, idealistic students, high achievers all, and eager to make a difference in the world. We spent the session getting to know one another, and I was impressed with their  accomplishments as well as their goals. Each of them wants to become a physician for all the right reasons. I left the class energized, thinking that the future looks very bright.

And then, I went to my other job, where, that very same evening, I sat in a conference room full of practicing physicians who issued veiled threats to our hospital leadership about the necessity of increasing call pay. Call pay is a relatively new phenomenon, something that did not exist in my clinical practice of academic emergency medicine, and something that I still find ethically questionable, but that I have come to accept in the modern culture of medical practice. What we were experiencing last week, however, when these physicians shared what other hospitals were paying, struck me as something approaching extortion, driven by greed, and reflecting an abandonment of the ideals that surely at least partially informed these physicians’ choice to enter the profession long ago.

The title of this post is a line from Kris Kristofferson’s brilliant song, “Sunday Morning, Comin’ Down,” an elegiac tale of lost innocence, and as I left that meeting last week, and walked to my car, I thought about those students I’d visited with that morning, and those doctors I’d visited with that evening, and felt myself drawn like a moth to the classroom, where I hope what I have to teach will influence future doctors in some small way, and remind them, long after I am gone, why they wanted to do this noble work.

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