“Is it good to try to live as moral a life as possible –a saintly life? Or does a life like that lack some crucial human quality? …Is it presumptuous, even blasphemous, for a person to imagine that he can transfigure the world –or to belive that it really matters what he does in his life when he’s only a tiny flickering speck in a vast universe?”

—Strangers Drowning, Larissa Macfarquhar

Frequently I think about the question of what I want to accomplish in my role as a physician.  Sometimes the answer is to get home at a reasonable hour that day.  However, when looking past the day-to-day, I definitely strive for more, even if I am only a tiny fleck in the universe.

I like to think that I’ve tried to help families that see me as best as I can.  I try to make sure that I am not overbooked so that I have enough time to think about problems carefully and perhaps have an opportunity to make a connection/have a conversation with families who come to see me.

So much of what I do everyday becomes fairly routine, particularly when in the office.  For a family who has a child with severe stomach pain and is missing school, this is a critical problem. Yet, I may see several similar children each day of the week.  I know that the child will improve, but I don’t know exactly how long it will take and how difficult it will be.

Most of the problems that I see are alarming for parents, including the following:

• severe stomach pain
• rectal bleeding
• poor growth
• difficulty feeding
• soiling
• vomiting

Yet, very few patients who come to our office need to be admitted to the hospital.  Most of the time, some fairly routine advice and/or treatment will resolve (or at least improve) these problems.

In clinical care, what really stands out for me is when a rare medical problem is quickly identified and treated.  I was delighted recently when I helped establish a diagnosis of chronic granulomatous disease in one child when he was seen at his first encounter with me.  In the previous week, I identified a child with familial Mediterranean fever.  Both of these problems are extremely rare and can be difficult to diagnose.

But truly, how often does it matter if a child sees me compared with another pediatric gastroenterologist?  My suspicion is that most of the time it does not matter; though this opinion may be due to the fact that I’ve had the chance to work with some truly terrific colleagues.  So while it is gratifying to help families, I am often thinking about what I can do to accomplish more.  I am sure others struggle with the same issue of trying to do meaningful work.  Some may leave a legacy through their focus on research, teaching or charity.

In some ways, I have considered my participation in the AAP, my blog, my role at the hospital, and (at times) research/teaching as important opportunities for different types of work to keep everyday a little more exciting and to make a useful contribution.

What are you trying to accomplish?

Related blog posts:

• Personal Look at 20 Years of Doctoring (Part 2) | gutsandgrowth
• Personal Look at 20 years of Doctoring (Part 1)
• Top  Physician Skill -Listening
• “It is never boring to be a physician” | gutsandgrowth

Sunrise at Spruce Point, Maine