How often do you think about your purpose? I ask because in today's time-crunched, stressful world of patient care, tapping into the power of purpose may help you hold on to the joys of medicine.
No phone app exists to guide clinicians through the solitary endeavor of finding purpose. Fortunately, privileges of practicing medicine include opportunities to experience vicariously a variety of life challenges and responses. You can test your beliefs about the meaning of life and your purpose, and then reaffirm or revise them. In that spirit, here's my story.
Youthful Purpose
I felt charmed, being one of the lucky few to find my purpose at a young age. My call came to me at my best friend's house while her father and brother argued about whether her mother's rheumatologist knew how much pain she was in and what they should do. Just a teenager at the time, I stared helplessly at the medicine bottles lined up on the kitchen table. That's when I knew: I'm going to become a doctor who communicates well with patients. Thereafter, an image of me in a white coat kept me directed and motivated. I sidestepped existential questions, confident of the meaningfulness and nobility of a career devoted to patient care.
Purposeful Writing
My vision became reality when I opened my medical practice. Seven years later, I lay in bed in pain, overcome with fears about surviving cancer. Reflecting on past conversations with many of my patients where I had felt tuned in to them, I realized that despite my best efforts I'd never grasped the breadth of the great divide. To capture the moment's intensity, I tiptoed into the kitchen that night at 2 a.m. and started writing.
Unlike how I dash off notes, I spent weeks wordsmithing, aiming for lyrical writing that accurately reflected my thoughts and feelings. The effort helped me grieve and adjust; the distraction provided a respite from nausea and leg pain; the finished essay helped a few colleagues understand their patients better, or so they said. Finding purpose in the writing was straightforward. Finding my life's purpose after cancer was not.
General Purpose
What if I die? That question preoccupied me until I began treatment, when my focus shifted to a more hopeful and practical concern: What if I live? Desperate to use my time optimally, I felt unsure about exactly how to do that. Inspirational readings, vivid dreams, and prayers provided fodder for conversations with my Rabbi, my philosopher husband, and close friends. Two themes emerged: The purpose of life is to help others. My purpose is to let goodness flow through me. Whether those were divine messages or soulless expressions of the neurochemical workings of a drugged and stressed brain, they resonated as "right." I was no closer, though, to figuring out how to fulfill those purposes.
Stopgap Purpose
After my diagnosis, I imagine my reaction mirrored how an astronomer abducted onto a spaceship might experience a launch: terrified and curiously excited to visit territory I'd worked earnestly to understand but had tried to avoid myself. My hope for firsthand experience making me a better clinician lessened my fear and grief and boosted my courage and fortitude.
On the other side of the stethoscope, I paid attention to my physical and emotional reactions, and to what helped. Revved on steroids, I began recording insights and tips for a pamphlet for my reception room. My cancer kept shrinking while my list kept growing into a book-length guide for patients. After the manuscript landed me a contract with a major publisher, family and friends cheered, "You're a writer!" I corrected them, insisting I was a clinician using writing as stopgap work until I could resume patient care. And I did, twice, between recurrences. Then ongoing cancer forced me to retire.
Living with Purpose
My worsening prognosis changed my view of most everything. I saw relationships and events through a lens of knowing that one century from now (let alone a millennium from now) not a single person will know the touch of my hand or remember my laugh. That not a single word of mine will remain in print. That the only remembrance of "me" will be a faint echo, a totally unidentifiable ripple effect of my words and actions.
That hyperawareness of my insignificance, combined with eye-opening experiences on the receiving end of others' compassion, had the paradoxical effect of energizing me with a new sense of purpose: fostering hope of moving toward a society that highlights our similarities and not our differences, and where people act on the teaching to "love thy neighbor as thyself." That hope is based on a belief that kind words and actions, like water dripping over granite, can reshape our world imperceptibly through the generations into one of love and peace.
With clarity, I saw purpose in every act of kindness. It mattered less what I did than doing it with kindness. That relieved the pressure to determine a single "right" purpose for me. My job was to embrace the day's challenges-and joys-after choosing from among my many options, a never-ending bounty of opportunities that evolved as my circumstances changed and as I changed. Just as when I practiced medicine, living with purpose was-and always would be-a work in progress.
Finding Purpose
For now, I plan to continue writing to help other patients. As for mundane choices about my time, I keep trying to make wise decisions about whether to sit a bit longer with my 98-year-old mother or help with the grandchildren, attend a virtual lecture or rest, work on my next book or meet a friend for coffee. However a decision turns out, I hope and pray that goodness flows through me.
As a busy clinician, finding or reaffirming your purpose may energize you to meet the challenges. From my perspective, each time you help change a life for the better, you help repair our world.
WENDY S. HARPHAM, MD, FACP, is an internist, cancer survivor, and author. Her books include Healing Hope-Through and Beyond Cancer, as well as Diagnosis Cancer, After Cancer, When a Parent Has Cancer, and Only 10 Seconds to Care: Help and Hope for Busy Clinicians. She lectures on "Healthy Survivorship" and "Healing Hope." As she notes on her website (http://wendyharpham.com) and her blog (http://wendyharpham.com/blog/), her mission is to help others through the synergy of science and caring.
Patient Handouts
Oncology Times offers helpful handouts on a wide-range of oncology topics, including: A Healthy Approach to Online Test Results, When Your Child Is Diagnosed With Cancer, and Coping With Treatment Delays. You can download all patient and clinician handouts at https://bit.ly/2FE9g6K.