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Where Has the Fun Gone?

Chloe G. Alexson, M.D.

Chloe Alexson, Professor of Pediatrics Emeritus at the University of Rochester School of Medicine and Dentistry and the Department of Pediatrics at Strong Memorial Hospital, grew up in Oradell a small town in Northern New Jersey and attended Cornell University as an undergraduate. She received her postgraduate training in pediatrics and pediatric cardiology at Strong Memorial Hospital and has remained there throughout her career as a pediatric cardiologist. She has received many awards for her skills in teaching medical students and house officers and for numerous services to Rochester's professional community. In retirement, she volunteers her energies at the Alumni Affairs office of the medical school.

We've been practicing medicine a long time. We've seen many changes, mostly good, some OK, some terrifying.

The explosion of scientific knowledge since we finished school has led to a lot of "on-the-job training" for all of us. The clinical use of blood gas measurements was only a poorly understood dream when we were in school. DNA wasn't even a dream. Immunology referred to "shots". Imaging was X-ray - and not very sophisticated at that. Now we have a horde of alphabets - MRI, MRA, CT scan, SMA 6, 12, 18 and on and on. All of that is good, though I worry about the modern physician’s loss of the ability to use his eyes and ears, his hands, his ability to think. This reliance on technology has taken away from us the most exciting part of our lives - the art of medicine, the joy of puzzle solving. No wonder doctors have lost a lot of the respect we once had. I'm afraid that by and large we no longer deserve it and I'm afraid we do deserve the changes being forced upon us. We've become cooks, slavishly following the recipe. Those changes are frightening.

To me, however, what's even more frightening and discouraging is the loss of fun, not that it’s fun having sick patients, but that it’s fun to find and follow clues, to figure out what’s wrong, to fix it. I never had more fun than when I was a 3rd year student and an intern - two years of intern fun! We all did. We relied on each other, not just for help in getting the work done, but as a hand to cling to when the going got rough - and it did.

I wish I saw more fun in the eyes and on the faces of students, house officers, and the younger physicians in practice. Unfortunately, they look on medicine as a job. They come to work, they do their work, and they leave when the clock says it's time to go. They have no chance to cry over a dead baby. I ask them to come with me while I tell a mother her child has died. Do they come? No, they're busy. They miss the opportunity to work through grief, their own as well, and I think they lose the real meaning of the practice of medicine. They cannot ever become important to their patients when medicine is just a job like any other.

I'm often asked what I would wish for our current students. My answer is always that I hope that when they're my age, they bound out of bed in the morning eager to go to work as I still am. Every morning I thank God that I knew what I wanted to be when I grew up - and that I was right.

I'm told I announced at the age of two that I wanted to be a doctor. I've never wavered from that. In the little New Jersey town where I grew up, in the central high school I attended, and at Cornell, I simply could not see myself as anything else. I could see other girls as teachers, secretaries, nurses, airline stewardesses (that was big in my day), but I couldn't put myself there.

Even the medical school interviewers didn’t change my mind. "My God! Another female! Why don't you go home and have babies?” That, of course, was not at the University of Rochester where I still remember with pleasure each of my interviews, discussing baseball with Dr. William Bradford, ecology (a brand new idea) with Dr. Hermann Rahn, having tea with Dean Whipple, and most of all being greeted by name and as if I mattered by Hilda DeBrine and Harriet Purdy in the Dean's office. I wouldn't and couldn't have gone to any other school.

Medical school was great because my classmates and my teachers were great. We liked each other. We respected each other. We all loved medicine. I no longer see the closeness, the love, the sharing that I used to see. Granted, we're bigger and there are more of us; but the competition, the laziness, the loose approach to facts, the inability to think, the lack of attention to detail in such simple things as spelling, handwriting, grammar, being on time - all these worry me for the future of medicine. Balancing that, however, is an unshakable belief in the nature of man. We'll come back to a more human and humane approach to medicine, just as we'll work out the "health care" crisis. We have to. Medicine will be fun again.