If you are a child of the 1960s, chances are your mother or grandmother made some of your clothes from scratch. They would go to a fabric store, look through the hundreds of small packets of printed sewing patterns, and select their next project. The patterns were sheets of thin tissue paper containing outlines of how the fabric should be cut, with instructions on how to piece them together. My mother dabbled in this when I was young, and while she is an accomplished woman, sewing was definitely not her forte. I remember some of the shirts that she made: buttons often not lining up, sleeves not quite the same length, too tight across my stomach, or too loose across my small shoulders. But one piece she sewed is part of my origin story in medicine.

Around the time I was in first grade, I watched the melodramatic medical show “Dr. Kildare” each week. I saw the dashing young intern look deeply into the eyes of his patients, hold their hands, and in less than an hour, elicit miraculous cures. More importantly, he was an inquisitive, sensitive, healing presence, and watching that show caused the six-year-old version of me to know that I would be a doctor.

My mother sensed this and found a pattern, Simplicity pattern number 4714, a themed set of pajamas. From this she made me an intern’s smock, even stitching a crude Caduceus over the left breast. I shamelessly wore this to school more times than I can remember during first grade. At that point in my life, it was not that I wanted to be like Dr. Kildare, I actually was Dr. Kildare. Looking back, it was pure, innocent, naive and, yes, it was figurative and literal simplicity. Such was my pathway into medicine.

The paradox of modern practice

I have been thinking about this origin story lately. More than three decades into practice, with a few missteps along the way, I still love my work. I look forward to going to my small private practice each day to see my patients, our staff, and my office partner, but more and more lately, I wonder why things have gotten so hard and complicated.

The field of rheumatology has seen almost indescribable advances for which I am grateful and in awe. So how is it possible that the same system that makes it possible to cure diseased bodies can create so many obstacles to our ability to bring healing to the people with those diseases, and to keep the healers whole? You know exactly the obstacles I am referring to. The frustrations and hurdles that we endure, and seemingly accept, most every day even as we try our best to care about patients and maintain passion for our work.

Reclaiming our foundational beliefs

As a profession, we are lost if we do not continually reexamine foundational things that make us and our profession what it is at its best. The foundational things that we hold dear called us to make the sacrifices it took to become physicians, core beliefs and longings that enable us to treat patients with dignity and great care. These core beliefs are our sense of calling, our values, our need for meaning; they are the sort of things that we must discern and honor, even as the importance of these is so seldom emphasized or modeled by larger forces that increasingly control our workplace.

When I think back on that six-year-old version of myself, I am inspired by his dream, but saddened by the things that will threaten it in the decades down the road. I want to protect him, to arm him with the courage and moral strength he will need to keep the dream pure and enduring. Perhaps I did.

Listening to the child within

In his seminal work “Crossing the Unknown Sea, Work as a Pilgrimage of Identity,” David Whyte writes, “We have our work now, a work that was formed in the growing imagination of the child we once were, but the work itself has changed and made us, formed us, into something different, something perhaps good but also disturbing at the same time. Distant now from all other voices that crowded our childhood, try to imagine what that dreaming young self would think of the strange adult we have become.”

That child informs us still, their dreams, the sense of calling that was forming even in those early days. In our quiet inner life, that version of us still speaks to us with their innocent wisdom, if we will only listen.

Brian Sayers is a rheumatologist.