The falling down people

January 7th, 2008

Here we go again. The news has me sassy again. This article in the Times recounts the tremulous state of high-status professions from which people are fleeing. It turns out a troubling percentage of lawyers don’t really want to be lawyers. Even more doctors don’t want to be doctors. They are successful, but not successful enough. They are rich but not rich enough. They wanted status but aren’t satisfied with the paltry status in hand. They were reaching for the brass ring, and it turns out it’s only brass.

Maybe they need a relax scedule like the one I’m on. Oh, I’m sure they do, but that’s not the half of it.

The article makes out like dissatisfaction is a rarefied thing. If only it were. Can we ever get off this page? This I’m Not Happy with My Life page? No, we can’t. Because the whole of human drama is just this story. A story with one page. That is, until you turn it.

And so the headline writer calls these the “falling down” professions, meaning I suppose that this is urgent news because these folks are swan diving off the highest board in town. Imagine that! Someone reaches for a false and delusional form of gratification and finds out it’s not real! Honey, you’ve got to read this!

Just the headline had me thinking of a truly fascinating story I read last year in The New Yorker about geriatric medicine, or the lack thereof. (Be afraid, be really afraid. There’s not enough money in geriatric medicine to keep it going, and I for one, am getting older. You can tell how cranky that makes me.) Anyway, in this worthwhile and highly readable essay, the author observes an intake examination by a geriatric specialist. The doctor is examining a new patient, a woman in her 80s with high blood pressure, arthritis, glaucoma, back pain, and suspected lung cancer. All this and the doctor is really only interested in her feet.

“You must always examine the feet,” the doctor says. It turns out that when we live this long, the single most serious threat we face is falling. Because we won’t get up again. When we can no longer care for our feet – clean, trim and treat them – they become calloused and sore and we lose our balance more easily.

It all comes down to what it comes down to. At the foot of the matter. The foundation. The underlying truth.

What are we building our lives on? Greedy expectations? Lustful aspirations? Selfish hopes and egotism?

Or are we building it on love?

In the Times article, a doctor complains about the paperwork he has to complete to get new tires on a patient’s wheelchair. “I’m a doctor, not Mr. Goodwrench,” he says.

Excuse me, but yes you are. Whether you are a doctor or a lawyer, a mother, a writer, a nurse, a teacher, a rocket scientist or a bricklayer, each of us is nothing but a mechanic. All we have to work with is our hands, and any good we do is only done with love.

Go ahead. Fall down and fall down again. One day I hope you look up and see what’s real. Love is the only thing that stands.


  1. I got to read exactly ONE article in the Times on Sunday, and it was that Mr. Goodwrench comment that made me groan out loud.

    Maybe your Georgia will make another schedule special for foot care?

    xo Jena

    Comment by Jena Strong — January 8, 2008 @ 1:55 am

  2. Good point. There already is a schedule for foot care. It’s called yoga. If you can still bend to reach your toes you can give them all the care they need. It’s surprising how essential toes are to yoga; but no more or less essential than they are to everything.

    Comment by Karen — January 8, 2008 @ 2:15 am

  3. Beautiful.

    Comment by Shelli — January 8, 2008 @ 3:06 am

  4. For real.


    Comment by mb — January 8, 2008 @ 3:44 am

  5. Hey. I love this blog. Absolutely love it. I have been happily reading and nodding along for 8 months. But for once, I cannot disagree with you more.

    As a doctor, who does what I do with love, for love, there is nothing harder than being unable to care for a patient because their insurance doesn’t cover, or ran out, or whatever. Every wheelchair I fix (and I have fixed many) is one less patient I can get off my surgery waitlist. Even assuming a 60-hour week. If someone else could step in and save these people’s eyesight, I would gladly fix more wheelchairs. And so would most of my colleagues.

    Forget a “relax scedule”. Forget status. Forget money. Every year I practice I push more paper and do less good. I see more unnecessary heartbreak for my patients because the emergency room was on “fly-by” and had no beds. Because the patient can’t afford the sight-saving eyedrop. Because there weren’t any appointments available, or it is a pre-existing condition, the medical records were unaccessible, the patient didn’t show because she had other priorities (childcare, food, a job without sick leave). We are human, and it sickens us to watch our patients sicken from curable, treatable, unnecessary conditions. And it saddens us to miss supper with our families yet again with our because we have covenanted to do the mountain of paperwork for that wheelchair.

    You do doctors a disservice to see only a desire for status and money. I doubt anyone who lives with a practising doctor or is truly close to one would agree with your post. Those who do see the love and dedication and heartbreak with which we practice (yes, “practice”) every day.

    Comment by Anonymous — January 8, 2008 @ 4:12 am

  6. Part of the problem may be too many tv shows about doctors and lawyers leaving too many unrealistic images out there.

    Comment by marta — January 8, 2008 @ 4:22 am

  7. Yes. Apparently also the NYT. I read a survey somewhere that showed that most people think doctors are greedy and statusminded- except for THEIR doctor.

    But it shocked and saddened (and to be honest, angered) me to see MommaZen buy into that stereotype of “Greedy expectations, Lustful aspirations, and Selfish hopes and egotism”. Is that truly based on knowledge and personal experience?

    Surely some doctor at some point has treated each of you with lovingkindness and respect? If they were professional about it, you never even knew they were missing the first birthday party for their son (or halloween costume/wedding anniversary/just plain old relax scedule) so they could be there when you needed them.

    Truly, every day my colleagues and I look into faces full of fear and pain and hope and love and “see what’s real”. We fall down and fall down again. And, thank god, most of us choose to get back up and “practice” some more. With love.

    Comment by Anonymous — January 8, 2008 @ 4:46 am

  8. I don’t believe the NY Times. I don’t believe stereotypes. I can see with my own eyes the multitude of sick, afflicted, impoverished, dissatisfied, unhappy and angry people no matter what their line of work.

    I don’t know all their names but to each of them I am indeed sorry to have caused even a moment’s suffering. There is a way out but it is not through me.

    I’m sorry.

    Comment by Karen — January 8, 2008 @ 5:40 am

  9. I am a doctor also,
    and I think your post is lovely.

    I agree that medicine, thousands of times over, has been guilty of reductionism… and losing sight of the ‘patient’, the human being, in all the science…

    This is something which we must consistently and diligently strive to overcome. To see the person first…and then the illness.

    Having said that, I do think that the expectations on our profession are sometimes completely and utterly unreasonable.

    We are expected to be all things to all people at all times… like the fourteen hour day i just had….where i was the only covering doctor for 2000 patients in the hospital where i work.

    I cannot speak for everyone, but i know that a large number of my colleagues do what we do because we want to serve. Because we want to make a difference.

    But we are human beings also. And as it is with all ‘thankless jobs’
    we need to respect our own limits.

    With love and thanks for this thought provoking and important post, Maithri

    Comment by Maithri — January 8, 2008 @ 8:44 am

  10. I think it’s unfair to assume MammaZen meant ALL doctors and lawyers feel that way. In fact, I think she was referring to those who have LEFT the field due to dissatisfaction. Unfortunately I have had the opportunity to work very closely with a lawyer who was far from a money grubber — he was generous and kind and looking to help me achieve the best outcome for my family. But I don’t think that’s who MammaZen was addressing–it’s those who are not like that, who don’t fix the wheelchairs, who don’t worry about patients, who put money first.

    I agree with this post and it gave me a good kick in the pants. Lately I’ve bemoaned my own financial struggle only to hear someone say that a 10-member family were sharing an 800 square foot house. I’m FINE! I’m living with my kids, I get to spend the majority of my time with them, and we have food in the refrigerator. I would have to agree that there’s a lot of us (including me) that expect to live grand and glorious lives instead of being grand and glorious people with those we love.

    Thank you.

    Comment by shauna — January 9, 2008 @ 1:37 am

  11. Ooh. Something of a hornet’s nest here. And I thought it was meant for me. If one has no love for one’s job, then what good is the work? I’m building on love, now, with my family. Right now, we have enough. I can “wait a year to get rich”. Or maybe more. Falling down feels good.

    Comment by RocketMom — January 9, 2008 @ 7:17 am

  12. Oh that’s right! Perhaps we should call you the MomRocket now. You make me smile.

    Comment by Karen — January 9, 2008 @ 3:57 pm

  13. Karen, I am coming up for air after a bout with something a lot like Ebola and just read your comments. Please let me apologize to you- I wrote in passion and anger but didn’t mean to give you angst and I’m sorry. You certainly haven’t caused the pain- I think the pain I wrote about is part of life, and choosing to love and commit and stay in the game no matter what. I could leave medicine but I choose to stay, because it is right for me.

    I guess I felt the need to defend those who have chosen to get out of this particular game, because I mistakenly thought, as Shauna said, that you were holding them up as an example of What We Ought to Try Hard Not to Be Like. Fallen-away doctors have so often been judged harshly for a purely human and valid choice. In 15 years as a doc, many friends have left medicine to raise children, design a vaccine, build a cabin, and (no joke) support a family as a professional poker player, among other things. But I have never known someone to move on (turn here) for lack of money or status. Maybe it’s closer to choosing to adopt a baby, but not a baby with AIDS. We all have our limits.

    The NYT article hit a nerve because it so completely missed the mark about why docs are leaving medicine, at least in my opinion. There are many many problems with health care, but docs leaving for lack of status isn’t one of them. It takes guts and courage to walk away, and guts and courage to stay. It’s really the same thing. That’s all.

    I have never posted in a forum like this (hence the “anon”) and I feel like i have fallen down a bit on this. So please accept my apologies and keep allowing us to follow along as you write to yourself.


    Comment by Anonymous — January 11, 2008 @ 2:45 am

  14. well. i want to say how could i have missed this one last year?? i loved this post and all it truly had to say about love. had to read it again after getting sucked dry a bit by the commmentary. but was all wet with sloppy kisses as soon as i did.

    Comment by latisha — July 23, 2009 @ 5:51 pm

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