Growing up in the United States of America was a blessing. As a little girl, I was told that unlike anywhere else and in any other time in the history of the world, “You can be whatever you want to be and do whatever you want to do.” So, I believed, worked hard, made good choices, and became a physician and surgeon at a time when medicine was transforming from a historically male profession. My parents were both first generation to go to college. My father, who overcame poverty to become a chairman of neurosurgery, had only two women in his medical school class. My mother defied her mother, who said she was wasting time and resources, and went to college and became an RN; my mom regrets not going on to medical school to this day. I would not make that mistake when opportunity knocked for girls as never before. The unspoken part of the message that little girls internalized was “you must prove women are truly worthy of this newly bestowed privilege.” To prove that we were worthy, we did many things that have come back to bite us. We were too trusting, too compliant, and too self-sacrificing. We did not question authority, we did whatever authority said, and we did what they asked and more for them at our expense, with a smile and a hug of gratitude for letting us do so- the female equivalent of “Thank you, sir, may I have another”.
We eagerly joined our male counterparts and shared a rite of passage known only to the rare few of us that have endured medical school, internship and residency in a day when “Men (and some of us women) were men, and giants walked the halls.” There are no words for this. We endured. We survived. We were damn good. This came at a cost. The high cost of becoming a physician is physical, intellectual, spiritual, psychological and monetary. This cannot be shared vicariously, it must be lived. We convince ourselves it is worth it when our patients shed tears of joy when they can see again, when babies are born, and when transplanted organs free lives from machines. We question ourselves when patients lash out at us at times of greatest suffering and when our babies lash out at us for not being there for them. We live the choices we make, and a life in medicine brings the highest of highs and the lowest of lows. We work until we drop, compartmentalize our lives, and try to get the most out of the ever-shrinking compartment where we are enjoying the fruits of our labors away from work.
Physicians, women and men alike, are now taken for granted-our services, our lives, granted as a right to people of an entitled society as part of the “free” healthcare package promised by an over-bloated federal government of naïve, egotistical central planners seeking to establish a false-medical Utopia. This manipulative lot demonizes us, degrades us, blames us, shames us, pushes us to our limits, coerces us, extorts us, threatens us, and lies to us. With our heads under water, peddling our bicycles as fast as we can, through our trusting complicity, self-sacrifice, and fatigue-blind faith-borne complacency, we have facilitated the destruction of our profession and sabotaged our blessings of liberty. We were told by government “Come back when you’re not willing to take what we give you”. We didn’t. We were complacent, trusting…scammed. By not questioning this authority, we have done whatever they said, and we did it asking for more at our expense, our smiles fading, too tired, too humiliated, to hug.
Worst of all, we now fear for our patients, our families, and our livelihoods. The central planners shoved a law on us that sic’s IRS agents and bounty hunters on us, reduces us to data gatherers, and threatens to fine and even imprison us for data-collecting errors. October 1, 2014, physicians who do not spend exorbitant amounts of money to implement the insane, WHO-derived ICD-10 billing/coding system will no longer be able to bill for services- we won’t be allowed to even play the game anymore. Operatives of the central planners infiltrated the AMA, our societies and our medical schools. The ACA empowers them to control our education, how we treat our patients, how we are perceived, and how we are paid. They stifle innovation, tax technology and fundamentally transform physicians from men and women of the mind to mindless drones. Our medical students, of which 50% are now women-including two of my daughters, continue to “prove we are worthy of the privilege”; ironically, the privilege has transformed to groveling for crumbs to serve government and fearing retaliation for questioning the ethics of this mission. Many of us continue to do whatever the overlords command, ironically hastening our demise.
Our desire to please, trust, and comply combined with our complacence, fatigue, and fear has resulted in complicity. We are functioning as unwitting facilitators of fundamental transformation, and if we do not change our behavior, we are to blame for the demise of American medicine and the Constitution of the United States of America. This will be tough, but we are just the women and men to do this. The time has come for physicians to stand tall like those giants who walked the halls not so long ago and proclaim “No thank you, sir, I will not have another. I have had enough. I have nothing left to prove. I am worthy. I am strong. I am an American. I stand on my Constitution. You, sir, are out of order. You, sir, work for me.”
Kristin S. Held, MD