Medicine Nonfiction Observations Reflection

Work Spouses and Mentors.

I recently had dinner with a good friend. He and I trained together at the same time and he has since gone on to become a super fancy academic psychologist on the East Coast. Over dinner, he opined that an optimal work situation includes two components: a “work spouse”, and a mentor.

“The work spouse is at the same level as you—same training, same work,” he said between bites of lasagna. “And a mentor is a mentor.”

“Yes!” I exclaimed. My mind recalled the respect and affection I had for all of my “work spouses” over the years:

  • Chris and Sohan both made me laugh, helped me with the endless scutwork to get me out of the hospital, and helped me keep things in perspective when we were interns.
  • Ryan, Scott, and Ryan also made me laugh, provided thoughtful clinical consultation, and gave sage personal advice while we became less human during residency. There was even that time when we were all on call on the same night, but at different sites… and we called each other sometime between 3am and 4am just to check in. Ryan and Scott also taught me how to throw a football; the other Ryan taught me how to improve my storytelling.
  • Sharon made me laugh during fellowship (do we see a theme here?) and provided an international perspective about community psychiatry. Sharon and her husband also invited me to experience a Passover Seder.
  • Joe made me laugh (…) and helped me cope with the stress and discomfort of 15-minute medication appointments. He also validated my opinion that such a model neither matched my values nor allowed me to provide the care that I believe people deserve.
  • Craig also made me laugh, helped me think through difficult clinical quandaries, and also validated the privileges and challenges associated with working in a jail.

In two cases I didn’t have a “work spouse”. They were both medical director positions… and in both instances I was the only physician who worked in those parts of the organizations. Let me be the not-first to say that, yes, doctors think about and approach things differently. Sometimes it’s useful; sometimes it annoys the heck out of everyone else. It’s often isolating: On the one hand, sometimes people elevate an opinion simply because it comes from a doctor; on the other hand, sometimes people disregard an opinion because the doctor’s perspective seems irrelevant. Both reactions are problematic.

“I haven’t had a mentor in years,” I said after a long pause. “Maybe that’s because there aren’t a lot of Asian women who work in public sector psychiatry?”

That might be true, but I don’t know that for sure (though, as I have progressed in my career, it seems that there are few psychiatrists who choose to work in public sector, non-hospital, non-clinic settings). My mind ran through the people I have considered mentors:

  • Randall, a gastroenterologist, taught me in medical school how to remember that patients are people.
  • James, a psychiatrist, highlighted the intellectual rewards of psychiatry and is arguably the person who persuaded me to pursue a career in psychiatry instead of internal medicine.
  • Matthew, an infection disease physician who longtime readers recognize at the Special Attending, demonstrated the intellect, kindness, and humanity that we want our doctors to possess. He was one of the few attendings I worked with who brought cold water and warm blankets to patients when they requested them.
  • Dick, a pharmacist, not only knew a ton about medications, but also dispensed Taoist wisdom about how to manage people in distress… including ourselves.
  • Deb, a psychiatry residency program director, demonstrated a steady grace and cool serenity despite the tumult of resident distress. I still recall and admire her steady support and faith.
  • Brad, a psychiatrist, taught me that “patients are called patients because they are patient with us” and that, while we have the privilege of helping people, we should discard any “rescue fantasies”. The true heroes are the patients, not us.
  • Sarah, a psychiatrist who worked as a medical director for a major US city, validated my interest in working at the boundaries of fields and also encouraged me to apply for positions that I thought were out of my league. “If something scares you, you should do it.”
  • Van, the only boss I’ve had who is both a psychiatrist an a person of color, continues to provide sage career advice and said that words, “Everyone should receive high quality psychiatric care, whether they go to a nice office on Park Avenue or if they sleep on a bench.” Just knowing that someone else thinks that makes me feel less lonely.

At the risk of sounding woo-woo, though, we can all find mentorship everyday. Everyone can be our teachers if we are willing to be students. I think about the bus driver who greets everyone with a warm smile, but has no qualms about commanding—firmly, but politely—a rider to stop harassing vulnerable people who are also on the bus. Consider the finance officer with no formal authority who speaks up during a meeting to advocate for more transparency in fiscal affairs. What about that coworker who picks up the litter in the lobby when he thinks no one is watching? Because he wants to leave a place looking better than it did when he walked in?

If you are fortunate to have a work spouse, bring him or her a treat. If you don’t think you have a mentor, remember that there are others who can provide guidance and inspiration.