Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.—As Dr Volpintesta points out,
the spiritual and emotional components of our lives indeed will shrivel and
die with our "inordinate adulation of work." What kind of physicians will
we be then? Patients, students, and junior faculty turn to us for these very
qualities, and we will be found lacking if they are undeveloped.
Perhaps the words of Bertrand Russell can speak to Dr Matz and to the
legions of other physicians who promote sacrifice as the "virtuous" quality
of our work. Matz and I disagreed about this issue 20 years ago when I was
an intern working on his medical service in the Bronx. Working conditions
were brutal: 36- to 44-hour shifts every third night (every other night in
the intensive care unit at the private hospital next door). I remember being
appalled at the lack of consideration given for the welfare of the medical
house staff. "If it is for the good of the patients: just do it" was the approach.
As an overworked, overwhelmed intern, I felt unable then to make any changes.
It was like being in a large room, pitch black, unable to find the light switch.
Linzer M. On Being a Physician: Choices, Sacrifice, and Balance—Reply. JAMA. 1998;279(20):1609. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-20-jbk0527