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May 27, 1998

On Being a Physician: Choices, Sacrifice, and Balance—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(20):1609. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-20-jbk0527

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.