Holiday musings.

A M d his Editor’s Page is being written during the Christmas reak, a traditional period of family reunions, relaxation, ecreation, and reflection. It is often a time when people tep back and try to put the daily activities in which their ives are immersed into a broader perspective. In that spirit, thought I would share with you some of my musings uring this time. The first issue that occurred to me relates to the distribution f our time as physicians. When I first considered becoming a octor, I was told that “medicine is a jealous mistress.” As I ook at myself as well as my colleagues this certainly seems to e the case. Starting in college, competition for limited medical chool positions fosters a sense of rivalry that engenders a attern of behavior emphasizing work over recreation. The ong hours on duty during residency further acclimate physiians to a lifestyle centered on work. Initiating a career, be it in cademics or in practice, further solidifies the focus on profesional over personal activities. As our careers mature, we have lready developed a work-oriented mindset that readily accepts he demands of being a physician. As practitioners, the needs f our patients are omnipresent. As academicians, there is lways another study that needs to be done or paper to be ritten. For both, it seems there is never enough time to read ll the journals or attend all the lectures to stay current with ew information. So we often evolve a lifestyle consisting of rief interludes of discretionary activities superimposed upon a onsuming backdrop of medical work. It seems to me that, as physicians, we could benefit by ore balance in our lives. I did not spend as much time with y children when they were growing up as I would have iked to, and now that same pattern is emerging with my randchildren. In my view, many of our families get hort-changed in the allocation of our time. I enjoyed sports uch as golf and skiing very much, but just could never find he time for them. How often do any of us travel when it is ot in conjunction with a medical meeting? It has often een said that a 60-h workweek is standard for physicians, n estimate which certainly rings true in my experience. ounger cardiologists are already frequently rejecting these emands and making career choices based upon lifestyle riorities. It seems to me that we could all benefit from an rientation that introduces more balance into our lives. The consuming nature of the practice of medicine is often ttributed to the enormous demands inherent in being esponsible for someone’s life. There is no question that in his respect medicine differs from virtually all other profes9 ions. However, this responsibility can clearly be discharged hile maintaining diverse lifestyle activities. In addition, it s important to keep in perspective our ability to salvage uman life relative to natural forces, and even to the actions f other humans. This latter point was certainly brought home this holiday y the tsunami disaster in Asia. It seems almost inconceivble that 150,000 people, most young and healthy, could ave lost their lives so quickly. The ultimate toll will almost ertainly be much higher. Medical measures could not have revented this diaster. In fact, food and water may well save ore additional lives than our most potent therapies. lthough scientific advances through the years have prouced wondrous benefits for human health, our abilities to ave lives and reduce suffering often pale compared to reater natural forces. In this same vein, it is hard to ignore the death and isability afflicted upon so many soldiers and civilians in the raqi conflict. The daily recounting through the press and edia of the number of victims killed or wounded in Iraq as become so routine that it is barely noticed. We are ecoming numb to the senseless loss of human life. The eath of military combatants in the war is hard to undertand. The killing of civilian non-combatants is even more rrational. Insanity reaches its epitome when suicide is ndertaken in the process of killing others. As a physician ho struggles to eke out every quality-adjusted life-year ossible, I find the deliberate killing of otherwise healthy oung people totally incomprehensible. So, as I sit here writing this issue’s Editor’s Page during he holidays, I’m struck by several thoughts. As physicians, e have committed ourselves to prolonging life and reducng suffering, and through hard work and dedication we ave been fairly successful. However, our success often eems modest compared to the effects of a natural disaster or s offset by senseless human behavior. Moreover, the benets we can deliver often come at considerable sacrifice to urselves and to our families. Given these considerations, I lan to introduce more balance into my life. Since I’m with y family in the Rockies and it has just snowed, I am going o end this Editor’s Page and go ski.