LETTERS * CORRESPONDANCE
We will consider for publication only letters submitted in duplicate, printed in letterquality type without proportional spacing and not exceeding 450 words. All the authors must sign a covering letter transferring copyright. Letters must not duplicate material being submitted elsewhere or already published. We routinely correspond only with authors ofaccepted letters. Rejected letters are destroyed. Accepted letters are subject to editing and abridgement.
Seules peuvent etre retenues pour publications les lettres recues en double dont la longueur n'excede pas 450 mots. Elles doivent etre mecanographiees en qualite "correspondance" sans espacement proportionnel. Tous les auteurs doivent signer une lettre d'accompagnement portant cession du copyright. Les lettres ne doivent rien contenir qui ait ete presente ailleurs pour publication ou deja paru. En principe, la redaction correspond uniquement avec les auteurs des lettres retenues pour publication. Les lettres refusees sont detruites. Les lettres retenues peuvent etre abreg&es ou faire l'objet de modifications d'ordre redactionnel.
Reflections from the trenches of the trenches, I read with some amusement and more concern the views of Dr. David McCann, a recent graduate from the rigours and grinds of the internship (Can Med Assoc J 1989; 141: 968-969). I became a bit depressed at A
s a veteran
McCann's naivety and perplexed at how I and my surviving unimpaired colleagues ever emerged at least partially intact. As with most veterans, I know we worked longer and harder. Having survived, it follows that we were a lot tougher than our new colleagues. I also know that doctors are very likely to suffer more from the slings and arrows
of outrageous fortune. I also know that lawyers, bricklayers and air traffic controllers do too. McCann makes the common error of tunnel vision. No doubt when he is in practice for a while he will come to realize that all humanity is subject to these problems and that he and his neophytic colleagues are not unique. The education of a physician is tough, but so is our profession. As physicians we are constantly buffeted by multitudinous problems, and one of the things that we are supposed to learn while we are training is that we frequently fail. Anyone who can come out of a training program thinking he is God was simply not paying attention and, even worse, not learning. If, as McCann says, we allow ourselves to be put on a pedestal, it is a small pedestal indeed and probably cracked. Did he ever rotate through oncology or neurosurgery? McCann decries the fact that he had to postpone his various gratifications - the typical mind set of a product of our age of narcissism. Gratification is a very personal thing: some are satisfied with very little, others not. Certainly at his stage he should be gratified by the knowledge that he had the chance to become a member of one of the world's finest professions, that he graduated and that he will now be able to have more from the materialistic point of view than 99% of the world's population. It depends on your
perspective. Finally, McCann should ignore other people's opinions of him. He should be himself and make sure his own opinion of himself is a good one. The primary reason for all the problems of
the doctors that I know that become impaired is lack of selfesteem rather than overwork. "Physician know thyself' is the most important lesson McCann should have learned in his training. My prescription to McCann would be to put his training behind him, get an understanding wife to whom he can talk, play hard, read some books about the real world outside of medicine and - as I know he will - be an effective physician and, more importantly, an effective human being. Noel B. Hershfield, MD (Class of 1959) 711 South Tower 3031 Hospital Dr. NW Calgary, Alta.
[Dr. McCann responds:] I thank Dr. Hershfield for his comments but must take issue
with several points. First, Hershfield implies that the difficult lifestyle of a physician necessitates a tough training process, and this is certainly true to a point. Unfortunately, postgraduate training frequently takes this to a ridiculous extreme that is totally unwarranted and at times cruel. He further states that because his colleagues and he worked even harder 30 years ago that makes them "tougher". I disagree. I think it simply means they were unable to improve the system back then and had no choice but to submit. The current generation of physicians is not weaker than our more senior colleagues: we are simply fed up with the crap being thrown at us for little or no good reason. Does Hershfield mean to imply that because training was CAN MED ASSOC J 1990; 142 (8)
795
We will consider for publication only letters submitted in duplicate, printed in letterquality type without proportional spacing and not exceeding 450 words. All the authors must sign a covering letter transferring copyright. Letters must not duplicate material being submitted elsewhere or already published. We routinely correspond only with authors ofaccepted letters. Rejected letters are destroyed. Accepted letters are subject to editing and abridgement.
Seules peuvent etre retenues pour publications les lettres recues en double dont la longueur n'excede pas 450 mots. Elles doivent etre mecanographiees en qualite "correspondance" sans espacement proportionnel. Tous les auteurs doivent signer une lettre d'accompagnement portant cession du copyright. Les lettres ne doivent rien contenir qui ait ete presente ailleurs pour publication ou deja paru. En principe, la redaction correspond uniquement avec les auteurs des lettres retenues pour publication. Les lettres refusees sont detruites. Les lettres retenues peuvent etre abreg&es ou faire l'objet de modifications d'ordre redactionnel.
Reflections from the trenches of the trenches, I read with some amusement and more concern the views of Dr. David McCann, a recent graduate from the rigours and grinds of the internship (Can Med Assoc J 1989; 141: 968-969). I became a bit depressed at A
s a veteran
McCann's naivety and perplexed at how I and my surviving unimpaired colleagues ever emerged at least partially intact. As with most veterans, I know we worked longer and harder. Having survived, it follows that we were a lot tougher than our new colleagues. I also know that doctors are very likely to suffer more from the slings and arrows
of outrageous fortune. I also know that lawyers, bricklayers and air traffic controllers do too. McCann makes the common error of tunnel vision. No doubt when he is in practice for a while he will come to realize that all humanity is subject to these problems and that he and his neophytic colleagues are not unique. The education of a physician is tough, but so is our profession. As physicians we are constantly buffeted by multitudinous problems, and one of the things that we are supposed to learn while we are training is that we frequently fail. Anyone who can come out of a training program thinking he is God was simply not paying attention and, even worse, not learning. If, as McCann says, we allow ourselves to be put on a pedestal, it is a small pedestal indeed and probably cracked. Did he ever rotate through oncology or neurosurgery? McCann decries the fact that he had to postpone his various gratifications - the typical mind set of a product of our age of narcissism. Gratification is a very personal thing: some are satisfied with very little, others not. Certainly at his stage he should be gratified by the knowledge that he had the chance to become a member of one of the world's finest professions, that he graduated and that he will now be able to have more from the materialistic point of view than 99% of the world's population. It depends on your
perspective. Finally, McCann should ignore other people's opinions of him. He should be himself and make sure his own opinion of himself is a good one. The primary reason for all the problems of
the doctors that I know that become impaired is lack of selfesteem rather than overwork. "Physician know thyself' is the most important lesson McCann should have learned in his training. My prescription to McCann would be to put his training behind him, get an understanding wife to whom he can talk, play hard, read some books about the real world outside of medicine and - as I know he will - be an effective physician and, more importantly, an effective human being. Noel B. Hershfield, MD (Class of 1959) 711 South Tower 3031 Hospital Dr. NW Calgary, Alta.
[Dr. McCann responds:] I thank Dr. Hershfield for his comments but must take issue
with several points. First, Hershfield implies that the difficult lifestyle of a physician necessitates a tough training process, and this is certainly true to a point. Unfortunately, postgraduate training frequently takes this to a ridiculous extreme that is totally unwarranted and at times cruel. He further states that because his colleagues and he worked even harder 30 years ago that makes them "tougher". I disagree. I think it simply means they were unable to improve the system back then and had no choice but to submit. The current generation of physicians is not weaker than our more senior colleagues: we are simply fed up with the crap being thrown at us for little or no good reason. Does Hershfield mean to imply that because training was CAN MED ASSOC J 1990; 142 (8)
795
