My Day Job

For the longest time I was vague, if not silent, about my day job in case my wife stumbled across this blog -- so she couldn't prove it was mine (long story for another time). But since I've been outed, I can be more forthcoming.

I am a medical dosimetrist. These days you can actually major in that at some schools, but most of us have degrees in physics or biology if we have a degree at all -- many don't, having come through a series of technical programs. Me, I have a BS in physics, and I stumbled providentially into a field that makes good use of my background without requiring me to do any actual physics.

So what do I do? For a given patient, the radiation oncologist will determine where the tumor is (or was) and might be and will tell me how much radiation he wants to give those areas. My job is to determine how to deliver that radiation to the tumor while minimizing the dose to normal tissues.

That is the fun part and, often, the hard part because many types of cancer cells are much harder to kill than normal cells. For example, lung cancer is typically given about 70 Gray (Gy); healthy lung dies at less than a third of that, 20Gy. When the tumor is nestled up between the heart, cord, esophagus, and lungs, it can be difficult to get enough dose to the tumor (and sometimes we just can't).

This job gives me a great way to help people without getting yucky stuff on my clothes. It can be very difficult, but it often allows me to be very creative. But the hardest thing about the job is not the work but the people. Specifically, doctors.

Talk to anyone in health care and you'll get pretty much the same response: "It'd be a great job if it weren't for doctors." That's not to say some aren't great. I've worked with some doctors who are absolutely fabulous people. But there are an awful lot of doctors who have extremely exaggerated opinions of their own importance and staggeringly low opinions of everyone else's. Theories abound as to why, but a lot of physicians (in any specialty, not just mine) are just jerks. A lot of doctors are just plain folks, but a lot of doctors think doctors are more valuable than human beings.

Why do I tell you this? Because I think it's why I'm in health care.

I said I think I stumbled across this field providentially, and I think part of the reason was to teach me submission.

You see, doctors run health care. Non-doctors -- whether they're nurses, accountants, lawyers, or policemen -- all report ultimately to a doctor. And doctors tend to stick together. So they have all the political power. And they know it.

So if you work with a doctor who is kind and humble and reasonable, you're lucky. And if you work with one who is arrogant, abusive, or a little stupid*, you're stuck.

And so I have to learn to take requests from thoughtful doctors and demands from nasty ones as if they were delivered the same way. I have to offer my ideas to doctors who will listen and carefully consider what I have to say and to doctors who will disregard me simply because I'm not a doctor (for the patient's sake, you have to try). And sometimes I have to work late on a case for a doctor who will be very appreciate of the extra effort, and sometimes it's for a doctor who believes I should be honored to be in the same room as him.

So how's learning submission going? Yeah, I'll get back to you on that. It's not easy. It's not fun. It's not pretty. But in the end I think I'll be more like Jesus than I would have been otherwise.

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*What do you call a guy who graduates at the bottom of his medical school class? Doctor.