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My father almost never went to the doctor. I think it stemmed from ideas of masculinity and not asking for help. In traditional Chinese culture, men are not expected to cry or show emotion, and a“ real man” doesn’ t need help. Growing up, I heard the idiom“ 男子汉”( nán zǐ hàn) constantly. It means something like a“ man’ s man,” one who is strong, resilient and most importantly, reliable. My father lived his entire life with this concept in mind. Subsequently, he was someone who only went to the doctor as a very last resort.
I don’ t know what happened that day he visited the ER, or what happened at the subsequent appointment. I was not there. I cannot speak to what his health providers saw, what they considered and why they made the decisions that they did. What I can say with any degree of confidence is that they were human beings working with whatever information they had and within whatever limitations they faced.
In times of crisis, the temptation to resort to blame is a very human response, one that I believe comes from a desire to attain certainty. Even the fleeting illusion of certainty through blame provides some comfort when one must wrestle with a staggeringly complex and painful reality. But it doesn’ t really help anybody, especially if we blame ourselves.
I blamed myself for not doing more to prevent my dad’ s untimely death – an excruciating cross to bear. However, coming out of that experience, I realized this: for everything that medicine can give us, it cannot give us certainty. There is nobody to blame because there are just too many factors that we do not and cannot know.
Medicine is asymptotic in practice: a profession that should reach for perfection, even if it knows it will never reach it. Every advancement in research and treatments moves the line slightly closer, but the gap never quite disappears. There will still remain the inescapable complexity of the human patients we treat.
In my current stage of medical training, we learn from an idealized version of medicine: through exam questions and patient vignettes with uncontroversial diagnoses and only one clear-cut answer. Unlike in real life, no patient ever lies to you on a question stem. The truth we begin to encounter in hospital and clinic corridors is much messier: overlapping diagnoses, incomplete histories, patient bodies that refuse to conform to textbook presentations.
Dr. Atul Gawande wrote,“ Medicine’ s ground state is uncertainty. And wisdom – for both the patients and doctors – is defined by how one copes with it.” That realization became painfully apparent after my father passed. I considered dropping out of medical school the following week. Every additional attempt to study only reminded me more of how my father died.
Instead, I took a leave of absence.
It was a difficult decision, but in hindsight, taking those six months was one of the best decisions of my life so far. In between moments of grief and healing, I deconstructed the reasons I initially wanted to become a doctor in the first place. I thought about cases like my father with tragic conclusions. But I also thought about the many instances I saw when the physician’ s clinical knowledge and the patient’ s willingness to participate in their own care align in just the right way. No other job in the world gets you close to that feeling.
My father’ s death did not make me abandon faith in medicine. If anything, it helped me better understand its limits alongside its power. We cannot promise a specific outcome or guarantee every critical diagnosis will be made. What we can promise is that we will learn relentlessly and deliver the best care possible, regardless of the constraints we face.
That day, there was a part of me that wanted to believe doing CPR correctly could bring back my dad. But I’ ve learned that medicine does not always work that way. I entered medical school believing that becoming a good doctor meant learning what to know and having confidence in what I knew. I’ m beginning to realize that becoming a great doctor means prioritizing the care of the patient above everything else, even the comfort of your own certainty.
Caleb He is a second-year medical student at the University of Louisville School of Medicine. He aspires to a career as a clinician-researcher in psychiatry with a focus on immigrant populations and culturally responsive mental health.
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