After our customary tea and chit-chat, and a leisurely dinner, we gathered in the sitting room, arraying ourselves on soothing leather sofas, colorful floor cushions, and straight-backed chairs. Several of us were fortified with mugs of tea, and one or two watched over a stray cookie or brownie. The rules of the group were simple—each member was to have a turn, and no one was to interrupt, or give advice, unless solicited. There was no time limit or prescribed order for the speakers. One commentary often sparked another, dragging a forgotten morsel up to consciousness and segueing from one person to the next.
Our topic for the coming month was selected at the end of every meeting. Recently we’d discussed ‘difficult patients’, ‘difficult doctors’ (only fair, we thought, to do both), problems with our office staff, and all the ways our professional lives were beggaring our personal ones. After this run of downers, we needed a more positive topic: it was fun, and absolutely therapeutic, to vent and share the misery, to hear each other bitch and moan about how awful that person or that thing was–but we wanted to reclaim the spirit that held us here, in the trenches, in spite of all the fear and loathing. We thought ‘mentors’ would remind us of the reasons why we stayed.
Mentor, as you may recall from high school, was a friend and advisor to Odysseus who became tutor to his son, Telemachus, while Odysseus was away fighting the Trojan War (and finding his extremely long and roundabout way home afterwards). Athena, the goddess of wisdom, appeared to the youth in Mentor’s guise throughout The Odyssey to give him helpful hints, and Telemachus grew under this tutelage from a callow child to a strong and capable adult. Mentor’s name is now synonymous with a wise and trusted counselor or teacher, as the dictionary tells it. Given the sheer number of years we’d spent in school and training, and the throng of classmates, professors, and colleagues each of us had accumulated, how hard could it be to come up with a couple of wise and trusted teachers—individuals who’d shared their experience with us, who’d helped to shape and encourage us, from any stage of our career?
The amazing thing, and to me the most disturbing, was just how hard it really was. We all struggled, some more and some less, to come up with people who’d been positive role models. This was true despite having been given the assignment a month ago, and pondering it in the interim–and lord knows this was no room full of slackers! Not only that: when many members spoke, there was a hesitancy about whether the individual they described had really been a mentor, or just someone they found congenial in some way. It felt as though we were reluctant to commit, to name the experience as mentoring, for fear of being wrong, which would leave us unmentored, orphaned, and totally self-made. Only one of us admitted that she’d never had a mentor—this from a physician years in practice, esteemed by patients and colleagues alike, who now mentored others. How tragic, I thought, that we are so adrift and isolated and unsure.
Perhaps most surprising to me was the near-complete absence of positive influences during medical school—the period in our long careers when we are most malleable, most enthusiastic, and most willing to learn. Several of us had been mentored by people prior to medical school, often a physician-parent or family physician who’d taken a particular interest in them at an early age, and several told of people they’d encountered during residency or once out in practice. There was the family practitioner who’d been encouraged to go into medicine by two family docs from his hometown he’d known since early childhood, and the woman who still views her father, now a colleague in family medicine, as a sounding board and source of wisdom. And the neurologist who’d finally—and happily–found a senior colleague to challenge him and test him, and model sincere and sweet compassion for his patients, unafraid to speak his mind and do what’s right. One member, an oncologist, spoke of a resident who’d inspired him to care for cancer patients and their families—a path filled with loss and heartache, but also love and empathy. An iconoclastic family doctor who cared for indigent patients recalled a bilingual mentor devoted to his Spanish-speaking patients, who worked punishing hours and was never unavailable, a role she herself had now assumed.
The common traits or behaviors of the mentors we described were not mysterious or magical—they were caring and not afraid to show it, they were ‘good’ with patients (a subjective quality, eluding definition but easily recognized, much like pornography), they were skilled clinically and technically, and they were patient with trainees. They made themselves available, encouraging and challenging the ‘mentee’ to grow and learn.
One woman, a gynecologist, commented that some of her mentors had in fact been nurses, not other physicians. A male group member expressed surprise, stating that in his experience nurses were cruel to female doctors. At first this did not resonate with me, but on reflection I realized I had seen this, many times. It was the female docs or med students who were the prettiest, and the ones who threw their weight around (like so many male doctors did—and do), brusquely ordering the nurses about, who received the worst treatment. I recalled one RN commenting to me, after being treated dismissively by a female resident, that it was bad enough she had to put up with that from the men, but that ‘women should know better’—the betrayal was heavily tinged with disappointment. Some nurses may also feel that female doctors were, by choosing medicine instead of nursing, denigrating their own choice and somehow labeling them as ‘less than’. As for ill-treatment of the most attractive female students and physicians, well, many of the younger nurses were single and may have viewed them as competition.
The saddest realization of the evening was that so many ‘anti-mentors’ sprang readily to mind for each group member. These were the evil ones, the residents who pilloried us for not knowing some obscure and useless fact or lab result, the attendings who yelled at us in the ERs and the ORs and the patients’ rooms, the professors who preferred to hole up in their research labs and couldn’t be bothered to teach effectively, the rogue colleague who engaged in passive or active sabotage to advance his or her own interests. Nearly everyone felt a pressure to discuss these anti-mentors, to paint the harsh and angry pictures that were so much more vivid than the soft pastels and muted oils of the mentors we’d gathered to honor and remember.
How sad for medicine that we do this to each other, that we torture and exploit and demean, that we have not moved beyond hazing and initiation to a nurturing, cooperative, and beneficial system. How sad that we recall so much more easily the horrors we have suffered than the moments of connection, joy, or discovery. And how sad that we must struggle with these wounds as we seek to heal our patients, to nurture them, and ease their sufferings.