Tuesday, August 15, 2006

Playing the Part

The way doctors are created has always fascinated me. It addition to the mastery of information we expect young physicians to create a role of "doctor" and play it perfectly. I wrote this piece when I was an intern:

It is strange to watch myself from inside myself while at the hospital. It is like watching an actor play a part. The element of acting is thrust upon me. There isn't supposed to be such a thing as a fearful, unknowing doctor so interns first learn the art of taking on a persona cool confidence while panicking inside. "Dr Whittemore, your patient is having trouble breathing." I think, "Oh shit, this man needs someone better than me!" but I never say it. I stay in character. "Get an ABG! I'm on my way," I say calmly. I always arrive smiling and keep smiling no matter what happens. Patients don't like it when doctors show fear. Never let them realize this is the first time you've taken care of this.

In addition to the general requirement that young doctors be actors, I have written a particular flare into my character. He is the gentle, happy healer. I play him quite convincingly. I like this character and so do my patients. The nurses too seem quite charmed. I can keep cool in a crisis and then hug all the nurses and thank them quite naturally. Then I hold the patient's hand until she is laughing and chatting like she doesn't have lines and catheters all over her body. No matter how sleepy, terrified, or angry I become I never break character.

It is strange to watch this character. He must have been stolen from the kindly old "Doc" in some movie or TV show. Overall I like him: somewhat simplistic, but overall good-hearted and humanistic. He may resemble what I might want to become, but he is most definitely not me. He comes out of a script; he is not an expression of who I am today.

I am realizing I act a lot these days. At home I sometimes even play the part of the "good husband," a character not too different from the "good doctor." I suppose I have less acting to do here at home because I really do love and admire this woman. But there are the unavoidable times when love and admiration are not as strong and the best thing to do is stay in character. I know the part well because this character is actually based on myself on my better days. I remember all the lines because I wrote them.

Suddenly this week I am aware of myself as an actor, because I suddenly find myself off stage and out of the heat of the spotlight. Joy is out of town so I have time alone.

I have forgotten how it feels to be alone. The actor is at a loss for who to be with no audience present.

Years ago when I never acted. I was myself. The man you saw or spoke to was more-or-less a true representation of my inner self. There was the freedom to not be good, or wise, or stable. Any desire for goodness, wisdom, or stability naturally required me to examine and improve my mind and character.

Now I find myself having taken on so much responsibility. With responsibilities come expectations. People trust me with their lives when they are ill and far more experienced professionals must obey my orders. These people expect us to behave in a certain way. This job demands acting. I cannot "just be myself" on a bad day. I have to be what those who depend on me need me to be. As an intern the character you must play wears a confidence and knowledge that hides abilities still lacking. As a family practitioner the role also calls for a level of warmth and trustworthiness.

I have become quite an actor out of necessity. I will act out the good doctor in order to become one. The funny thing I have found is that it is much easier to act than to be. So on the days I come home too tired to be a loving husband I still have the strength to play him convincingly. Acting is not wrong –everyone has to occasionally act the part to live up to our responsibilities. However, when you act as much as an intern you replace personal growth with improving your acting. Now to improve myself –my confidence, my goodness, my stability– I just adjust the character I play. No internal changes are needed because the internal never reveals itself.

And then comes a week of solitude. I spend nights of silence and feel suddenly at a loss without a part to play. I used to love to be alone with my thoughts. I used to read and think through my emotions, beliefs, and actions. But I find myself devoid of any emotions, beliefs, or actions at all.

I have been acting so long that I have forgotten how to speak without a script. I have forgotten how to play myself.