Op-Ed: Dismantle the Hierarchy in Medicine?

Op-Ed: Dismantle the Hierarchy in Medicine?

About a year ago, before the pandemic hit, I was at the local fitness center, having just completed a group exercise class, when my former residency program director entered the room. I hadn’t seen him in 20 years. He looked exactly the same, give or take a few grey hairs. We smiled and heartily greeted each other. We’d known each other since I was a medical student. When I did my rotation through radiology as a fourth year, he’d mentored me and encouraged me to pursue radiology as a career. His fervor for his work was admirable. He was young and enthusiastic, with a great smile and sense of humor. I wanted to stay local because my spouse had a great job in the area. He promised me a residency slot outside the formal match and he delivered. He was a hero to me.

But as happens to all of us when trying to climb the ladder of success, we get distracted and our interpersonal relationships take a back seat. Working with him during residency was difficult because his behavior was unpredictable, vacillating between friendly and cold. I began to see him as egocentric. Our special connection faded as I became another “cog in the wheel” left to fend for myself.

Seeing him again, unexpectedly and out of context, my heart started to race. My mind flashed back to my last year of residency when he’d been trying to get tenure and I’d been trying to pass my boards with a newborn. I’d gone to see him for career advice and he’d been short-tempered. All this time later, I felt that same wave of shame waft over me, remembering how inadequate I’d felt; how much I’d wanted his approval but never sensing I’d earned it.

My own insecurities didn’t last long, however, because very quickly, he opened up to me about what he’d been going through the past few years. He’s now in his 60s and had to retire early because of Parkinson’s disease. He’d worked for more than two years without telling anyone at the university hospital about his illness. Worse yet, somehow a neurologist had misdiagnosed him with ALS (amyotrophic lateral sclerosis/Lou Gehrig’s disease) and for more than nine months, he’d thought he was dying. The depression that followed was extremely dark and isolating, some

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