Dr. Lesko: The moment I knew medicine was my calling

AMA Wire
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Physicians are privileged to see patients at their most vulnerable, to reshape lives and continually revitalize the nation’s health system. In a challenging practice environment, physicians remain driven by the power of healing and the indelible connections they form with patients and families.

The AMA Wire®When I Knew Medicine Was My Calling” series profiles a wide variety of doctors, offering a glimpse into the lives of the busy women and men navigating new courses in their careers and in American medicine. No matter their age, their specialty or their career stage, they were born to do this and they tell us why.

Share a moment with: Joshua Lesko, MD, U.S.  Navy flight surgeon, San Diego; delegate to the AMA Resident and Fellow Section; chair of the AMA RFS Legislative Advocacy Committee.                                                                                                      

I was born to: Blaze the trail.

The moment I knew medicine was my calling: In the summer before my senior year of high school, I shadowed an electrophysiological cardiologist. One day, I got to observe an open heart surgery. While standing at the head of the bed, I received a face mask full of blood. That was when I knew I wanted to be a doctor.

An experience from residency that confirmed my calling as a physician: Rotating through the trauma and medical ICUs as an emergency medicine doctor, you get exposed to all of the extremes that the human body can endure. In these cases, it often falls to the patient's loved ones to make the care decisions, and being there to help them make the best decisions for the patient is one of the most fulfilling aspects of being a doctor.

An experience from medical school that kept me going: The change from the preclinical years to the clinical is the breath of fresh air needed just when you feel like you are about to drown. It is so easy to lose yourself in the constant reading and studying that so define the first part of med school, but when you finally make it onto the wards and into the clinics and begin to apply everything you have been committing to memory, it  makes it all fall into place.

My source of inspiration: My biggest inspiration is, easily, my parents. They both are working professionals who have dedicated their lives to their respective fields and have been great examples of hard work paying off.  They never pressured me into medicine; they simply allowed me to push myself and then gave me the latitude to chart my own course from there.

My hope for the future of medicine: I want to see a future where doctors can care for their patients without fear of anyone else interfering with the relationship. Our entire profession has been hamstrung by regulations, requirements and restrictions from people who largely do not understand everything that medicine entails. We are by no means innocent, either. Too many doctors shy away from actively working on policy and legislation, and as a result, we have ended up where we are today. I would love doctors to be at every table where medical decisions are made.

The hardest moment in medicine and how I got past it: Honestly, the hardest part was facing the rejection of not getting into medical school the first time I applied. It was a big ego check, and I came out stronger for it, but I really had to re-evaluate my approach, my background, really everything about myself to make sure that this is what I wanted to do. The rest--studying for all of the exams, moving into clinical medicine first as a student and then as a doctor--all built upon each other. If you've done your research, none of it should come as a surprise. That first round of rejections, though, was definitely not in my original five-year plan.

Favorite experience working with the medical team:  As terrible as the circumstances surrounding the situation are, there is nothing quite like working a code or trauma alert with a well-functioning team. When everyone is in sync and knows their roles, the area immediately surrounding the patient is a calm, effective oasis in the chaos. Every call is different, and everyone has to be simultaneously able to react to whatever comes our way.

The most challenging aspects of caring for patients:  Everyone at some point will encounter a patient who is there trying to game the system, for any variety of goals, and it can be difficult to give them the same care as a patient who is in legitimate need.

The most rewarding aspect of caring for patients:  More so than being able to completely resolve a patient's complaint, oftentimes just being able to provide them with answers is enough to improve their situation. I have had a number of patients who have been bounced around seeking any sort of forward progress, and you can just see the look of relief in their eyes when they finally get an answer. When we can do something about it, so much the better, but it seems like the not knowing is worse.

The skills every physician should have but won’t be tested for on the board exam:  The ability to communicate with a patient on their level so they can understand and become an active participant in their care, is vital.

One question students should ask themselves before pursuing medicine: Why do I want to be a doctor?

A quick insight I would give students who are considering medicine:  The advice I give every medical student, every prospective applicant, is to find something outside of medicine that is just for you. It is so easy to lose yourself in being a doctor. Everyone needs a stress-relief valve of some form, and it is much better to have it when you start the process than try to discover it later on.

Song to describe my life in medicine: "The Road Goes Ever On."

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