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“By the end of medical school, most students tended to focus on "lifestyle" specialities - those with more humane hours, higher salaries, and lower pressures - the idealism of their med school application essays tempered or lost. As graduation neared and we sat down, in a Yale tradition, to re-write our commencement oath - a melding of the words of Hippocrates, Maimonides, Osler, along with a few other great medical forefathers - several students argued for the removal of language insisting that we place our patients' interests above our own. (The rest of us didn't allow this discussion to continue for long. The words stayed. This kind of egotism struck me as antithetical to medicine and, it should be noted, entirely reasonable. Indeed, this is how 99 percent of people select their jobs: pay, work environment, hours. But thats the point. Putting lifestyle first is how you find a job - not a calling).”

“My fellow resident Jeff and I worked traumas together. When he called me down to the trauma bay because of a concurrent head injury, we were always in sync. He'd assess the abdomen, then ask for my prognosis on a patient's cognitive function. "Well, he could still be a senator," I once replied, "but only from a small state." Jeff laughed, and from that moment on, state population became our barometer for head-injury severity. "Is he a Wyoming or a California?" Jeff would ask, trying to determine how intensive his care plan should be. Or I'd say, "Jeff, I know his blood pressure is labile, but I gotta get him to the OR or he's gonna go from Washington to Idaho---can you get him stabilized?”