On becoming

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I've been thinking about Rainer Maria Rilke lately and what it means to be a doctor. In “Archaic Torso of Apollo” Rilke advised that in order to become something, one must change one's life. This slogan should have been emblazoned on all of my medical school pencils and notebooks, every professor should have started with it on the first Powerpoint slide, and instead of the Hippocratic oath as the culmination of our life-changing at graduation, we could have collectively recited this totalizing maxim as we received our degrees. To put it kindly, for many there is often a lag between the being and the becoming. One day, I was looking for a prescription pad in my pocket. I was taking care of an elderly poet, and I had to fish through wadded-up receipts, keys and change. My hands kept scrambling through the right pocket, then the left pocket, then back to the right. His response was devastating: he said, after a minute of this, “I fear for your poetry.” It was uppercut Rilke: how can one create anything out of such disorder? I announced myself as a mess. And this is not the place to itemize that mess: let me say that icebergs were in my pockets. But what about the being and becoming a doctor? I arrive at the office in a hurry, after dressing my daughter and scurrying her off to school. I look at my list and dread certain personalities who are neither being nor becoming; they merely are disorder. There is no open end to my day: I must finish in time to pick my daughter up. Then the evenings — oh, that they were filled with poetry or textbooks, with emotions recollected in tranquility, with edification or even love. But I admit it here: I stuff myself with reality television. And I think I have settled into the “be” of myself. Doctoring is, as William Carlos Williams has said, an essentially creative activity; and as I weave disparate strands into a narrative, as I suggest hope as a logical position, I wonder about the example part of doctoring: about the creativity of inspiration, not the other way around. If I were less overweight, would the lifestyle change I preach have more success? If I weren't sullen, would I lead my moodies out of their clouded vales? I recall the old Herman cartoon of the gross old physician counselling the obese patient that he needs to get more exercise. Everyone thinks that they could do better, be better, but many settle, despite this thought. Read Rilke's statement a little differently and it might be a warning. Listen to my old poet's statement with insight, as opposed to shock, and realize that he was saying, “I fear for you.” The receipts pile up, indicating a wasted life; the tide of patients is strong, but threatens to swamp my little boat of care; and as I am distracted, and succumb to these distractions, I begin to develop a fear of change. I do hear it as a warning, the very voice of experience is throttling me, saying See, See! Shane Neilson MD Family physician Guelph, Ont. Figure Image by: Fred Sebastian