I swore I would never become a psychiatrist

I entered medical school with one thing certain: I did not want to be a psychiatrist like my father.

I’m sure someone like Freud could come up with a deeper therapeutic reason why I didn’t want to follow in my father’s footsteps. Or, maybe I could ask the surgeon who belittled me as a medical student and asked me, “Will you go into the same field as your father?” while looking blankly at me holding the reteractor during the operation. But all I can find is that my father’s shoes are big, and I was afraid to try to fill them. It was like a goal I would never reach or a competition I would never win. And I don’t like to lose.

However, don’t get me wrong, I have a lot of respect for my father. He is an expert in his field of addiction and a researcher with hundreds of publications to his name. Many people at my medical school knew him because he trained there. Once, I went to an addictions meeting, and someone saw my last name on the name board and asked me if we were related. I tried hard to deny it, but apparently by protesting, my mannerisms, humor and sarcasm made it even more clear that I was my father’s daughter.

Avoidance, to me, felt like the safest tactic. Fascinated by the brain, I tried my best to branch out into neuroscience. When I was in medical school, I joined a neuroscience group, sought out brain consultants, and did brain research. But I always felt very happy when I could talk to the patients and hear their stories. Even when I had to focus on something or do a tricky test, I just wanted to pull up a chair and talk to patients about their lives.

I remember, during my third year internal medicine fellowship in medical school, I cared for a patient named Rosa, a 75-year-old woman with progressive chronic obstructive pulmonary disease ( COPD), progressive lung disease. Every morning at 6 am, I would go into his room and ask him, “How are you doing this morning?” He would smile, apparently not caring that I woke him (unlike the patient who taped a note on the hospital door that said, “Do not disturb the patient until 6 a.m., especially the students of medicine”). Without skipping a beat, she always said, “Hello, Cookie.”

I found his greeting sweet; it made me think of my grandmother, who like Rosa also loved red lipstick and talked about her grandchildren.

One morning, my medical team found a page: “East Pavilion 5-512. New chest pain. Please come and check it out for yourself.

“That’s Rosa’s room,” I said out loud to no one, as the group had already gone up the stairs to see her. As we got closer, I heard the sound of her cry – weak but urgent.

As soon as I was in her room, I locked eyes with Rosa, who looked nothing like she had a few hours earlier, when we were joking. Now he was crying and sweating, almost like an uncomfortable child, begging someone to listen to him. In fact, he was shouting for someone to listen.

Residents insisted on completing a routine chest pain assessment, removing his top coat and attaching the electrodes of an EKG machine to his deep chest to determine his heart rhythm. Another person came in for a blood test to see if he had elevated troponin, a protein that rises when the heart muscle is damaged. Someone ordered a chest X-ray. No one noticed that Rosa was upset that her chest was exposed. No one made any attempt to hide him.

I was in the corner of the room, out of sight of everyone, watching the scene unfold like following a list of “what to do for chest pains.” At each step, the residents told me – I was the only medical student in the room – what they were doing. They wanted to teach me something, even in the controlled chaos of an emergency, and I wanted to take it all in. But I couldn’t stop looking at Rosa’s face.

Suddenly he coughed, which caused him to pierce his ear “Oh my God,” while looking at the ceiling, it is possible that he was praying to God. He spoke English well, but now the only words that came out of his pain were Spanish. Sometimes there is safety and comfort in one’s own language.

I felt a pit in my stomach, and I took it as a sign to do something. Ignoring the unspoken rules of medical professionals, I ran to Rosa’s side, making sure not to get in the way of the real doctors. Then I asked him to let me hold his hand, and he nodded. I also rearranged her outfit so that her chest was not exposed, again being careful not to interfere with the group’s plans. After that, I leaned towards him so that we were at eye level, and quietly whispered, “It’s going to be okay.”

Rosa replied, “Thank you, Cookie, for taking care of me.”

I immediately felt protective of the group, knowing they cared too, but as I looked around the room, I noticed Rosa’s point. It wasn’t as if there was anything wrong with these doctors, or at this well-respected teaching hospital, or that anyone was doing anything wrong. They were all trying to save his life. But in the chaos of beeping monitors and diagnostic measures, they forget it’s someone they’re saving.

I couldn’t stop seeing that person, in this case Rosa. I wondered if in the future I would be able to pull myself together as my colleagues seemed to be able to. And at the same time, I wasn’t sure that I wanted to do that.

Maybe that’s what drew me to psychiatry. It is not only a field where patients feel seen, but inside it I felt seen, too.

Quoted in “How do you feel?: Another Doctor of Humane Research in Medicine” by Jessi Gold. Copyright © 2024 by Jessi Gold. Reprinted with permission from Simon Element, an image of Simon & Schuster, LLC. All rights reserved.

Jessi Gold, MD, MS, is the chief health officer for the University of Tennessee System and an assistant professor of psychiatry at the Tennessee Health Sciences Center.