The Dark Side

Growing up, I was exposed to an upper middle class lifestyle with a lot of perks. My brother and I enjoyed back stage passes to big rock concerts, exclusive dinners for the US Gymnastic Olympic Trials, condos and skiing at Deer Valley, and even a vacation to Disneyland. The perks were all due to my father's job. While he was schmoozing with execs, we knew to be on our best behavior and still have fun. It was a love/hate experience. It was a lot of fun but it just felt, well, phony.

When I tell people I'm married to a doctor, a set of assumptions pop into their heads. They assume there is a lot of money for one. I should set the record straight here that during all of J's training I was always the breadwinner when working full time. This is very difficult to do when you are a social worker. Social worker, folks.

Furthermore, not all medical practices are reimbursed equally. Here's a good rule to follow: procedures to bill = money in the pocket. This is why surgeons, radiologists, gastroenterologists, etc, make quite a bit of cash. Your general primary care doc, you know, the one you go to when you have green snot, vomit, and odd chest pain? Yeah, that one? They make next to nothing. Another good rule to follow is to follow market demands. If pharmaceutical companies, bio tech industries, and medical equipment organizations have something to market then that specialty generally earns more. Palliative care doctors (aka Dr. Death) don't exactly spawn repeat customers from the drug companies. They also function as general practitioners in the last stages of life.

It is a bit annoying when people assume so much. Doctors have not had a income adjustment to the quality of life since the 1970s, but school costs have risen significantly. Our student loans are the equivalent of a second mortgage. Needless to say, I will not be the country club wife, with hobbies of shopping and lunching, and tennis lessons. And you know what? I am way ok with that. I am actually quite proud of J's choice not to sell out and be seduced by the dark side. He is staying true to the roots of medicine; serving those who need care and being ethically aware.

Last night one of J's friends from medical school was in town for a conference. He chose a different path: Radiology oncology. These are brilliant individuals who like physics theory and the human body. They are not well known for their human relation skills. J's friend invited us down to the hotel where a talk was just finishing up. Something about proton accelerators and chest wall tumors. We grabbed a free Sam Adams and excused ourselves from the break-out session to catch up.

As this session was ending, Dr. Rad-Onc suggested we catch one of the other parties around town: the aquarium, science museum, or museum of fine arts. I had to pause for a moment because with my profession I'm just grateful for a continential breakfast at one of my conferences. Here the sponsors have enough in their advertising budget to rent out several huge attractions for a private party, have it catered, free bar, and live entertainment. What is ironic about this is that these individuals have enough money to pay for admission to these attractions and yet companies shell out big bucks for them.

Typically we avoid all drug rep dinners. The "educational component" are an exchange for the free steak and wine. Its product pushing by college grads who do not know how these chemicals work but are taught the "research" that was sponsored by the drug companies in the first place. Are you really going to think about that drug when prescribing because it is in the best interest of your patient or because its in your memory from the dinner?

Right or wrong, we headed with our friend and his growing entourage to the aquarium. What I first noticed was my incredible concern for the penguins. Here they are tired from being gawked at by children all day long and now they have a sound system pushing baselines into their faux ecosystem. Poor guys! They just want to sleep and instead Phillips, yes the electric light bulb company, is pushing their new MRI/gamma ray/technology gadget, and have taken over their habitat. We had drinks, a flight of nations hors d'oeuvres and wandered the usual $20-something admission attraction. We hung out there for awhile and then went to the science museum. There the reception was catered by Wolfgang Puck. I never did find out who sponsored this event. By 11:00 we were saturated, morally conflicted, and tired. I was more than tipsy. It was time to go.

Dr. Rad-Onc invited us back to crash another party tonight sponsored by someone else. The dark side is quite alluring, but I think we'll abstain. While I know that the big wig companies don't feel the financial impact of me crashing the party and having 2 glasses of wine and a small plate of dim sum, but I feel it in my soul.