Medical Madhouse recently commented that at least some of what is done by doctors is "F**king awesome" and added that in the heat of the moment we do not appreciate the awesomeness of the activity. (having made that attribution I can't find that comment on his blog site).He is right.
Further to that, when you retire from medicine the fact is that very little you routinely do is even in the same neighborhood as awesome. The intensity of the awe generating activities for most physicians may peak out in the house officer years, at least I believe that is true for internsts. For example, as a first year resident ( now called a second year resident) I treated 14 cases of DKA in coma.They all seemed to occur at night and in those days the first year resident ran the show. All recovered-one was apneic in the ER.In many years of practice I saw no DKA with coma, and in general the awesome incidence was much lower. Lower, but not absent.There was also more low key awe. Longer term relationships with patients, small victories and the occasional burst of awe.There is the satisfaction of doing things in keeping with current thinking in a given application and explaining to a patient why this or that approach might be best and having the patient actually do what you suggest and subsequently seeing that particular approach actually work. There is a bit of awe there. It is clearly awesome to treat an acute asthmatic patient and see their dyspnea lessened fairly quickly and to see the shortness of breath markedly improve in minutes with treatment of acute pulmonary edema. I thought it awesome to have several members of a law firm call for check up appointments because you had diagnosed atrial septal defect in their 46 year old female partner who claimed she couldn't have that because she had had 30 exams in her life and none had said anything, but she had it and she was operated. But....
I have recently been at my 1965 medical school class reunion. Many had retired and none of the retirees would admit they missed anything. No one talked about the awe of medicine.
(admittedly this sample is likely biased i.e. limited to those who retired and who go to reunions, while some or maybe all of the reunion non-goers may be euphoric or at least content at their continuing practice) But at least for a sizeable number of my class they could not wait to retire and miss nothing of it according to their accounts. Those who retired could only speak of the multiple negative effects of managed care and concern about malpractice. Many had been retired for 4 or 5 years having retired before age 60. The alumni organization had arranged lectures on various aspects of current medical education and those who spoke radiated enthusiasm and described exciting medical advances and I left that meeting supported by their energy.
The 1965 class dinner, though filled with handshakes and hugs and a few shared memories and seemingly sincere laughter, projected the picture of a group of people who were glad to quit and sad that the profession that seemed to offer so much a few decades ago offered them now no pleasure and little satisfaction and more than a little bitterness. I hope that the docs who don't go to med school reunions represent a different mindset.