If you’ve ever been pregnant, you may recall the mental and emotional acrobatics of swinging hormones.  If not, just imagine turning suddenly and severely manic-depressive, while watching your body metamorphose on a daily basis into something unrecognizable and terrifying, all of it utterly out of your control.

I sat in the dining room of our new home, staring blankly at the warren of boxes to be sorted and unpacked.  Well into my third trimester with #2, I felt whale-like and exhausted.  My son was almost four years old, the center of my universe.  Suddenly, panic: What am I doing?  This is crazy!  How could there possibly be enough love for more than one?  I could not fathom loving any other the way I loved him, the single focus of my entire sphere of existence.  Thankfully, the moment my daughter was born, I immediately understood the true miracle of parenthood—love is infinite.  My sphere simply grew to an ellipsoid.  There was more than enough love, and space in my heart, for both of them and more, easily.

As physicians, we possess a similarly infinite capacity to love our patients.  Sometimes we have to work much harder to feel it, though.  Like parenting, the path of medical practice is not paved with lollipops and ice cream.  It’s more like an uphill dirt road with pits and grooves, erratic weather, and hairpin turns that make you dizzy and nauseated.  It can also offer astoundingly beautiful scenery along the way—like parenting.  Most of us come to medicine thoughtfully, and few could withstand the crucible of training without some enduring core of dedication and calling.  Parent-love feels innate, encoded.  You stick with it through the hard parts, driven by something primal.  Doctor-love, while also born of the internal and deep, requires more conscious intention to maintain.  This commitment feels far more vulnerable to external forces.  Physicians’ social and emotional exhaustion can lead to disengagement, hardening, and reticence to a system we feel impotent to change.  We get burned out, and everybody suffers.

When we dig deeper, though, and uncover the original reserves of humanity and compassion that first called us to this work, when we nurture and cultivate them, we find the love.  We not only survive, we thrive.  Everyone benefits—ourselves, our patients, colleagues, family, communities—we can literally save the world.  We can achieve this by reaching out, sharing stories, judging ourselves more gently, and withholding our negative judgments of others.

A doctor’s medical practice, like life itself, will go through phases.  The focus may change over time, and the fundamental mission remains the same.  Why do we do this work?  The answer holds the key to our fulfillment, if we can remember it through the hard parts.

Like parents, we physicians share the hard dirt road, and traffic can get heavy.  We can choose to ride alone, or with a cooperative group that takes care of its members, and doesn’t leave anyone behind.  We can share the vistas, take pee breaks, and pack healthy snacks.  If we build our riding tribes right, we can ensure that each of us has more than enough love for the journey.