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Why rheumatology?

I’m often asked why I chose rheumatology.

Well the answer is that I didn’t- at first. In fact during most of my internal medicine residency, I thought I was going to be a gastroenterologist.


Like any competitive GI hopeful, I worked hard on research, publications, mentoring, and even applied and interviewed for GI fellowships. It was during the application process where I had to write all about why I loved the field of gastroenterology so much that I realized that I really did not.


After this earth shattering revelation, I had to exercise some deep soul searching to figure out what I really was passionate for. Everywhere I looked, I saw exceptional heroes. The surgeon cutting out the tumor and saving the day. The cardiologist thumping the heart back to life like a knight in shining armor. The gastroenterologist stopping the bleeding like Spiderman with those sticky fingers.


Although mesmerized by the glitter of heroism, I knew I was looking for something different. The artist in me rejected algorithms and longed for creativity- for a kind of medicine that artfully designed a gown to perfectly fit an individual patient. My passion for mystery and puzzles also spoke up. I have always liked being a detective, finding clues where there are few to find, and solving the case. After all, it is an art.


It soon became clear to me that rheumatology had all the ingredients I was looking for. Since many of its diseases are so rare, it truly takes a dedicated detective to solve the case. By the same token, there are often no algorithms to lead the treatment- therapy requires artfulness in creating a regimen that works for that patient given their unique circumstances. I sometimes compare rheumatology to trying to solve a 50-piece puzzle, when you have only 10 pieces available to you. It takes some craftiness to get the full picture. And that is why I love this field.


And now, the field of rheumatology is evolving. New treatments have emerged for many of our diseases, and they have revolutionized treatment of these diseases. This has made my job even more exciting. Every day, when I figure out a disease that may have gone undetected for months, and artfully craft a treatment that dramatically impacts someone’s quality of life, I truly feel like a hero.