Rheuminations: The Evolution of Identity Over Time

Even as the demographics shift and the tools of our trade evolve, a core ethos unites us. Whether in private practice or academic settings, in the U.S. or abroad, we are very much defined by our willingness to listen deeply, think expansively and engage humanely. Our collective identity is formed in conferences and clinics, in journals and coffee breaks. It is most definitely affected by new technologies, challenged by the ever-present burnout and refined through continuous medical education. In that sense, our collective identity is more than the sum of our individual identities.

Forty is quite a lot, but it is also a pitifully tiny number. This ambiguity gets to the heart of a major dilemma that people have been trying to grapple with since the beginning of time: Although we can count the number of days that we have lived, we cannot do so with any degree of certainty for the number of days that we will remain on this Earth.

This asymmetry and the anxiety associated with it can easily crowd out our sense of aspiration and ambition. Worse yet, it can compromise our ability to relate to the present. That’s why identity formation is so vital, because it provides a counterbalance to these natural anxieties. Identity formation places a mirror to ourselves so that those asymmetries seem less glaring, and we can return to being fully ourselves in the present, as bridges between the past and the future.

Or I could be completely wrong. Maybe when I am blowing out a half-century’s worth of candles in the year 2035, I’ll look back and say what an idiot I was at age 40 to write such things. Only time will tell whether this column stands the test of time. I for one, am looking forward to the revelation.

Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS, is the director of the rheumatology fellowship training program at the University of Iowa, Iowa City, and the physician editor of The Rheumatologist. Follow him on X (formerly Twitter) @BharatKumarMD.

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