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According to recently published doctors' autobiographies, some of the motives for choice of medicine as a profession are the desire to follow a family tradition;
compliance with, or defiance of, parental wishes; the challenge and mystery of medicine or the lure of solid facts; and, finally, the desire for prestige and an adequate income. The motive generally accepted as primary is the desire to relieve suffering and preserve life.
Besides these conscious motives, unconscious motives must be sought to account for perseverance and success in the practice of medicine. Some possible unconscious motives are the following: benevolent or hostile identification with the father or father surrogate, a wish to please the mother, or identification with the mother as the healing member of the family. Other unconscious motives may be the need to atone for aggressive impulses, and curiosity about the body, originally the mother's body.
The author considers psychological factors in the choice of various medical specialities. Pediatrics affords opportunities for 'proxy mothering'. In obstetrics, curiosity about childbirth and identification with the delivering mother may be expressed. Proctology, besides offering obvious gratification to the doctor with interest stemming from the anal phase, may offer him, in our fastidious culture, a kind of humility. The doctor who has little guilt over his sadism, so that he may sublimate it efficiently, may find satisfaction in surgery. Men drawn to psychiatry may, through their work with lonely people, be attempting to handle a repressed feeling of loneliness in themselves. Psychiatrists who are zealous to refute the idea that mental illness represents a punishment for forbidden impulses may be attempting to deal with their own early fears. Interest in medicine is, however, much more than an attempt to express infantile aims and overcome infantile fears. It is autonomous and may arise from a mature belief that people can be helped.