What would be the best area of medicine for a doctor that moonlights in fighting evil to specialize their career in to deal with unexplained absences?

Question

I have a character who is involved in the typical, secretive supernatural shenanigans of my setting (think something like a superhero, a monster hunter, or the vampires in Vampire: The Masquerade) but has a day job as a medical doctor in a Western country. Being a doctor is their main job, as their supernatural work is mandatory (they have no choice in the matter) but doesn't pay anything. The supernatural is also not medical-themed in this setting so it is not like they are doing medicine by day and fighting plague demons by night that might lend them to a particular area of medical specialization.

The problem with being a medical doctor is you often have long hours and you don't get to choose when you get to work. Sometimes you have to work ER or operating room shifts and if you live in a small town and are the only doctor you will get called in every time there is an emergency, even if you are a general practitioner. And before that being a med student often demands long hours and work in very difficult positions.

At the same time, you can't ignore the plot when it comes calling if you are a superhero, monster hunter, etc. People will die if you're a doctor and don't operate on them, but they will also die if you ignore the supernatural nonsense that is killing and eating people. While that conflict makes for good tension in small doses if it happens often enough you have to wonder how the character keeps their job, especially since doctors can get in big trouble if they don't fulfill their duties enough times.

On the other hand, the character wants and prefers to be a doctor, despite being drafted into dealing with the supernatural (which they don't like), so the character is unlikely to say "well, my life situation prevents me from having a career in medicine".

This is a common trope for people living a double life in supernatural fiction (e.g., Spider-Man and Daredevil have this as chronic issues), but I've never seen it done with medicine.

I'm trying to figure out what branch of medicine would be the best one for this person to be in, given they already have the commitment of dealing with supernatural issues before they even enter medical school. I.e., what branch of medicine/medical career would be the most amenable for someone hiding a supernatural secret and occasionally having to take unexplained absences?

I'm asking this here because there isn't really a good real-world analogue for "doctor has to moonlight by fighting evil". About the closest I've been able to find is when doctors have chronic health issues, but having talked to IRL doctors usually what they do in these cases is power through the health issues and do the job anyway. For most doctors I've talked to practicing medicine is often the first and primary concern. This is a case where issues come up that the character simply cannot back-burner for the sake of their job.

Answer 1

Pathologist:

This field of medicine often involves a lot of time in an office looking at tissue and other THINGS that get pulled out of people. You diagnose cancers, rare diseases, and the like. There are a LOT of tests involved, but the pathologist just orders them - they don't do many real-time tests.

Further, of all fields of medicine that I've seen, they require the least direct patient care. Often they hand down pronouncements from on high that the regular doctors then need to deliver. The good ones talk to patients. The bad ones get away with not doing it because it isn't required.

The work that does get done is often not on a specific schedule. I've watched many pathologists keep strange hours late at night and on weekends to cover their needs. So if your pathologist keeps weird hours but gets all his/her work done, no one really cares that much. Certain specific things in hospitals might require a pathologist to be available and on-call, but pick and choose the position and that need can be avoided.

Further, if there is a masquerade to maintain, then all the dead werewolves and vampires show up in the morgue where - you guessed it - a pathologist is usually performing the autopsy. The report can just gloss over the unimportant details of the pronounced overbite and fangs, and focus instead on the gunshot wound and silver knife protruding from the chest (did I say silver? No, that was steel...).

Some places have special vehicles or parking passes for people who work in the coroner's office. They are kind of part of the team responding to crimes. No one questions if a coroner is at the scene of a death. Wow, how did you guys beat the ambulance here?

So if you need a doctor's job where they can disappear at a moment's notice and no one so much as blinks, where they have their hand controlling medical reports that might embarrass the powers-that-be, keeping nocturnal hours if required, then nothing beats a pathologist.

• PS. Telling everyone you volunteer for Doctors Without Borders can explain those sudden long absences where your character is unavailable helping somewhere in sub-Saharan Africa out of reach of cell phones. As a pathologist you can say you are using your specialty at any time. Sorry, I'll be gone an extra week. I was exposed to ticks infested with the newest fever in Madagascar and have to isolate.

Answer 2

Personal Physician

Having someone whose health they are personally in charge of would naturally take priority over a general practice as well as provide an excuse for for failing to answer a call. Better yet, if their charge was (or believed to be) wealthy, the priority could be explained as a means to fund the general practice.

Answer 3

Short Term Locum

Your hero works as a locum doctor. They take short term contracts of several days or weeks across different hospitals. They usually end up replacing someone else who got a minor illness like the flu or bitten by a dog.

Switching hospitals is a good way to keep a low profile and stop people noticing irregularities in your work schedule. Wikipedia says there are thousands of locum doctors in the UK so this is a normal thing to do.

In the middle of crime season they tell their locum agency they are not taking any more contracts. The agency doesn't care. It has thousands of other doctors to find places for.

Which specialization is best -- well whatever one leads to its doctors getting sick most often!

Answer 4

Toxicologist/herpetologist

Q: Why the 3-week absence, fang scars, and mysterious vials in your office?

A: I had to fly to Sydney, track some taipans for a few days, then extract their venom.

Answer 5

Hospitalist.

https://www.hospitalmedicine.org/about/what-is-a-hospitalist/

What is hospital medicine, and what is a hospitalist?

Hospital Medicine is a medical specialty dedicated to the delivery of comprehensive medical care to hospitalized patients. Practitioners of hospital medicine include physicians (“hospitalists”) and non-physician clinicians who engage in clinical care, teaching, research, and or leadership in the field of general hospital medicine. Hospitalists manage and treat a significant range of complex and comorbid disease conditions. Hospitalists typically undergo residency training in general internal medicine, general pediatrics, or family practice.

Hospitalists are usually internists and they work shifts. When it is not their shift they don't get called. Also they can pick up shifts as they choose; hospitalist work offers flexible hours and so is attractive for a new mother or physician who has other life committments, including fighting evil. Hospitalists are also largely interchangeable and will hand off their patients at the end of a shift to an incoming hospitalist. I can imagine your character's long suffering coworker who covers the patients when your patient must abruptly leave to fight evil.

All this is true for emergency medicine docs too but I feel like the emergency room has been done a lot. The hospital is relatively unexciting.

Answer 6

Psychiatry

Doctors of psychiatry have medical degrees (because they can prescribe medication).

A psychiatrist can have their own private practice, which then gives them some flexibility to pick and choose their patients, which is important for your hero because psychiatric problems can indeed cause urgent, life-threatening emergencies; having a private practice will give her the ability to avoid taking on any patient whose troubles are likely to lead to that kind of emergency.

Of course, a private practice doesn't have to be a one-doc affair; she and a few colleagues could form a practice together (or maybe she joins one that already exists), and she could redirect those problematic patients to her other partners. (Probably some quid-pro-quo would need to be worked out, otherwise she's just cherry-picking the pleasant cases.)

Practicing psychiatry has a few semi-unique benefits, one of which is that it can technically be performed anywhere -- anywhere that the doctor and patient are both comfortable. It does not generally require specialized equipment that might tie the activity to a specific location. She may need to keep a scrip pad in her overnight/crime-fighting bag, but I think many real docs do just that.

It doesn't even have to be done in-person: some patients might be satisfied with a video call, audio call, or just a text, depending on the circumstances. Your hero will have to use her best judgment, of course: just because a patient says they are willing to settle for text message, that doesn't make it true. If she is good at her day job, she'll develop a feel for this.

And psychiatry really does help people. Not everybody needs a therapist, and not everybody can be helped by just a therapist, but when you need a therapist, only a therapist will do. A good shrink can save your life.

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For the author, there are some other advantages. Psychiatry went through at least one period of heightened cachet in the real world, which means your hero can be highly respected or regarded as a quack, or both! -- whatever suits your needs.

If your hero gets lucky and manages to help a patient who is particularly rich or famous or influential, it could make her career. She could end up with a long waiting list of people who wish to be clients, which will allow her to be more selective and also charge more for her services. She could write a book and use the proceeds to fund her supernatural work. These developments can occur at practically any time that is convenient for your story.

Psychiatry is also pretty intimate, so the social connections made with patients will be strong. Again, if any of these patients are important, they might open doors for your hero that might be impassable otherwise. "Friends in high places" is a very convenient deus ex machina.

Shrinks also get to dress right instead of walking around in lab coats all day. If yours is a visual medium, this means you are not denied the use of personal wardrobe as a way to develop her character.

Answer 7

Unless you want them to be a surgeon constantly leaving patients on the operating room to save lives. Unless that then it's doable.

But the trick is not their field of medicine but their boss.

Think about it. Working for a normal hospital will seriously conflict with their life style as you figured out. But also trying to grow a personal practice, like a private clinic, would still have issues. If you are unreliable then what's the point?

So. What is the solution?

Avoid life or death fields

Optometrists, dentist, otolaryngologist, dermatologist, neurologist...etc. Basically any field in which you can cancel an appointment and your patient does not just die. The patient can get their teeth cleaned later, skins conditions are not a joke but again they are not waiting for you to operate on them.

Better still. Make the doctor specialize in a field in which they have to do a lot of research. Rare diseases anyone? Kinda like House. So. Your doctor can ponder over the rare condition that the patient is having while they drive to fight the monster of the week.

Logistics

It's rather simple. If you can hook them up with a sort of a connection to the underworld that can get them a job in a hospital or similar place without having them follow the rules then you know what to do. Maybe they uncovered the truth about a conspiracy against a big vampire. The vampire just happens to have good connections with a hospital, because they have to get human blood without killing people for example, and to repay them the vampire made it clear that the doctor practices medicine on their own terms. Unless they bring a machine gun and shoot people, nobody dares bother them.

The same can be done with a private clinic. If they just make one with a couple of friends and possibly provide funding or other big contribution in exchange of being able to simply leave if needed.

Again you can connect it to their supernatural life. Maybe they acquired a nice downtown property while they are fighting the supernatural. Then they got together with a couple of doctor friends and sat up the clinic in part of the property. Maybe it's one of those old places with like gargoyles and stuff. And if you are adamant about that life style not paying off. You can justify it by that fact that their ownership is cursed. They can't sell the property, and they can't rent it. Or they can use some sort of powerful magical item to ward off the supernatural but they can only use or afford to use it in like few floors and so the rest is not really usable.

I support finding a connection to their supernatural world. But you can still solve it without that.

Answer 8

Kamen Rider Ex-Aid features four heroes all of whom are doctors and all of whom specialize in one area of medicine... The main character is an intern and thus changes departments (he starts as a pediatrician and is more of an appointment character), the next is a surgeon and one who is by appointment only. The third is a Corner and can excuse himself as part of investigations, the fourth is a radiologist (and additionally an unlicensed doctor at that.). It also helps that the setting is in Japan's government funded medical system, and the Ministry of Health knows about the doctor rider's superhero activities and actively supports them (the bad guys of the series are monsters that are the results of a human becoming infected by a computer virus that somehow turned into a biological virus.) so they are able to pull strings.