Education Informal-curriculum Medicine Reflection

Some Thank Yous.

To the intern on the trauma surgery service when I was a medical student: Thanks for occasionally wearing leather pants to work. Thanks for smiling and having a sense of humor despite having to round on thirty patients. Thanks for teaching us medical students while running a significant sleep deficit.

To the internal medicine resident who wanted to become a cardiologist: Thank you for indulging me and telling me how you dealt with the stress of medical training: You became still and tried to hear your heartbeat. When everything else seemed out of control, you focused on the steady rhythm emanating from your chest. That’s still something I do from time to time.

To the family practice physician who worked in the suburbs: I still don’t understand why you thought it was okay to pour liquid nitrogen on my head in front of the patient after you frosted the warts off of her feet. I mean, I do understand—you had power! I had none! what an amusement for you!—and thank you for showing me what a professional should never do.

To the surgical tech who was shaving the pubic hair off of a woman who was already under anesthesia: I don’t know why you and I were the only ones in the operating room. You knew I was there. As you were shaving her groin, you said, “You’re a fat bitch. You are such an ugly, fat bitch. I hate that I have to shave your fat ass.” She may not have heard you, but I did. As a medical student, I was too scared to tell you to stop. Thank you for showing me your cowardice and cruelty, as there are, unfortunately, others like you in medicine. I have since learned to speak up when people say violent things.

To two of my fellow interns: You stand out in my memory from that year. (One now works as a senior medical officer for a public health district in New Zealand; the other works in emergency medicine in an academic medical center in Texas.) We were brand new doctors running around the hospital and had no idea what we were doing. Do first, think later! I admired both of you for your intelligence and am grateful that we worked well together. I remember how you offered to help me when I was buried with neverending work. What I remember most, though, is how you made me laugh. When things were terrible—when the disease, dying, and death was crushing—you helped me smile when there was nothing else we could do.

To one of my medical students when I was an intern: Thank you for taking the time to write a letter to my residency director to express praise for my teaching abilities. You were both precocious and earnest: “I should know what a good teacher is, since I’m a medical student and many people teach me….” I hope you continue to write letters to those teachers who helped you grow.

To the male psychiatrist who took me to see a patient in a post-surgical setting: Thank you for teaching me who benefits from the questions we ask. We had just met her; she was weeping and told us she was uncomfortable. Out of nowhere you asked her if she experienced sexual abuse as a child. She answered yes. You then ended the interview and, while we were walking away, said to me, “I knew from her behavior that she was sexually abused as a kid.” I learned that I should never ask people questions just to show off.

To a female VA attending psychiatrist: Thank you for your enthusiasm for Cole Haan shoes. You were always so well-groomed—I imagine you still are—and your delight for shoes showed me that even sharp, warm attending physicians get excited when expensive shoes go on sale. You showed me that you weren’t just a doctor; you were also a person.

To the pharmacist who said little, but brimmed with wisdom when he did speak: I wish you were still alive. I think of you often: sometimes when I’m flummoxed over someone’s medication regimen, more often when I’m not sure how to best connect with the person in my care. You are the only person who has ever compared me to a bottle gourd: “Circumstances and people might try to bring and keep you down, but you’re like a bottle gourd in water: You pop right back up again.” After you died, I bought a bottle gourd to remind me of your high praise.

To the male psychiatrist who paid too much attention to me: Everything about that situation still makes me sad, but it helped me grow as a person and as a professional. I now tell trainees—particularly the women—that they must speak up, that they aren’t alone, that they don’t have to put up with bad behavior.

To the psychiatrist who worked as a commissioner for mental health: I wish you were still alive, too. I also think of you often: When systems don’t work and seem designed to fail, when people focus more on how things look than on how they actually are, when money seems to matter more than people…. I wish I could ask you what I should do. You often advised me to continue to ask questions, especially when I wanted to “do” something. I still heed your advice: If it scares you, then you should probably do it. Sometimes it is scary to ask questions, too.

To a male VA attending psychiatrist: Thanks for your candor while I was crying. “I had no idea that you were that upset,” you said. “You should know that you don’t show how you’re feeling. People probably have no idea.” You weren’t the first (nor last) person to recognize that I often don’t show how I’m feeling, but you were the first supervisor to tell me this to my face. You weren’t warm in that moment, but you were kind. And thanks for not freaking out when I started crying.

To my first boss: Thanks for saying explicitly that it’s okay to be mad. As an unintended corollary to the feedback I got from the male VA attending psychiatrist, you told me that it’s okay for people to know that I’m angry. “It shows people that you care. And sometimes people need to know that.”

To all the people who have allowed me to be your doctor: Thank you for your patience. The longer I practice, the more I realize how little I know. Thank you for your grace when I ask you intrusive questions. Thank you for your calling me out when I mess up. Thank you for giving me the opportunity to try to help you. Thank you for thanking me when you are better and don’t need to see me anymore. Thank you for teaching me new things and reminding me of things I still need to work on.