Wednesday, February 13, 2008

Letter #13

Dear Physician of the Future,

You have undertaken a career that is more of a journey that a job, a journey that is heavy in sacrifice but rich in reward. It carries with it much responsibility but much respect as well; please use care with how you handle both of those. Your journey is one that begins steeped in lore, in fact, and in information condensed into textbooks and databases. While this information is absolutely vital, and I am sure you will study it diligently, it does not provide you with the complete picture of your patients. We do not step forth out of the pages of textbooks or spring to life out of prescribed numbers. No one informed God that when man invented the textbook, he was to be sure to follow it. We, your patients, are people on our own journeys just like you and there are some things we would like for you to know to make our travels together more enjoyable.

I realize that you have spent a great deal of money to accomplish the MD that now follows, or that will follow, your name. It is a great honor and a sign of the tremendous amount of work you have accomplished. However, it does not inherently erase any education or intelligence that I, the patient, may possess. I have an intrinsic knowledge about my own body that can never be taught, studied, researched, or reproduced simply because I am the person within the body experiencing it. You have the same intrinsic knowledge about your body. Please respect my knowledge, in all of its forms, and do not assume that because I have not graduated from medical school that I am incapable of comprehending the issues of my own body. Also, please be honest with me when you do not have a ready answer for a symptom, an illness, or a problem. I am much more willing to trust you when I know that you don't think you have all of the answers yourself and that you will ask for help from others when necessary.

Please be extremely cautious when you dismiss a child, or anyone, as hopeless. Denying a family of hope is to deny them of life before life ends. Sometimes, in spite of all of the "cutting edge medical technology" and vast information at your disposal, you will discover that you were wrong. The impossible is indeed sometimes possible, it just requires a little more work. Twenty six years ago the top pediatric specialists in the state reached the unanimous decision that I had suffered severe, profound, and terminal brain damage as the result of prolonged lack of oxygen. Their prognosis was that I would be dead within 6 months, and never achieve any developmental milestones beyond what I had achieved before the sustained apnea episode. I began reading at age 2 ½, and when my IQ was tested in elementary school I landed securely in the genius range. The only area of deficit, in terms of any signs of brain damage, is in visual-spatial relations. I can live just fine without being able to parallel park, or figure out how many cubes fit inside of a box. What we could not have lived without was hope. The doctors tried to deny my parents hope, but my parents held firm. Hope, faith, and a miracle (medical professionals bristle at that word, but have offered no other explanation) took a terminal infant and created a successful special education teacher.

I want to end this letter to you with a list of "rules for doctors" that I created as a child. I spent a great deal of my childhood in doctors' offices and children's hospitals due to a variety of genetic and autoimmune dysfunctions. Sometimes I think the innocence of a child is the best truth of all. I have certainly learned more from the children that I teach than I ever learned from any professor. So, without further interruption, the great Rules for Doctors:

1) Talk to Me. I can hear you anyway.

2) Laugh. It lets me know you are alive.

3) Don't tell me it won't hurt – I will decide that on my own.

4) Let me wear my own clothes when I meet you, unless you want to wear a gown


5) Listen to me.

6) When I say no, I mean no.

7) Don't tell me how much it hurts unless you have had it done to you.

8) Know my name.

9) Don't ask stupid questions. [ i.e. why are you here today? Um, because you made me come back in two weeks?]

10) Get better prizes.

11) Don't think just because I am small I can't take pills. I can. I can't take banana medicine. [Ditropan in its liquid form is/was banana flavored. I still hate bananas.]

12) When you say you will count to three, count to three. Not two.

13) Never. Pat. My. Head.

14) Explain big words that you use.

15) Make my mom smile.

So thank you for taking on this journey that is being a physician. I offer you best wishes for your travels, and great blessings along the way. Most of all I wish you the knowledge that comes from viewing patients not as bed numbers, or symptoms, or puzzling cases, but as people. Nothing in this world is a nice, neat, and tidy as a textbook but then nothing n a textbook is as rewarding and vibrant as the human spirit.

Best wishes,


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