Dear Future Physician,
Thank you. Thank you for caring enough about your fellow man that you chose to become a physician. As a parent in the medical profession, and as the parent to a "medically complicated" child, I understand some of what has prompted you to become a physician. You have a genuine concern for others, and need to make things right.
My biggest piece of advice to you is this: never discount a mother's (or father's) intuition. While I respect that you have a job to do; a job that you take seriously, this is my child. If I say that something isn't right, or tell you "this is not normal", please do not dismiss me as a frantic parent who is overreacting. I am frantic. I very well may be overreacting. But this is my baby. And something is not normal. Help me understand what is going on, ask questions that may help me think in a different direction, explain to me WHY you feel that your diagnosis is correct. Do not tell me, "You are just a mother. You could not possibly know something is wrong." I have been told this by a physician, and I almost punched her.
My child is not your only concern; you have many patients. But while you are in an exam room with me and my child, please act as if my child is your only patient for the time you spend with us. Examine my child, talk to my child, tell my child what you are doing. Do not speak harshly to my child, or promise that something won't hurt when you know very well it will.
Please understand that while I am a "medical mom" who has pushed IV fluids through her child's central line, placed a naso-gastric tube properly a million times, has prepared TPN, who knows what a paracentesis is, who has seen no less than 8 liters of fluid drained from her child's abdomen (not at one time, but still 8 liters from a three-month-old!)...I am still a mom. I love my child, and hate to see anything hurt my child. Let me remain in the room to help calm my child, but don't scoff at my tears. It hurts to see a catheter inserted into my child's side, and to see you press on my child's abdomen to remove ascites. If it takes six NICU nurses, three flight nurses, and four surgeons to finally place one IV in my child's head, I am going to cry. But I don't want to leave my child's side.
Have compassion. I think that is almost as essential as the piece of paper that declares you have successfully completed the degree of Medical Doctor.
Sincerely,
Laurie C.
Mom to Anthony, Living Donor Liver Transplant Recipient
Four years old, four years post-transplant, and living life to the fullest!
Thursday, February 14, 2008
Letter #26
Dear Future Physician,
I’m going to say thanks in advance because more than likely you’ll run across me or someone like me during you career.
Here are some rules to follow and some advice from a patient you might encounter.
1. I know it’s Halloween and there are lots of people in the ER with various injuries from the nights festivities. I know you would rather be at home with your own family. But, when an 8 year old girl comes in with a suspected broken femur from a mere slip. Be patient with her when she doesn’t want you to touch her.
2. With that same girl, on that same evening, when you get her X-Ray back and confirm that her femur is shattered, don’t assume anything about her or her family.
3. Also, when the radiologist looks at the X-Ray and sees the “cyst” on her X-Ray, do the biopsy to confirm that it is in fact benign. You are NOT God. You can’t tell by looking at it.
4. When said girl is in traction for the next three and a half weeks, talk to her when you do rounds, not her parents. She is your actual patient.
5. When you finally do get around to asking her how she is feeling and she says "with her fingers", don’t roll your eyes. She was trying to engage you in a bit of conversation.
6. When she comes back to start physical therapy to re-learn how to walk and complains that it hurts too badly. NEVER CALL HER A WHINER. Ask her what she is feeling.
7. When after 3 sessions her leg re-breaks and you see her cyst is now the size of a football. Look her parents in the eyes and admit that you made a big mistake.
8. Be honest from the start. Don’t lie and say it won’t hurt when it will.
9. Do not read the medical consent forms out loud to the parents with the patient in the room. The whole part about possibly dying while in surgery will scare her and make her cry.
10. Most importantly. Treat her, as you would want your daughter or son or mother or father treated. Remember how frightened you were when you got shots or stitches. Do not break your patients trust. If you don’t know, be honest about it, they’ll respect you more.
Thank you for making this decision, someone like me needs you.
Kati G. age 27
DX Ewings Sarcoma, amputation due to misdiagnosis at onset of disease.
I’m going to say thanks in advance because more than likely you’ll run across me or someone like me during you career.
Here are some rules to follow and some advice from a patient you might encounter.
1. I know it’s Halloween and there are lots of people in the ER with various injuries from the nights festivities. I know you would rather be at home with your own family. But, when an 8 year old girl comes in with a suspected broken femur from a mere slip. Be patient with her when she doesn’t want you to touch her.
2. With that same girl, on that same evening, when you get her X-Ray back and confirm that her femur is shattered, don’t assume anything about her or her family.
3. Also, when the radiologist looks at the X-Ray and sees the “cyst” on her X-Ray, do the biopsy to confirm that it is in fact benign. You are NOT God. You can’t tell by looking at it.
4. When said girl is in traction for the next three and a half weeks, talk to her when you do rounds, not her parents. She is your actual patient.
5. When you finally do get around to asking her how she is feeling and she says "with her fingers", don’t roll your eyes. She was trying to engage you in a bit of conversation.
6. When she comes back to start physical therapy to re-learn how to walk and complains that it hurts too badly. NEVER CALL HER A WHINER. Ask her what she is feeling.
7. When after 3 sessions her leg re-breaks and you see her cyst is now the size of a football. Look her parents in the eyes and admit that you made a big mistake.
8. Be honest from the start. Don’t lie and say it won’t hurt when it will.
9. Do not read the medical consent forms out loud to the parents with the patient in the room. The whole part about possibly dying while in surgery will scare her and make her cry.
10. Most importantly. Treat her, as you would want your daughter or son or mother or father treated. Remember how frightened you were when you got shots or stitches. Do not break your patients trust. If you don’t know, be honest about it, they’ll respect you more.
Thank you for making this decision, someone like me needs you.
Kati G. age 27
DX Ewings Sarcoma, amputation due to misdiagnosis at onset of disease.
Letter #25
Dear Future Physician,
I've had to deal with the medical establishment since the day I was born
back in 1964.
First of all, I was born with a very rare condition called arhinia.
Arhinia is the complete absence of the nose. Arhinia is extremely rare
and there's not a lot of info about it. I have the most info about it
on my website as far at the internet goes. You can visit the "My Life"
portion of my website at http://www.simplykristi.com/me/my_life/ I
pretty much lay my condition out for the world to read about. I don't
try to hide it. If people would leave their hands off my pics, I would
post pics of me when I was younger. But thanks to the search engines I
can no longer do that. Until I come up with a way to keep the search
engines out of photo pages, the photos will remain offline.
I have had many dealings with physicians over the years. I have learned
many things over the years.
1. Never sugar-coat anything - Tell it like it is even if it is bad
news.
This is a pet peeve of mine. I do not like medical news sugar-coated.
I am an adult not a 5 yr. old.
2. Don't hold back!
This is another pet peeve of mine. I am the one who has to deal with
the information that you give me. Just come out and tell me up front.
I hate surprises. I especially do when it comes to my medical stuff.
3. Don't ever assume that a patient's problem is simply something that
is part of the condition he or she already has.
I talk about a problem where the pituitary gland can't signal the
ovaries to kick in on their own. No doctor ever delved into it because
I was going thru too much surgery at the time. It would have been nice
to know if it was an actual problem from arhinia (brain anomalies are
always associated with the condition) or something else. At this point,
I will never know.
4. Don't brush someone off because he or she has a condition that you
know nothing about.
I've had this happen to me a time or two when I have gone into a
doctor's office, especially to see a primary care physician. If you
don't know about the condition either ask the patient or do some
research to learn about the patient's condition. Don't pretend you know
something when you don't.. Educate yourself or send the patient on to
someone who does!
5. Refer the patient on to the specialist he or she needs.
I actually had a primary care physician tell me that an ENT needed to do
the surgery that I needed a plastic surgeon to do! Fortunately, the
plastic surgeon was just coming on board with the HMO at the time and
talked to the primary care physician himself. I also hand-delivered my
retired plastic surgeon (which the HMO misplaced in the beginning). It
was scary for me
6. Communicate with your patients
Communication is a must! A patient-doctor relationship is very
important, especially if you have patients over a long period of time.
Since I was young (probably before I was five), I was very vocal about
my medical stuff. Let's say I was my plastic surgeon's worst nightmare
(in a good way). :) I had to know everything. :) Everyone would have
to stop and explain things in terms that I could understand. If I were
to have surgery today, I would not need a lot explained to me.
I am a surgery veteran... I've had over 3 dozen.... I had my first one
when I was 9 or 10 days old and had my last one in January 1999 when I
was 34.
I have dealt with doctors locally and internationally. My longtime
plastic surgeon was like a member of our family. He was my plastic
surgeon for twenty-nine years. I know that I gave him sooo much grief
over the years. :) It was a very sad day when he retired in June 1993.
I give a lot of credit to my plastic surgeon, Dr. Paul Tessier, a
pioneer surgeon in the world of craniofacial surgery. My medical care
has never really been the same even tho my last plastic surgeon was
great. It was just not the same for me.
Studying to be a medical doctor is a wonderful thing but don't forget
why you are a doctor.. To help those who are in need medically. Good
Luck with your studies! :) I am sure that you will make a great doctor!
:)
Hugs,
Kristi
I've had to deal with the medical establishment since the day I was born
back in 1964.
First of all, I was born with a very rare condition called arhinia.
Arhinia is the complete absence of the nose. Arhinia is extremely rare
and there's not a lot of info about it. I have the most info about it
on my website as far at the internet goes. You can visit the "My Life"
portion of my website at http://www.simplykristi.com/me/my_life/ I
pretty much lay my condition out for the world to read about. I don't
try to hide it. If people would leave their hands off my pics, I would
post pics of me when I was younger. But thanks to the search engines I
can no longer do that. Until I come up with a way to keep the search
engines out of photo pages, the photos will remain offline.
I have had many dealings with physicians over the years. I have learned
many things over the years.
1. Never sugar-coat anything - Tell it like it is even if it is bad
news.
This is a pet peeve of mine. I do not like medical news sugar-coated.
I am an adult not a 5 yr. old.
2. Don't hold back!
This is another pet peeve of mine. I am the one who has to deal with
the information that you give me. Just come out and tell me up front.
I hate surprises. I especially do when it comes to my medical stuff.
3. Don't ever assume that a patient's problem is simply something that
is part of the condition he or she already has.
I talk about a problem where the pituitary gland can't signal the
ovaries to kick in on their own. No doctor ever delved into it because
I was going thru too much surgery at the time. It would have been nice
to know if it was an actual problem from arhinia (brain anomalies are
always associated with the condition) or something else. At this point,
I will never know.
4. Don't brush someone off because he or she has a condition that you
know nothing about.
I've had this happen to me a time or two when I have gone into a
doctor's office, especially to see a primary care physician. If you
don't know about the condition either ask the patient or do some
research to learn about the patient's condition. Don't pretend you know
something when you don't.. Educate yourself or send the patient on to
someone who does!
5. Refer the patient on to the specialist he or she needs.
I actually had a primary care physician tell me that an ENT needed to do
the surgery that I needed a plastic surgeon to do! Fortunately, the
plastic surgeon was just coming on board with the HMO at the time and
talked to the primary care physician himself. I also hand-delivered my
retired plastic surgeon (which the HMO misplaced in the beginning). It
was scary for me
6. Communicate with your patients
Communication is a must! A patient-doctor relationship is very
important, especially if you have patients over a long period of time.
Since I was young (probably before I was five), I was very vocal about
my medical stuff. Let's say I was my plastic surgeon's worst nightmare
(in a good way). :) I had to know everything. :) Everyone would have
to stop and explain things in terms that I could understand. If I were
to have surgery today, I would not need a lot explained to me.
I am a surgery veteran... I've had over 3 dozen.... I had my first one
when I was 9 or 10 days old and had my last one in January 1999 when I
was 34.
I have dealt with doctors locally and internationally. My longtime
plastic surgeon was like a member of our family. He was my plastic
surgeon for twenty-nine years. I know that I gave him sooo much grief
over the years. :) It was a very sad day when he retired in June 1993.
I give a lot of credit to my plastic surgeon, Dr. Paul Tessier, a
pioneer surgeon in the world of craniofacial surgery. My medical care
has never really been the same even tho my last plastic surgeon was
great. It was just not the same for me.
Studying to be a medical doctor is a wonderful thing but don't forget
why you are a doctor.. To help those who are in need medically. Good
Luck with your studies! :) I am sure that you will make a great doctor!
:)
Hugs,
Kristi
Letter #24
Dear Future Physician:
Thank you for deciding to dedicate your life to helping others!
My children have both had issues, and I am diabetic so we have had a lot of experience with doctors. My son was born at 35 weeks and was not breathing when he came out. The doctors told me nothing, my husband disappeared to be with our son, and I was scared. Don’t be afraid to talk to your patients! Let us know what is going on, and if you really don’t know what’s going on be honest. But then find out! While my son was in the NICU for 5 weeks, doctors’ communication was horrible. I had no place to stay near the hospital, so I had to go home every night and wait for my husband to be done with work so we could go see our son. The doctors treated us like scum and acted as if we had no right or clue. Had I known then what I know now, it would have gone differently… but ultimately the doctors didn’t care what we thought. Please don’t under-estimate the value of parents. My daughter was a surprise and we found out that she had hydrocephalus at our first prenatal ultrasound. I found the best doctors during this time. There was one that was brutally honest, but I still appreciated his honesty. We had many tests and were uncertain about our daughter’s future. We were scared. But the compassion shown to us was amazing and it got me through. My daughter was born via a planned c-section at 39 weeks and things could not have gone better. The NICU staff at that hospital was phenomenal! They communicated well, respected my husband and I, and tried to involve our son even though he couldn’t go into the NICU to see his new sister. She had surgery at 7 days of age. She has had many more surgeries, but we have found doctors that respect us and keep us informed. My daughter’s neurosurgeon is wonderful because he uses my name! Please, when you speak to parents, know their names (even Mr. or Mrs. Soandso would be better than “mom” or “dad”). We now travel to another state to see an epileptologist for my daughter’s epilepsy because they care. We drive 900 miles one way to see them!
Ultimately you need to remember that parents are the eyes and ears “in the trenches”. We know what happens on a day to day basis, we know what is “normal” for our children, we have instincts and feelings that are indescribable. And now that my daughter is older, she appreciates having a doctor take the time to talk to her. She likes to know what is going to happen before it happens. She likes to know she matters. As a doctor, be human. Be willing to admit you don’t know everything and you will learn more than you can imagine!
Good luck!
Heather
Mom to Jack (age 5) and Megan (age 3 ½)
Thank you for deciding to dedicate your life to helping others!
My children have both had issues, and I am diabetic so we have had a lot of experience with doctors. My son was born at 35 weeks and was not breathing when he came out. The doctors told me nothing, my husband disappeared to be with our son, and I was scared. Don’t be afraid to talk to your patients! Let us know what is going on, and if you really don’t know what’s going on be honest. But then find out! While my son was in the NICU for 5 weeks, doctors’ communication was horrible. I had no place to stay near the hospital, so I had to go home every night and wait for my husband to be done with work so we could go see our son. The doctors treated us like scum and acted as if we had no right or clue. Had I known then what I know now, it would have gone differently… but ultimately the doctors didn’t care what we thought. Please don’t under-estimate the value of parents. My daughter was a surprise and we found out that she had hydrocephalus at our first prenatal ultrasound. I found the best doctors during this time. There was one that was brutally honest, but I still appreciated his honesty. We had many tests and were uncertain about our daughter’s future. We were scared. But the compassion shown to us was amazing and it got me through. My daughter was born via a planned c-section at 39 weeks and things could not have gone better. The NICU staff at that hospital was phenomenal! They communicated well, respected my husband and I, and tried to involve our son even though he couldn’t go into the NICU to see his new sister. She had surgery at 7 days of age. She has had many more surgeries, but we have found doctors that respect us and keep us informed. My daughter’s neurosurgeon is wonderful because he uses my name! Please, when you speak to parents, know their names (even Mr. or Mrs. Soandso would be better than “mom” or “dad”). We now travel to another state to see an epileptologist for my daughter’s epilepsy because they care. We drive 900 miles one way to see them!
Ultimately you need to remember that parents are the eyes and ears “in the trenches”. We know what happens on a day to day basis, we know what is “normal” for our children, we have instincts and feelings that are indescribable. And now that my daughter is older, she appreciates having a doctor take the time to talk to her. She likes to know what is going to happen before it happens. She likes to know she matters. As a doctor, be human. Be willing to admit you don’t know everything and you will learn more than you can imagine!
Good luck!
Heather
Mom to Jack (age 5) and Megan (age 3 ½)
Letter #23
Dear Future Physician,
First, Congratulations, and second, Thank You for choosing one of the
most difficult, yet rewarding career paths there is to offer. I
imagine doctoring to be as much a way of life as it is a career. You
live, sleep, eat and breathe medicine, everything else, to include
your own family becomes secondary to those you treat. That is
certainly a difficult balance.
In that balance I hope you always remember that in the hundreds, even
thousands of patients with the myriad of problems we have, that while
your colleagues and peers lump is in to categories and cases, and put
us in a rank and file order of difficulty and importance...we are
people. Individuals with individual problems. We don't all feel pain
the same way, we don't all explain the pain we have in the same
manner.
Listen. Sometimes when you don't feel well, just having somebody
believe that you don't feel well is the best medicine. And then, on
your most harried day when you've seen a hundred patients and you are
an hour behind schedule and you've finally made your way to the last
patient of the day, treat them like they are your first. They may
have a serious problem. The problem that is going to change their
life forever. And if they can sense or feel like they've been rushed,
or ignored, or not listened to, when they do get that diagnosis, what
will they remember? Who and how will it be remembered? Remember that
even if you are not the doctor who makes that final diagnosis, people
think back to when they first noticed the problem. Where do you want
to fit in?
I remember to the very second the moment my son was diagnosed with
kidney disease. The doctor was patient and kind and we'd been in the
Emergency Room all day long. I also remember to the very second,
three months later when a different doctor in that same Emergency Room
kicked us out saying we needed to call and make a regular daily
appointment, only later that same day being transported by ambulance
from that Emergency Room to a bigger hospital two hours away with my
son needing Pediatric Intensive Care. He was only two. The doctor
who had sent us away...couldn't look me in the eye. The doctor who
was kind when diagnosing my son I have the utmost respect for. The
"other guy", well, take a guess.
Be that doctor who cares. Be that doctor people remember so
positively and rave to their friends about. It's good networking!
And laughter is always the best in medicine.
Best of luck to you in all your endeavors,
Brenda H
First, Congratulations, and second, Thank You for choosing one of the
most difficult, yet rewarding career paths there is to offer. I
imagine doctoring to be as much a way of life as it is a career. You
live, sleep, eat and breathe medicine, everything else, to include
your own family becomes secondary to those you treat. That is
certainly a difficult balance.
In that balance I hope you always remember that in the hundreds, even
thousands of patients with the myriad of problems we have, that while
your colleagues and peers lump is in to categories and cases, and put
us in a rank and file order of difficulty and importance...we are
people. Individuals with individual problems. We don't all feel pain
the same way, we don't all explain the pain we have in the same
manner.
Listen. Sometimes when you don't feel well, just having somebody
believe that you don't feel well is the best medicine. And then, on
your most harried day when you've seen a hundred patients and you are
an hour behind schedule and you've finally made your way to the last
patient of the day, treat them like they are your first. They may
have a serious problem. The problem that is going to change their
life forever. And if they can sense or feel like they've been rushed,
or ignored, or not listened to, when they do get that diagnosis, what
will they remember? Who and how will it be remembered? Remember that
even if you are not the doctor who makes that final diagnosis, people
think back to when they first noticed the problem. Where do you want
to fit in?
I remember to the very second the moment my son was diagnosed with
kidney disease. The doctor was patient and kind and we'd been in the
Emergency Room all day long. I also remember to the very second,
three months later when a different doctor in that same Emergency Room
kicked us out saying we needed to call and make a regular daily
appointment, only later that same day being transported by ambulance
from that Emergency Room to a bigger hospital two hours away with my
son needing Pediatric Intensive Care. He was only two. The doctor
who had sent us away...couldn't look me in the eye. The doctor who
was kind when diagnosing my son I have the utmost respect for. The
"other guy", well, take a guess.
Be that doctor who cares. Be that doctor people remember so
positively and rave to their friends about. It's good networking!
And laughter is always the best in medicine.
Best of luck to you in all your endeavors,
Brenda H
Letter #22
Dear Future Physician,
Congratulations on your choice of careers. I know it has been a long road to get here and that the learning never stops. I have a child with Congenital Heart Defects. We were rushed to the hospital when he was 8 days old as he was in heart failure and literally dying in front of us.
To the ER doctor: I understand that when a child arrives in heart failure, you are the expert and have certain protocols you must follow. I also understand that you run a very busy ER at the Children's Hospital. But please don't make me feel as if our unplanned arrival was your biggest inconvenience of the day, as if I should have known he was going to go into heart failure. Keep me informed, be honest with me. I am willing to answer your questions and provide answers to whatever you need. In return I expect that you will update me and include me in choices for his health care. Don't send in the hospital's social worker to do your job. Take a moment and speak with me. I need the assurance that you are doing all you can and I need to know what the next step will be. If you need me to leave the room, have a nurse explain why. Don't just order me out. That is my precious baby you are working on and I need to know why you would want me to leave him.
To the doctors in the PICU - thank you. Thank you for holding our hands and for drawing countless pictures of his heart so that my husband and I were able to get our heads around what was happening. Thank you for finding a computer and printing out the information for us so we had a tangible resource to refer to. Thank you for explaining each and every wire and tube, the reason they were there and for being honest with us about his likely outcome. Thank you also for encouraging us to talk to him and to touch him and for arranging for us to hold him again as soon as he was stable enough after surgery. Thank you for making us feel like we were a vital part of his care and for rebuilding our confidence in our ability to take care of our baby.
To the pediatric Cardiologist - your honesty was appreciated. The fact that you also provided us all of your numbers and then followed up with us when we moved to the other Children's hospital meant a lot. We appreciate that you answered our questions about surgery and the outcome as well as other organ damage. You didn't scare, you didn't give false hope. You put it into terms we were able to understand and digest at the time. Thank you for also being concerned about our 2 year old and for arranging to check her for CHD in order to give us peace of mind. Thank you for remembering we are a family, not just a sick baby.
To the Med Students - when you do your rounds every morning, appreciate what a strange feeling it is for parents to have 10 or more people standing around their child's bed as if they were a science experiment. I know you have to discuss each case, but please, take the time to learn our names and say hello. Also, learn my son's name. If he is awake, please say hello to him before you discuss him. Make eye contact with us, and don't assume that we don't know anything because we aren't wearing the stethoscope.
Good Luck Future Physician, I hope this is helpful to you.
Wendy - mom to Christopher who has multiple Congenital Heart Defects and who had emergency heart surgery at 10 days old
Congratulations on your choice of careers. I know it has been a long road to get here and that the learning never stops. I have a child with Congenital Heart Defects. We were rushed to the hospital when he was 8 days old as he was in heart failure and literally dying in front of us.
To the ER doctor: I understand that when a child arrives in heart failure, you are the expert and have certain protocols you must follow. I also understand that you run a very busy ER at the Children's Hospital. But please don't make me feel as if our unplanned arrival was your biggest inconvenience of the day, as if I should have known he was going to go into heart failure. Keep me informed, be honest with me. I am willing to answer your questions and provide answers to whatever you need. In return I expect that you will update me and include me in choices for his health care. Don't send in the hospital's social worker to do your job. Take a moment and speak with me. I need the assurance that you are doing all you can and I need to know what the next step will be. If you need me to leave the room, have a nurse explain why. Don't just order me out. That is my precious baby you are working on and I need to know why you would want me to leave him.
To the doctors in the PICU - thank you. Thank you for holding our hands and for drawing countless pictures of his heart so that my husband and I were able to get our heads around what was happening. Thank you for finding a computer and printing out the information for us so we had a tangible resource to refer to. Thank you for explaining each and every wire and tube, the reason they were there and for being honest with us about his likely outcome. Thank you also for encouraging us to talk to him and to touch him and for arranging for us to hold him again as soon as he was stable enough after surgery. Thank you for making us feel like we were a vital part of his care and for rebuilding our confidence in our ability to take care of our baby.
To the pediatric Cardiologist - your honesty was appreciated. The fact that you also provided us all of your numbers and then followed up with us when we moved to the other Children's hospital meant a lot. We appreciate that you answered our questions about surgery and the outcome as well as other organ damage. You didn't scare, you didn't give false hope. You put it into terms we were able to understand and digest at the time. Thank you for also being concerned about our 2 year old and for arranging to check her for CHD in order to give us peace of mind. Thank you for remembering we are a family, not just a sick baby.
To the Med Students - when you do your rounds every morning, appreciate what a strange feeling it is for parents to have 10 or more people standing around their child's bed as if they were a science experiment. I know you have to discuss each case, but please, take the time to learn our names and say hello. Also, learn my son's name. If he is awake, please say hello to him before you discuss him. Make eye contact with us, and don't assume that we don't know anything because we aren't wearing the stethoscope.
Good Luck Future Physician, I hope this is helpful to you.
Wendy - mom to Christopher who has multiple Congenital Heart Defects and who had emergency heart surgery at 10 days old
Letter #21
Dear Future Physician,
Have you ever tasted barium contrast, magnesium citrate or golytely, liquid iron, prednisone or flagyl? You know it won't make you sick if you just taste them, so don't be afraid to try. I will be forever grateful from the day my doctor took a sip of CT contrast before me, because I was afraid it would make me gag from the taste.
Have you learned about the fight or flight response yet? I'm pretty sure you have. You know, being sick is a big stressor in one's life, some of your patients will be real fighters in front of their disease. Some will prefer to run. I was that kind of kid. I literally ran away from my doctor's office once, at the age of 10. I was a difficult patient; my doctor wouldn't get straight answers to his questions and sometimes, not even an eye contact. I was so scared, I didn't want to see him. I didn't want to look at him because it was just as if I were looking at my disease. It was my defense mechanism. There are a number of them, and remember they are there to help the person to adapt to a new situation. When it comes to an illness, it's a very scary situation, trust me! My doctor did not force things, he let me come to him. Today he is one of the most significant person I have ever met. You know, us patients already have to find a way to get a new balance, we have to adjust our life to our disease. You, on the other hand, have to adapt to your patients.
When I'm sick, I sometimes feel out of control, or even powerless. There are ways to comfort your patients. Be calm, smile, listen, take your time. I always appreciated when my doctor sat down on my hospital bed. Or when he put his hand on my shoulder. One day, while in the hospital, he brang me a popsicle because I was unable to eat, and he had one for him too. I felt so special! And I loved to talk about my new dog, and the recent software on my computer. It made me feel as if I were a real person, not just one thick medical file!
At school, you learn the 5 stages of grief, how to structure your interview, all the theory. Once you get on the floors, you'll get into action. Emotions are hard to learn in textbooks; there are no protocols, no guidelines to follow. Follow your heart, show empathy, respect your patients. We are all humans trying to carry on with life, but we all do it in different ways.
Renee, age 21
Dx'ed with Crohn's disease a few weeks after turning 10.
Have you ever tasted barium contrast, magnesium citrate or golytely, liquid iron, prednisone or flagyl? You know it won't make you sick if you just taste them, so don't be afraid to try. I will be forever grateful from the day my doctor took a sip of CT contrast before me, because I was afraid it would make me gag from the taste.
Have you learned about the fight or flight response yet? I'm pretty sure you have. You know, being sick is a big stressor in one's life, some of your patients will be real fighters in front of their disease. Some will prefer to run. I was that kind of kid. I literally ran away from my doctor's office once, at the age of 10. I was a difficult patient; my doctor wouldn't get straight answers to his questions and sometimes, not even an eye contact. I was so scared, I didn't want to see him. I didn't want to look at him because it was just as if I were looking at my disease. It was my defense mechanism. There are a number of them, and remember they are there to help the person to adapt to a new situation. When it comes to an illness, it's a very scary situation, trust me! My doctor did not force things, he let me come to him. Today he is one of the most significant person I have ever met. You know, us patients already have to find a way to get a new balance, we have to adjust our life to our disease. You, on the other hand, have to adapt to your patients.
When I'm sick, I sometimes feel out of control, or even powerless. There are ways to comfort your patients. Be calm, smile, listen, take your time. I always appreciated when my doctor sat down on my hospital bed. Or when he put his hand on my shoulder. One day, while in the hospital, he brang me a popsicle because I was unable to eat, and he had one for him too. I felt so special! And I loved to talk about my new dog, and the recent software on my computer. It made me feel as if I were a real person, not just one thick medical file!
At school, you learn the 5 stages of grief, how to structure your interview, all the theory. Once you get on the floors, you'll get into action. Emotions are hard to learn in textbooks; there are no protocols, no guidelines to follow. Follow your heart, show empathy, respect your patients. We are all humans trying to carry on with life, but we all do it in different ways.
Renee, age 21
Dx'ed with Crohn's disease a few weeks after turning 10.
Wednesday, February 13, 2008
Letter #20
Dear Future Physician,
I congratulate you on your choice of career, it is a difficult path for you and your family. As the mother of a child who suffered a serious injury, spent five weeks in two hospitals, and who is still under a physician's care two and a half years later, I know there are things that would have made the experience easier.
Since my daughter's injury was an accident we were thrown into the hospital world unexpectedly. In fact my husband wore his swimsuit for three days straight. We were frightened and confused. The fact that this occurred while we were on vacation out of state made it even more difficult.
1. Please do not repeat painful tests if the answers aren't worth the pain and don't contribute to better care.
2. Please do not use words like amputation around a child unless you speak to her parents first.
3. Please do not make jokes about the circumstances of the accident.
4. Please don't question why she is in ICU when she is on a ventilator, it shows that you aren't even looking at my daughter.
5. If we want to fly our daughter home and it can be safely accomplished, please try to help us.
5. Don't be afraid to tell us you don't have all the answers, otherwise we might feel like you are misleading us.
6. Please don't be offended if we ask who is the best in the field of care required.
7. I know you have a lot of patients, but if possible please look at the record and call me Mrs. Gxxxxx and not "mom."
Do keep us informed.
Be polite.
Show concern if you are concerned.
Thank you and best wishes!
Jackie G
8/1/2005 14 year old daughter was pulled by a ski rope wrapped around her leg. Cut two arteries, resulted in 8 debridements, muscle transfer and skin graft, and second skin graft a year later.
I congratulate you on your choice of career, it is a difficult path for you and your family. As the mother of a child who suffered a serious injury, spent five weeks in two hospitals, and who is still under a physician's care two and a half years later, I know there are things that would have made the experience easier.
Since my daughter's injury was an accident we were thrown into the hospital world unexpectedly. In fact my husband wore his swimsuit for three days straight. We were frightened and confused. The fact that this occurred while we were on vacation out of state made it even more difficult.
1. Please do not repeat painful tests if the answers aren't worth the pain and don't contribute to better care.
2. Please do not use words like amputation around a child unless you speak to her parents first.
3. Please do not make jokes about the circumstances of the accident.
4. Please don't question why she is in ICU when she is on a ventilator, it shows that you aren't even looking at my daughter.
5. If we want to fly our daughter home and it can be safely accomplished, please try to help us.
5. Don't be afraid to tell us you don't have all the answers, otherwise we might feel like you are misleading us.
6. Please don't be offended if we ask who is the best in the field of care required.
7. I know you have a lot of patients, but if possible please look at the record and call me Mrs. Gxxxxx and not "mom."
Do keep us informed.
Be polite.
Show concern if you are concerned.
Thank you and best wishes!
Jackie G
8/1/2005 14 year old daughter was pulled by a ski rope wrapped around her leg. Cut two arteries, resulted in 8 debridements, muscle transfer and skin graft, and second skin graft a year later.
Letter #20
Dear Future Physician,
As someone who works in the healthcare field, I deal with physicians every day. One thing that I think is helpful to patients is being well-informed prior to having exams. Sometimes physicians forget that these exams and the equipment used for them can be very scary for the sick patient and their family members. If a study needs to be ordered, the physician should take the time to educate themself about the procedure and explain to the patient what they can expect when they go to the sepcific department.
As a new parent, it can be daunting to go to the pediatrician's office. I have found that the more personable the physician, the more at ease I feel. For instance, one of my daughter's physicians always makes me feel as though we are the only people she needs to see that day. I know she has a busy schedule, but she never lets on as she talks about my daughter and shares little tidbits about her own children. On the other hand, another physician in that office tends to rush and seems very judgemental. When we see her I always feel a little disconcerted after the appointment.
So good luck, future physician! I hope this is helpful to you as you begin your career.
Trisha
As someone who works in the healthcare field, I deal with physicians every day. One thing that I think is helpful to patients is being well-informed prior to having exams. Sometimes physicians forget that these exams and the equipment used for them can be very scary for the sick patient and their family members. If a study needs to be ordered, the physician should take the time to educate themself about the procedure and explain to the patient what they can expect when they go to the sepcific department.
As a new parent, it can be daunting to go to the pediatrician's office. I have found that the more personable the physician, the more at ease I feel. For instance, one of my daughter's physicians always makes me feel as though we are the only people she needs to see that day. I know she has a busy schedule, but she never lets on as she talks about my daughter and shares little tidbits about her own children. On the other hand, another physician in that office tends to rush and seems very judgemental. When we see her I always feel a little disconcerted after the appointment.
So good luck, future physician! I hope this is helpful to you as you begin your career.
Trisha
Letter #19
Dear Physician of the Future,
On a cold January day in 1999, my two month old son was admitted to the PICU of one of the top ten Children’s Hospitals, in respiratory distress. Five months later, my son left the PICU with a tube in his neck, a tube in his stomach and connected to a ventilator to support his breathing. My son was born with a congenital muscular dystrophy. As a result of his disease, my son has severe muscle weakness and is ventilator dependent 24/7. As the parent of a child with chronic and complex medical needs, it’s not only important to find a physician who is knowledgeable and skilled in his or her specialty, it’s perhaps more important to find a physician who will give me and my child his or her time, who will listen and who is willing to go the extra mile in this time of managed care. It’s important to find a physician who cares.
As my child’s physician, you need to understand that I was sent home with a medically fragile child and I had no choice but to learn how to care for him. Understand that I am capable of changing out a trach tube and replacing a gastrostomy button. I know how and when to suction my child’s airway. I can give breathing treatments, perform CPT and I can bag my child when he is in respiratory distress. I can trouble shoot a ventilator. If my child requires a hospital stay, don’t treat me like I don’t know how to care for him and don’t prohibit me from being an active participant in his care. Remember that I am part of the team and my vote counts in all decisions to be made. While I didn’t go to medical school, I know more about my child’s medical condition than you do and when I bring something to your attention, please genuinely consider it. Respect me.
Recognize that sometimes all I need for you to do is to listen as I vent my frustrations and my sadness. I don’t need you to have all the answers; I just need you to care. Make yourself accessible. Give me your email address and don’t be afraid to answer my questions in writing. Return my phone call the same day I leave a message. I will only email you or call you when I really need your help.
Due to his disease, my son cannot walk, talk or breathe on his own. Yet my son is a human being with feelings. When you walk into the room, acknowledge my son. Talk to him, he can hear. Look into his eyes, they will speak volumes to you. See his smile, it will light up the room.
I’d like to share with you an example of a simple gesture performed by one of my son’s physicians that I will always remember:
It was early one morning as I was sitting in the chair next to my son’s bed when the PICU intensivist came over to talk with me. What will always stay with me was this physician’s simple act of getting down on one knee so that he was eye level with me, rather than looking down on me, when he spoke. To most, this may seem like a meaningless, trivial gesture. On the contrary, it is indicative of the person this physician is. He is unassuming, his is respectful and he is kind. To this day, this physician has remained a part of our “team” – not as someone who provides hands-on care to my son but someone who is there to listen, to coordinate care and to offer words of support and encouragement. He is a physician who epitomizes what it means to practice medicine from the heart. It really is the little things that make all the difference. As someone who must develop long term relationships with physicians because of my son’s chronic condition, I have come to realize that, if I have to choose, I’ll take a physician who cares over one who is the “best”.
Over the last nine years, I’ve had the opportunity to spend a great deal of time in the presence of physicians. I’ve encountered the good, the bad and the indifferent. But, by and large, I’ve had the privilege of dealing with an exceptional team of physicians who have provided the best of care to my son. One of my biggest fears the day my son and I left the PICU was that of being abandoned by the people who – from my perspective – put me in this position in the first place. I’ve been very fortunate. I’ve not been abandoned, I’ve been embraced by several very special physicians who have done, and who continue to do, everything they can to ensure that my son and I have the best quality of life under the circumstances. They’ve not only cared for my son, they have cared for me. They have supported me, educated me, guided me and, in doing so, they have truly made it possible for me to “keep on keeping on”.
Be a physician who cares. Be a physician who practices medicine from the heart.
Godspeed.
Ann – mom to Jack
(www.jack-schrooten.blogspot.com)
On a cold January day in 1999, my two month old son was admitted to the PICU of one of the top ten Children’s Hospitals, in respiratory distress. Five months later, my son left the PICU with a tube in his neck, a tube in his stomach and connected to a ventilator to support his breathing. My son was born with a congenital muscular dystrophy. As a result of his disease, my son has severe muscle weakness and is ventilator dependent 24/7. As the parent of a child with chronic and complex medical needs, it’s not only important to find a physician who is knowledgeable and skilled in his or her specialty, it’s perhaps more important to find a physician who will give me and my child his or her time, who will listen and who is willing to go the extra mile in this time of managed care. It’s important to find a physician who cares.
As my child’s physician, you need to understand that I was sent home with a medically fragile child and I had no choice but to learn how to care for him. Understand that I am capable of changing out a trach tube and replacing a gastrostomy button. I know how and when to suction my child’s airway. I can give breathing treatments, perform CPT and I can bag my child when he is in respiratory distress. I can trouble shoot a ventilator. If my child requires a hospital stay, don’t treat me like I don’t know how to care for him and don’t prohibit me from being an active participant in his care. Remember that I am part of the team and my vote counts in all decisions to be made. While I didn’t go to medical school, I know more about my child’s medical condition than you do and when I bring something to your attention, please genuinely consider it. Respect me.
Recognize that sometimes all I need for you to do is to listen as I vent my frustrations and my sadness. I don’t need you to have all the answers; I just need you to care. Make yourself accessible. Give me your email address and don’t be afraid to answer my questions in writing. Return my phone call the same day I leave a message. I will only email you or call you when I really need your help.
Due to his disease, my son cannot walk, talk or breathe on his own. Yet my son is a human being with feelings. When you walk into the room, acknowledge my son. Talk to him, he can hear. Look into his eyes, they will speak volumes to you. See his smile, it will light up the room.
I’d like to share with you an example of a simple gesture performed by one of my son’s physicians that I will always remember:
It was early one morning as I was sitting in the chair next to my son’s bed when the PICU intensivist came over to talk with me. What will always stay with me was this physician’s simple act of getting down on one knee so that he was eye level with me, rather than looking down on me, when he spoke. To most, this may seem like a meaningless, trivial gesture. On the contrary, it is indicative of the person this physician is. He is unassuming, his is respectful and he is kind. To this day, this physician has remained a part of our “team” – not as someone who provides hands-on care to my son but someone who is there to listen, to coordinate care and to offer words of support and encouragement. He is a physician who epitomizes what it means to practice medicine from the heart. It really is the little things that make all the difference. As someone who must develop long term relationships with physicians because of my son’s chronic condition, I have come to realize that, if I have to choose, I’ll take a physician who cares over one who is the “best”.
Over the last nine years, I’ve had the opportunity to spend a great deal of time in the presence of physicians. I’ve encountered the good, the bad and the indifferent. But, by and large, I’ve had the privilege of dealing with an exceptional team of physicians who have provided the best of care to my son. One of my biggest fears the day my son and I left the PICU was that of being abandoned by the people who – from my perspective – put me in this position in the first place. I’ve been very fortunate. I’ve not been abandoned, I’ve been embraced by several very special physicians who have done, and who continue to do, everything they can to ensure that my son and I have the best quality of life under the circumstances. They’ve not only cared for my son, they have cared for me. They have supported me, educated me, guided me and, in doing so, they have truly made it possible for me to “keep on keeping on”.
Be a physician who cares. Be a physician who practices medicine from the heart.
Godspeed.
Ann – mom to Jack
(www.jack-schrooten.blogspot.com)
Letter #18
Dear Future Physician,
Congratulations on your success this far – I applaud you on your noble career choice and wish you the best of luck with your future endeavors. You are entering the medical profession at a time of great need. While there may be plenty of physicians to go around quantitatively speaking, through my experiences as a patient I've found that the quality of doctors can vary in a number of ways. I wish I could say every MD I've encountered was phenomenal, but the fact of the matter is that there is only so much one can be taught during medical school – good doctoring is about the patient, not just the disease, and that part comes when you are out in the real world.
As a formally perfectly health sixteen year old, finding myself in the hospital for the first time ever was beyond frightening. Basic tests showed nothing wrong and my first doctors only looked at the tests, not at me, and thought they were being comforting by saying "I promise it's not your heart" when my (obviously GI) pain was in the epigastric area. It took over a month of traveling to different hospitals, evenly highly respected ones such as the Mayo Clinic, before I even had some semblance of a diagnosis, and that's because one doctor truly looked at ME and not just my CT/MRI/endoscopy/labs/you-name-the-test. Just because you can't find an obvious abnormality on a lab or diagnostic test doesn't mean there's nothing wrong, and it most certainly doesn't mean it's "all in my head." After my "godsend" doctor took the time to treat me as a person, we quickly received the correct diagnosis: Chronic Pancreatitis. Ironically I was treated completely different after that diagnosis popped up on my chart. And six months later when my ICP was 330 there was no question that I truly had a "headache behind my eye" – we got the diagnosis of Pseudotumor Cerebri while I was still in the ER and I had shunt surgery a year later. Basically what I'm saying is to trust your patient – you know the anatomy, pathophysiology and differential diagnoses… they know their body, and certainly know when something isn't right.
As my main treating hospital is a prominent teaching hospital, I've encountered more than my share of residents and medical students. Some were great, and I let them know that. Some I shuddered when they walked in my room. While in the end the most important part is what is coming out of the physician's mouth, there is so much more to communication, which I believe to be the essence of a successful patient-doctor relationship. It's been proven that about 7% of meaning is transmitted by words, while 38% is by vocal cues and 55% by body cues. Please keep in mind that whether you like it or not, you are being judged from the moment you walk in a patient's room. Your body stance and opening remarks set the tone for the entire visit. It was the doctors that first asked about me and not about my disease that I developed a deep sense of respect for. And it's not just your communication with your patients that matter. Whether intentionally or not, we see the impression you have made on our nurse, and since she sees every combination of medical talent and personality, we tend to respect her opinions. If your patient is in pain at 3am and you're on call, please don't complain when you're woken up… you signed up for it! I say that half-jokingly… as a nursing student, I know that nurses don't enjoy having to call and wake you up in the middle of the night just as much as you don't like being woken up. They are just doing their jobs as patient advocates – please respect them! If you haven't figured it out by now, nurses can be your best friend or worst enemy!
Patients understand that it's impossible for one person to be an expert in everything, hence the reason we have sub-specialties. However, nothing bothers me more than a doctor who has too much pride to admit he's out of his realm of knowledge. "I don't know" is not an acceptable answer to any question, big or small… the answer is "I don't know, but I will find out" and you should follow through! Big egos are perhaps the biggest turnoff in doctors – even if you are world-renowned, you are still a person just like the rest of us. You may be superior to your patient in medical knowledge, but chances are they know more about another topic than you do. On that note, while patients are more knowledgeable on their own conditions than ever before thanks to the internet, please explain things in words your patient can comprehend. A sentence full of "medical lingo" just adds anxiety to an already anxious patient. In school they tell you that "the only dumb question is the one you didn't ask" – same goes for patients. It may be something you think is as obvious as the fact that the sky is blue, but if your patient brought it up to you, it's important to them, and therefore should be important to you.
In a similar vein, there is a huge difference between delivering a new diagnosis, poor prognosis, or other difficult news realistically versus bluntly. The former shows respect while the latter indicates that you don't care, even if that's not what you intend to communicate. And in times like those, a little compassion can go a long way. It's the little things that matter – that extra minute you stayed to assure a frightened parent… to play a game of cards with a child receiving chemo… to hear a terminal patient's reflections on life… those are the moments we remember as patients. And frankly, I think you will remember them too, as they are the essence of the wonderful "helping" profession you have chosen.
Above all else, please remember each day as you enter the hospital or office why you went to medical school in the first place. Think of the older woman who is hard of hearing and needs everything repeated as your mother, the annoying, impatient little boy as your future son, and the young woman distraught over her new diagnosis of breast cancer as your sister. Just remember that you are treating people, not specimens, and everything else will fall into place.
Best of luck!
Diana
Age 20, Chronic pancreatitis (dx 4/05), Pseudotumor Cerebri (dx 8/05), VP shunt (7/06)
www.caringbridge.org/visit/dianaleigh
Congratulations on your success this far – I applaud you on your noble career choice and wish you the best of luck with your future endeavors. You are entering the medical profession at a time of great need. While there may be plenty of physicians to go around quantitatively speaking, through my experiences as a patient I've found that the quality of doctors can vary in a number of ways. I wish I could say every MD I've encountered was phenomenal, but the fact of the matter is that there is only so much one can be taught during medical school – good doctoring is about the patient, not just the disease, and that part comes when you are out in the real world.
As a formally perfectly health sixteen year old, finding myself in the hospital for the first time ever was beyond frightening. Basic tests showed nothing wrong and my first doctors only looked at the tests, not at me, and thought they were being comforting by saying "I promise it's not your heart" when my (obviously GI) pain was in the epigastric area. It took over a month of traveling to different hospitals, evenly highly respected ones such as the Mayo Clinic, before I even had some semblance of a diagnosis, and that's because one doctor truly looked at ME and not just my CT/MRI/endoscopy/labs/you-name-the-test. Just because you can't find an obvious abnormality on a lab or diagnostic test doesn't mean there's nothing wrong, and it most certainly doesn't mean it's "all in my head." After my "godsend" doctor took the time to treat me as a person, we quickly received the correct diagnosis: Chronic Pancreatitis. Ironically I was treated completely different after that diagnosis popped up on my chart. And six months later when my ICP was 330 there was no question that I truly had a "headache behind my eye" – we got the diagnosis of Pseudotumor Cerebri while I was still in the ER and I had shunt surgery a year later. Basically what I'm saying is to trust your patient – you know the anatomy, pathophysiology and differential diagnoses… they know their body, and certainly know when something isn't right.
As my main treating hospital is a prominent teaching hospital, I've encountered more than my share of residents and medical students. Some were great, and I let them know that. Some I shuddered when they walked in my room. While in the end the most important part is what is coming out of the physician's mouth, there is so much more to communication, which I believe to be the essence of a successful patient-doctor relationship. It's been proven that about 7% of meaning is transmitted by words, while 38% is by vocal cues and 55% by body cues. Please keep in mind that whether you like it or not, you are being judged from the moment you walk in a patient's room. Your body stance and opening remarks set the tone for the entire visit. It was the doctors that first asked about me and not about my disease that I developed a deep sense of respect for. And it's not just your communication with your patients that matter. Whether intentionally or not, we see the impression you have made on our nurse, and since she sees every combination of medical talent and personality, we tend to respect her opinions. If your patient is in pain at 3am and you're on call, please don't complain when you're woken up… you signed up for it! I say that half-jokingly… as a nursing student, I know that nurses don't enjoy having to call and wake you up in the middle of the night just as much as you don't like being woken up. They are just doing their jobs as patient advocates – please respect them! If you haven't figured it out by now, nurses can be your best friend or worst enemy!
Patients understand that it's impossible for one person to be an expert in everything, hence the reason we have sub-specialties. However, nothing bothers me more than a doctor who has too much pride to admit he's out of his realm of knowledge. "I don't know" is not an acceptable answer to any question, big or small… the answer is "I don't know, but I will find out" and you should follow through! Big egos are perhaps the biggest turnoff in doctors – even if you are world-renowned, you are still a person just like the rest of us. You may be superior to your patient in medical knowledge, but chances are they know more about another topic than you do. On that note, while patients are more knowledgeable on their own conditions than ever before thanks to the internet, please explain things in words your patient can comprehend. A sentence full of "medical lingo" just adds anxiety to an already anxious patient. In school they tell you that "the only dumb question is the one you didn't ask" – same goes for patients. It may be something you think is as obvious as the fact that the sky is blue, but if your patient brought it up to you, it's important to them, and therefore should be important to you.
In a similar vein, there is a huge difference between delivering a new diagnosis, poor prognosis, or other difficult news realistically versus bluntly. The former shows respect while the latter indicates that you don't care, even if that's not what you intend to communicate. And in times like those, a little compassion can go a long way. It's the little things that matter – that extra minute you stayed to assure a frightened parent… to play a game of cards with a child receiving chemo… to hear a terminal patient's reflections on life… those are the moments we remember as patients. And frankly, I think you will remember them too, as they are the essence of the wonderful "helping" profession you have chosen.
Above all else, please remember each day as you enter the hospital or office why you went to medical school in the first place. Think of the older woman who is hard of hearing and needs everything repeated as your mother, the annoying, impatient little boy as your future son, and the young woman distraught over her new diagnosis of breast cancer as your sister. Just remember that you are treating people, not specimens, and everything else will fall into place.
Best of luck!
Diana
Age 20, Chronic pancreatitis (dx 4/05), Pseudotumor Cerebri (dx 8/05), VP shunt (7/06)
www.caringbridge.org/visit/dianaleigh
Letter #17
Dear Future Physician,
Let me start with saying thank you. Thank you for choosing to become a physician. It is my hopes that not only will you learn a tremendous amount of medicine, but that while in medical school, you’ll learn a lot about patients, and how it feels to be a patient, because those two, in combination can make for a great doctor!
My name is Dayna, and I am a mother of three young children, ages 7, 5 & 4. In addition to being a mother, I am also a patient advocate and speak on our families experiences navigating the medical system, this came about after I had a magazine column about what it's like to parent chronically ill children. I hope this letter will be short testament to the power a doctor has, and what one family looks for in a doctor.
This letter is taken from a blog post I wrote on my experience navigating the medical system with my three chronically ill children. All three of my children were born missing part of their immune system, the disease, once thought to be rare is generally only known to people as “The Boy In The Bubble Disease.” Yes, there was a real boy who lived in a bubble, but no, kids do not live in bubbles anymore.
I share this with you because of our experience with doctors, you see, for 3 years I felt something was wrong with my oldest child, and then with the second child I delivered, but I was repeatedly dismissed by doctors of different specialties, including a pediatrician, a Gastrointestinal Doctor, and a Pediatric Infectious Disease Doctor.
I was told that I needed counseling because I was an overreacting first time mother. I was told that my daughter was too fat to be sick and that fat babies do not get sick, and that I should stop taking her temperature, and stop taking her to the doctor. I was accused of being a germaphobic parent.
All the while I kept trying to explain that it didn’t matter where I went or what I did, my children kept getting sick. I was alarmed and scared, and I was repeatedly dismissed and made to feel crazy. Despite all the doctors that kept telling me everything was okay, in my heart, I felt like something was wrong – call it my Mommy instinct.
In the end, when I was pregnant with our third child our first two children were diagnosed by an expert in pediatric immunology as missing part of their immune system. They were put on IVIG, and their symptoms were greatly lessened. Our third child was born, and at six months diagnosed as also missing part of his immune system, and started on plasma derived IVIG by the time he was one year old.
I spent some time being angry with the doctors that dismissed my concerns, I worried what would have happened had I not listened to my instincts, had I not found a doctor who would listen to me.
I now know that our road is not unlike most who deal with immune disorders, in fact according to a study done by the Immune Deficiency Foundation, the average time from the onset of symptoms to diagnosis in the US is 9.2 years. In that time many patients experience many infections that leave long term damage to major organs such as the lungs, damage that is not reversible.
After navigating the medical system for the past five years, as we've added more and more specialists to our team...pediatric infectious disease, GI, ENT, dermatology, rheumatology, and immunology... I've learned what kind of doctor I want on our team.
We don't care if the doctor we see knows the most, I want the doctor willing to learn or investigate the most
We don't care if the doctor we see has the nicest office, we want the doctor who is nicest while in his office, not just to his patients, to his staff as well.
We don't need a doctor who can talk with authority on everything he knows, we want a doctor who knows what he doesn't know.
We don't need the doctor who can solve everything, we need the doctor who can find someone who can, when help is needed.
We don't need the doctor who will do all the talking, we need a doctor who can listen.
We don't need a doctor who always agrees, but we need a doctor whose opinion I can respect when they do disagree.
We’ve also learned that the best doctors are the ones who know that I will know more about my child, and their disease then most doctors do and will take a moment to learn from our experience.
I've learned, over time, that my job as the parent of a chronically ill child is not just to be concerned with physical health, but I need to keep their psychological well being in mind too, and at the same time, I need to help them learn to navigate the medical system as well.
They need to learn now to speak for themselves, because someday, that will be their job, and if I don't equip them now, they will not be able to handle that job if it's suddenly thrust upon them in their teen years.
A short story to give you a piece of what chronically ill children, know from a very young age:
Two years ago we were in our hospital with our then 3 1/2 year old daughter, getting a picc line, and sinus culture for an icky sinus infection that wouldn't go away after 7 rounds of antibiotics, it was supposed to be a three day stay.
My daughter was so medically compliant and verbal, they asked to have their entire medical school class come by to observe her being examined. They split the group into three groups and the first two went off without a hitch.
The third group entered and it was the chief resident leading the group. This one was different than that last one that had led the first two groups. First, he was patronizing her. He was talking in "baby" talk to a chronically ill 3 year old who had likely been through more medical procedures than he had ever been in his life. Second, he was disrespectful to me. He didn't offer a hand shake, or even greet me for that matter. Third, he didn't wash his hands. This is the cardinal sin.
As he approached my daughter with his scope already at his eye, he asked her in baby talk "Can I look at you" he added in her formal name, something she is NEVER called unless she is in trouble, something that is noted in her chart, under preferred name, her nickname is right there.
My medically compliant three year old looked right at him and said "No"
"No?" He asked seemingly shocked, I'm guessing the first doctor had told him how compliant she was.
"NO." She responded
"Why not?" He asked her, the first thing he had done right since walking in the room. He turned to his students as if to show them he was in control of the situation.
"Because you didn't wash your hands" she said handing him antibacterial gel as his entire class laughed" Here, it smells like blueberries" she said with a smirk.
I've never been more proud in my entire life.
Not because she was sassy, which, she was.
Not because, she made him wash his hands, which he did.
I was proud because she took control and made sure he knew she was the boss of her body, and as a chronically ill child she deserved respect. I hope every student in that room will carry that lesson with them for the rest of their career. The day the 3 year old outsmarted the chief resident.
I guess what it really comes down to, I don't care how busy a doctor is, how great they are in their field, or how much they know, when they walk in the room, they need to check their day, their ego and their agenda at the door and take a minute to get to know their patient, and give them an ounce of respect before even attempting an exam.
Good luck to each one of you. I sincerely hope that these letters will be taken with what they are, the experiences of many patients, and caregivers, who took their time to help you become the kind of doctor you are meant to be, the kind of doctors we, and our children need.
As an aside, should you ever want to take a more in depth look at what patients go through, please check out the internet blog world (google blog & the name of a disease), and the world of caringbridge.com where patients and caregivers often write with heartfelt emotions on what it feels like to navigate the medical system, to get a devastating diagnosis, and what they’ve learned along the way.
All the Best,
Dayna,, CA
Mom to Charlie, Kate & Tommy
All Primary Immunodeficient and
IVIG dependent
www.lookthroughoureyes.blogspot.com
Let me start with saying thank you. Thank you for choosing to become a physician. It is my hopes that not only will you learn a tremendous amount of medicine, but that while in medical school, you’ll learn a lot about patients, and how it feels to be a patient, because those two, in combination can make for a great doctor!
My name is Dayna, and I am a mother of three young children, ages 7, 5 & 4. In addition to being a mother, I am also a patient advocate and speak on our families experiences navigating the medical system, this came about after I had a magazine column about what it's like to parent chronically ill children. I hope this letter will be short testament to the power a doctor has, and what one family looks for in a doctor.
This letter is taken from a blog post I wrote on my experience navigating the medical system with my three chronically ill children. All three of my children were born missing part of their immune system, the disease, once thought to be rare is generally only known to people as “The Boy In The Bubble Disease.” Yes, there was a real boy who lived in a bubble, but no, kids do not live in bubbles anymore.
I share this with you because of our experience with doctors, you see, for 3 years I felt something was wrong with my oldest child, and then with the second child I delivered, but I was repeatedly dismissed by doctors of different specialties, including a pediatrician, a Gastrointestinal Doctor, and a Pediatric Infectious Disease Doctor.
I was told that I needed counseling because I was an overreacting first time mother. I was told that my daughter was too fat to be sick and that fat babies do not get sick, and that I should stop taking her temperature, and stop taking her to the doctor. I was accused of being a germaphobic parent.
All the while I kept trying to explain that it didn’t matter where I went or what I did, my children kept getting sick. I was alarmed and scared, and I was repeatedly dismissed and made to feel crazy. Despite all the doctors that kept telling me everything was okay, in my heart, I felt like something was wrong – call it my Mommy instinct.
In the end, when I was pregnant with our third child our first two children were diagnosed by an expert in pediatric immunology as missing part of their immune system. They were put on IVIG, and their symptoms were greatly lessened. Our third child was born, and at six months diagnosed as also missing part of his immune system, and started on plasma derived IVIG by the time he was one year old.
I spent some time being angry with the doctors that dismissed my concerns, I worried what would have happened had I not listened to my instincts, had I not found a doctor who would listen to me.
I now know that our road is not unlike most who deal with immune disorders, in fact according to a study done by the Immune Deficiency Foundation, the average time from the onset of symptoms to diagnosis in the US is 9.2 years. In that time many patients experience many infections that leave long term damage to major organs such as the lungs, damage that is not reversible.
After navigating the medical system for the past five years, as we've added more and more specialists to our team...pediatric infectious disease, GI, ENT, dermatology, rheumatology, and immunology... I've learned what kind of doctor I want on our team.
We don't care if the doctor we see knows the most, I want the doctor willing to learn or investigate the most
We don't care if the doctor we see has the nicest office, we want the doctor who is nicest while in his office, not just to his patients, to his staff as well.
We don't need a doctor who can talk with authority on everything he knows, we want a doctor who knows what he doesn't know.
We don't need the doctor who can solve everything, we need the doctor who can find someone who can, when help is needed.
We don't need the doctor who will do all the talking, we need a doctor who can listen.
We don't need a doctor who always agrees, but we need a doctor whose opinion I can respect when they do disagree.
We’ve also learned that the best doctors are the ones who know that I will know more about my child, and their disease then most doctors do and will take a moment to learn from our experience.
I've learned, over time, that my job as the parent of a chronically ill child is not just to be concerned with physical health, but I need to keep their psychological well being in mind too, and at the same time, I need to help them learn to navigate the medical system as well.
They need to learn now to speak for themselves, because someday, that will be their job, and if I don't equip them now, they will not be able to handle that job if it's suddenly thrust upon them in their teen years.
A short story to give you a piece of what chronically ill children, know from a very young age:
Two years ago we were in our hospital with our then 3 1/2 year old daughter, getting a picc line, and sinus culture for an icky sinus infection that wouldn't go away after 7 rounds of antibiotics, it was supposed to be a three day stay.
My daughter was so medically compliant and verbal, they asked to have their entire medical school class come by to observe her being examined. They split the group into three groups and the first two went off without a hitch.
The third group entered and it was the chief resident leading the group. This one was different than that last one that had led the first two groups. First, he was patronizing her. He was talking in "baby" talk to a chronically ill 3 year old who had likely been through more medical procedures than he had ever been in his life. Second, he was disrespectful to me. He didn't offer a hand shake, or even greet me for that matter. Third, he didn't wash his hands. This is the cardinal sin.
As he approached my daughter with his scope already at his eye, he asked her in baby talk "Can I look at you" he added in her formal name, something she is NEVER called unless she is in trouble, something that is noted in her chart, under preferred name, her nickname is right there.
My medically compliant three year old looked right at him and said "No"
"No?" He asked seemingly shocked, I'm guessing the first doctor had told him how compliant she was.
"NO." She responded
"Why not?" He asked her, the first thing he had done right since walking in the room. He turned to his students as if to show them he was in control of the situation.
"Because you didn't wash your hands" she said handing him antibacterial gel as his entire class laughed" Here, it smells like blueberries" she said with a smirk.
I've never been more proud in my entire life.
Not because she was sassy, which, she was.
Not because, she made him wash his hands, which he did.
I was proud because she took control and made sure he knew she was the boss of her body, and as a chronically ill child she deserved respect. I hope every student in that room will carry that lesson with them for the rest of their career. The day the 3 year old outsmarted the chief resident.
I guess what it really comes down to, I don't care how busy a doctor is, how great they are in their field, or how much they know, when they walk in the room, they need to check their day, their ego and their agenda at the door and take a minute to get to know their patient, and give them an ounce of respect before even attempting an exam.
Good luck to each one of you. I sincerely hope that these letters will be taken with what they are, the experiences of many patients, and caregivers, who took their time to help you become the kind of doctor you are meant to be, the kind of doctors we, and our children need.
As an aside, should you ever want to take a more in depth look at what patients go through, please check out the internet blog world (google blog & the name of a disease), and the world of caringbridge.com where patients and caregivers often write with heartfelt emotions on what it feels like to navigate the medical system, to get a devastating diagnosis, and what they’ve learned along the way.
All the Best,
Dayna,, CA
Mom to Charlie, Kate & Tommy
All Primary Immunodeficient and
IVIG dependent
www.lookthroughoureyes.blogspot.com
Letter #16
Dear Future Physician,
I applaud you for making the decision to seek out a medical degree. I hope you will use it to help those truly in need of medical help. We need more caring physicians who will take the time to get to know their patients and their caregivers instead of treating them as another patient and/or study.
There will be many children and adults you will see over your career. Please take the time to truly listen to their concerns. So much goes unnoticed, usually too late, when a Doctor doesn’t take the time to truly listen. It might seem trivial to you, but to the patients, parents and caregivers, it isn’t. Also, remember, the parents know their children the best. They are with them 24/7.
I am the mother to four wonderful sons. Two of which have rare birth defects and one suffers from severe Chronic health issues. Many things have been missed or thought to have been something else when it was a more serious issue. His Doctors were not listening to me.
If there is anything I can impress upon your mind, is listening to your patients and their caregivers and to communicate with them what is going on with their treatment.
Our Pediatrician heads up the Residency program at our local Childrens Hospital. He has always listened to me and communicates what he is going to do for my sons. He has taught me how to care for my sons and because of that, they are pretty darn healthy considering what they have. He has always been there for us regardless and he is that way with all his patients. He teaches what he preaches to all his parents and Residents. We have had many opportunities to move elsewhere but don’t because of our Doctor. He has helped one son defy the odds of his life expectancy because he truly cares. He is dedicated to doing what needs to be done, not what the insurance wants.
I hope you will find some time to write some goals to set throughout your medical career. It isn’t about how many surgeries you have done or what rare new disease you found, but how you treat others, by listening and communicating effectively.
Mrs. Shelly R.
Mom to the only boys who are the same birth defect: hypospadius. Paul, Sean, Daniel and Peter….all repaired.
Sean: VACTERLS Association, Dysautonomia, Suspected Mitochondrial Disorder, Chronic Lung Disease, Horner’s syndrome, Cyclic Vomiting syndrome, Heat Intolerance, Stressed Induced Diabetes, Fever sydrome, Tracheaomalacia, Syringomyelia…….the list goes on. Dx’d 2days old. 17 surgeries. One happy and smart boy!
Daniel: Chiari Malformation-decompressed, Syringomyelia, Dysautonomia. Sweet and precious to all.
I applaud you for making the decision to seek out a medical degree. I hope you will use it to help those truly in need of medical help. We need more caring physicians who will take the time to get to know their patients and their caregivers instead of treating them as another patient and/or study.
There will be many children and adults you will see over your career. Please take the time to truly listen to their concerns. So much goes unnoticed, usually too late, when a Doctor doesn’t take the time to truly listen. It might seem trivial to you, but to the patients, parents and caregivers, it isn’t. Also, remember, the parents know their children the best. They are with them 24/7.
I am the mother to four wonderful sons. Two of which have rare birth defects and one suffers from severe Chronic health issues. Many things have been missed or thought to have been something else when it was a more serious issue. His Doctors were not listening to me.
If there is anything I can impress upon your mind, is listening to your patients and their caregivers and to communicate with them what is going on with their treatment.
Our Pediatrician heads up the Residency program at our local Childrens Hospital. He has always listened to me and communicates what he is going to do for my sons. He has taught me how to care for my sons and because of that, they are pretty darn healthy considering what they have. He has always been there for us regardless and he is that way with all his patients. He teaches what he preaches to all his parents and Residents. We have had many opportunities to move elsewhere but don’t because of our Doctor. He has helped one son defy the odds of his life expectancy because he truly cares. He is dedicated to doing what needs to be done, not what the insurance wants.
I hope you will find some time to write some goals to set throughout your medical career. It isn’t about how many surgeries you have done or what rare new disease you found, but how you treat others, by listening and communicating effectively.
Mrs. Shelly R.
Mom to the only boys who are the same birth defect: hypospadius. Paul, Sean, Daniel and Peter….all repaired.
Sean: VACTERLS Association, Dysautonomia, Suspected Mitochondrial Disorder, Chronic Lung Disease, Horner’s syndrome, Cyclic Vomiting syndrome, Heat Intolerance, Stressed Induced Diabetes, Fever sydrome, Tracheaomalacia, Syringomyelia…….the list goes on. Dx’d 2days old. 17 surgeries. One happy and smart boy!
Daniel: Chiari Malformation-decompressed, Syringomyelia, Dysautonomia. Sweet and precious to all.
Letter #15
Dear Future Physician,
Congratulations on your career choice to help make a difference in peoples lives. The amount of time, energy and work that you will put into this choice will reward you greatly in the years to come.
As a mom to a child who has been living with chronic illnesses (POTS, Chiari Malformation, Chronic Headaches, Chronic Fatigue) for the last 13 years, I would like to give you my suggestions on what makes a good doctor a great one.
One of the most important things you can do for your patients is to listen to them. Do not make them feel as though they are crazy when they tell you what symptoms they have been suffering. Take notes as they talk to you so that you will always be able to go back and say, “yes, you did tell me that before”. Be there for your patients. Let them know that you are the one person they can be themselves around, that you are willing to let them be able t o vent to you and that you will understand.
Realize that when you are dealing with patients with chronic illness that you are also dealing with their families. Their families along with the patient are the ones who deal with these illnesses on a daily basis. You will only see the patient, possibly 6 or more times a year but the family deals with this every day. Sometimes the other family members see things that the patient does not see. These details can sometimes be very important in regards to how you will treat the patient.
One of the very best doctors my daughter has is the one that she is so comfortable with that she feels like she can tell him anything and he won’t pass judgment on her. She is able to let him see her on her good days, her frustrating days, and she feels free to tell him that this or that is just not working. She can be herself with him and this makes for a GREAT patient/doctor relationship
Another important thing for you as future physician is to be available for your patient. Let them know that their concerns and questions are important. Although you are very busy, you still have those few minutes a day to answer their questions either by phone, e-mail or whatever means works for both you and the patient. My daughter’s doctor is always available by his beeper. We can beep him any time of the day and he usually responds within the hour. Although, I know that all doctors are not this way, I can tell you that this has endeared us to this physician in more ways than one. It makes my daughter feel that she matters and that her health matters.
Don’t ever be afraid to admit that you don’t have the answers. Be open minded when the patient brings you some research they have done or heard about in regards to their condition. Always be willing to refer your patient to someone who you feel can help them better. In saying that, DON’T refer them to someone else because you don’t have the TIME for them. Make the time to learn about their illness and how you can help them. If you really believe that you cannot help them, don’t be afraid to send them to other doctors who don’t work within your institution. One of the best things our daughter’s doctor did for her was to send her to a doctor 4 hours away who had the expertise in what was happening with her.
The best doctors that we have dealt with over the last 9 years are the ones who have left their egos at the door. They are the ones who have the patient’s best interest at hearts and are truly there to practice the art of medicine and to help make a difference in their patient’s live.
In closing, know that you too will make a difference in someone’s life. It is an awesome job and one that has great rewards at the end of the day. May you have what it takes to be one of the great ones!
Kathy
Mom to Kerri
Congratulations on your career choice to help make a difference in peoples lives. The amount of time, energy and work that you will put into this choice will reward you greatly in the years to come.
As a mom to a child who has been living with chronic illnesses (POTS, Chiari Malformation, Chronic Headaches, Chronic Fatigue) for the last 13 years, I would like to give you my suggestions on what makes a good doctor a great one.
One of the most important things you can do for your patients is to listen to them. Do not make them feel as though they are crazy when they tell you what symptoms they have been suffering. Take notes as they talk to you so that you will always be able to go back and say, “yes, you did tell me that before”. Be there for your patients. Let them know that you are the one person they can be themselves around, that you are willing to let them be able t o vent to you and that you will understand.
Realize that when you are dealing with patients with chronic illness that you are also dealing with their families. Their families along with the patient are the ones who deal with these illnesses on a daily basis. You will only see the patient, possibly 6 or more times a year but the family deals with this every day. Sometimes the other family members see things that the patient does not see. These details can sometimes be very important in regards to how you will treat the patient.
One of the very best doctors my daughter has is the one that she is so comfortable with that she feels like she can tell him anything and he won’t pass judgment on her. She is able to let him see her on her good days, her frustrating days, and she feels free to tell him that this or that is just not working. She can be herself with him and this makes for a GREAT patient/doctor relationship
Another important thing for you as future physician is to be available for your patient. Let them know that their concerns and questions are important. Although you are very busy, you still have those few minutes a day to answer their questions either by phone, e-mail or whatever means works for both you and the patient. My daughter’s doctor is always available by his beeper. We can beep him any time of the day and he usually responds within the hour. Although, I know that all doctors are not this way, I can tell you that this has endeared us to this physician in more ways than one. It makes my daughter feel that she matters and that her health matters.
Don’t ever be afraid to admit that you don’t have the answers. Be open minded when the patient brings you some research they have done or heard about in regards to their condition. Always be willing to refer your patient to someone who you feel can help them better. In saying that, DON’T refer them to someone else because you don’t have the TIME for them. Make the time to learn about their illness and how you can help them. If you really believe that you cannot help them, don’t be afraid to send them to other doctors who don’t work within your institution. One of the best things our daughter’s doctor did for her was to send her to a doctor 4 hours away who had the expertise in what was happening with her.
The best doctors that we have dealt with over the last 9 years are the ones who have left their egos at the door. They are the ones who have the patient’s best interest at hearts and are truly there to practice the art of medicine and to help make a difference in their patient’s live.
In closing, know that you too will make a difference in someone’s life. It is an awesome job and one that has great rewards at the end of the day. May you have what it takes to be one of the great ones!
Kathy
Mom to Kerri
Letter #14
Dear Future Doctor,
In 1991 I gave birth to a baby boy born at 25 ½ weeks gestation. Christopher was my second child, my first born on her due date at 9 lbs., 4 oz. There were no indications that there were any difficulties with my second pregnancy. My biggest fear with my second was having a bigger baby than my first.
I awoke at 3:00am with Flu like symptoms. A call to the maternity ward, at the hospital where I would be delivering, was not comforting. The nurse I spoke to said I had likely strained my back lifting my then two year old. Back to bed, no comfort. Shook hubby awake in tears at 4:00am. Off to the hospital with two year old in tow.
Arrive at hospital, walk ¼ mile to Maternity Unit; OB nurses blow me off as hysterical. Hubby, with two year old off parking the car. Hubby arrives in Maternity Ward; nurses still have not even checked me. He pitches a fit, they check me and find I am 9cm dilated, all h-ll breaks loose. A call to my OB/Gyn goes out, she arrives in short order.
My doctor offers comfort and reality at the same time. 25 ½ weeks, not good, but she will be by our side until Peanut is delivered. Tests, more tests, not good. Doc is still there, many hours later. We are her only patient that day, not really, but she makes that happen. She stays with us, she is funny, she is reassuring, and she is realistic. After all tests results are in the turbutaline is stopped and Peanut is delivered. He is delivered vaginally, the squeeze through the birth canal and the stress of the delivery will help him produce surfactant, which is he is lacking. ;
Two pushes and he is out. She holds him up; he takes a big breath and cries. His lungs immediately collapse. He is whisked away, now in the hands of the many in the room who have been awaiting his arrival. She stays with us, she delivers the placenta. She assures us, she hugs us. She comes every day to see us, at least once, to report and interpret what is happening in NICU. She is our advocate, she is our intermediary. We never ask for this, she just assumes the role.
One hundred days this goes on. Sixteen years later, this 25 ½ weeker has just received his driver’s license. He is six feet tall and a wonderful young man. We cannot help but credit this wonderful doctor. We still hear from this doctor, we have moved many states away. We send her pictures and thanks. We do believe that her involvement in our lives had a positive outcome in Peanut’s life and in ours!
You too, can make a difference in the life of an individual and their family.
Roberta and family in MA
In 1991 I gave birth to a baby boy born at 25 ½ weeks gestation. Christopher was my second child, my first born on her due date at 9 lbs., 4 oz. There were no indications that there were any difficulties with my second pregnancy. My biggest fear with my second was having a bigger baby than my first.
I awoke at 3:00am with Flu like symptoms. A call to the maternity ward, at the hospital where I would be delivering, was not comforting. The nurse I spoke to said I had likely strained my back lifting my then two year old. Back to bed, no comfort. Shook hubby awake in tears at 4:00am. Off to the hospital with two year old in tow.
Arrive at hospital, walk ¼ mile to Maternity Unit; OB nurses blow me off as hysterical. Hubby, with two year old off parking the car. Hubby arrives in Maternity Ward; nurses still have not even checked me. He pitches a fit, they check me and find I am 9cm dilated, all h-ll breaks loose. A call to my OB/Gyn goes out, she arrives in short order.
My doctor offers comfort and reality at the same time. 25 ½ weeks, not good, but she will be by our side until Peanut is delivered. Tests, more tests, not good. Doc is still there, many hours later. We are her only patient that day, not really, but she makes that happen. She stays with us, she is funny, she is reassuring, and she is realistic. After all tests results are in the turbutaline is stopped and Peanut is delivered. He is delivered vaginally, the squeeze through the birth canal and the stress of the delivery will help him produce surfactant, which is he is lacking. ;
Two pushes and he is out. She holds him up; he takes a big breath and cries. His lungs immediately collapse. He is whisked away, now in the hands of the many in the room who have been awaiting his arrival. She stays with us, she delivers the placenta. She assures us, she hugs us. She comes every day to see us, at least once, to report and interpret what is happening in NICU. She is our advocate, she is our intermediary. We never ask for this, she just assumes the role.
One hundred days this goes on. Sixteen years later, this 25 ½ weeker has just received his driver’s license. He is six feet tall and a wonderful young man. We cannot help but credit this wonderful doctor. We still hear from this doctor, we have moved many states away. We send her pictures and thanks. We do believe that her involvement in our lives had a positive outcome in Peanut’s life and in ours!
You too, can make a difference in the life of an individual and their family.
Roberta and family in MA
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
too.
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,
Bethany
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
too.
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,
Bethany
Letter #12
Dear Future Physician,
I am not sure how much my words will affect any decision you make as a doctor, but I wish you the best as you embark on a very admirable career path. Coming from a family filled with multiple autoimmune disorders and fractures of pretty much any bone out there I assure you that people are going to question you and have lots of them. So be prepared, be caring, and always get back to your patients when you say you will.
Our experience in the hospital, or should I say my experience began in 1991. Actually take it back a few hours on that blistery cold January day to my physician’s office. Dr. S., my pediatrician was a small, petite, caring woman in her late fifties. When she was unsure of what was wrong with me she quickly took me to the laboratory which was closing. When the laboratory technicians refused to help me she quickly took out the equipment and did the tests herself. Her knowledge amazes me to this day. I was diagnosed with Type 1 Diabetes and quickly whisked off to the hospital shortly thereafter. My story and life with diabetes most certainly doesn’t end there but Dr. S. played an important part in my young life and I might not be here today if it weren’t for her. So one of the wishes I have for you is to take the time to show your patients that you care. Sure, I was scared but it was because of the courage and determination that night that got me through the next few hours. I arrived at North Shore University Medical Center Emergency Room late at night. Please remember not to shine any bright lights in a child’s face while you’re trying to access a vein and insert an IV. It will not only hurt there eyes but make them cranky. I don’t ever recall a time in my life that I was so cranky except for when that evil physician shined that light ever so bright right into my beautiful, brown eyes. After a child asks to use the bathroom don’t tell them “NO” – oh no, that means they really have to go. And most of all don’t poke and prod me at an early morning hour without introducing yourself as “Dr. So and So”. Nothing is worse than not knowing your doctor’s name. Oh and when my parents say, “Thank god it’s not cancer” don’t tell them your right you should be thankful it’s not cancer because that fourteen year old girl standing beside my bed will be diagnosed with a rare form of cancer in three short years.
The next experience takes place in… you’ve probably already figured that out. A Hematology/Oncology Floor at the Children’s Hospital down the street,Schneider's Children's Hospital. Picture yourself standing over your patient’s bed; now guess who the patient is. That’s right that girl who was standing next to my bed as my parent’s expressed that they were thankful it wasn’t cancer. The only lesson I can tell you now is, Don’t tell the seventeen year old girl that she belongs in the Psych ward with the Anorexic patients when she is upset after a break up with her “first love” in the Bone Marrow Unit. Some things are meant to be left unsaid future physician, and that would be one of them. THINK before you speak to your patient, patient’s family members, friends, grandparents, aunts, uncles, cousins.
Our Journey most certainly does not end there future physician but I believe that as long as you show that you care and think before you speak you’ll do just great. Don’t worry about those broken femurs (yes, both the cancer and diabetes patient broke their legs within six months of each other) in our life story just remember to answer questions and be hopeful even when the situation isn’t! If you become someone’s “Dr. S.” you’ll be highly regarded in life and always highly thought of. God Bless and I will pray for you as you embark on this journey!
I am not sure how much my words will affect any decision you make as a doctor, but I wish you the best as you embark on a very admirable career path. Coming from a family filled with multiple autoimmune disorders and fractures of pretty much any bone out there I assure you that people are going to question you and have lots of them. So be prepared, be caring, and always get back to your patients when you say you will.
Our experience in the hospital, or should I say my experience began in 1991. Actually take it back a few hours on that blistery cold January day to my physician’s office. Dr. S., my pediatrician was a small, petite, caring woman in her late fifties. When she was unsure of what was wrong with me she quickly took me to the laboratory which was closing. When the laboratory technicians refused to help me she quickly took out the equipment and did the tests herself. Her knowledge amazes me to this day. I was diagnosed with Type 1 Diabetes and quickly whisked off to the hospital shortly thereafter. My story and life with diabetes most certainly doesn’t end there but Dr. S. played an important part in my young life and I might not be here today if it weren’t for her. So one of the wishes I have for you is to take the time to show your patients that you care. Sure, I was scared but it was because of the courage and determination that night that got me through the next few hours. I arrived at North Shore University Medical Center Emergency Room late at night. Please remember not to shine any bright lights in a child’s face while you’re trying to access a vein and insert an IV. It will not only hurt there eyes but make them cranky. I don’t ever recall a time in my life that I was so cranky except for when that evil physician shined that light ever so bright right into my beautiful, brown eyes. After a child asks to use the bathroom don’t tell them “NO” – oh no, that means they really have to go. And most of all don’t poke and prod me at an early morning hour without introducing yourself as “Dr. So and So”. Nothing is worse than not knowing your doctor’s name. Oh and when my parents say, “Thank god it’s not cancer” don’t tell them your right you should be thankful it’s not cancer because that fourteen year old girl standing beside my bed will be diagnosed with a rare form of cancer in three short years.
The next experience takes place in… you’ve probably already figured that out. A Hematology/Oncology Floor at the Children’s Hospital down the street,Schneider's Children's Hospital. Picture yourself standing over your patient’s bed; now guess who the patient is. That’s right that girl who was standing next to my bed as my parent’s expressed that they were thankful it wasn’t cancer. The only lesson I can tell you now is, Don’t tell the seventeen year old girl that she belongs in the Psych ward with the Anorexic patients when she is upset after a break up with her “first love” in the Bone Marrow Unit. Some things are meant to be left unsaid future physician, and that would be one of them. THINK before you speak to your patient, patient’s family members, friends, grandparents, aunts, uncles, cousins.
Our Journey most certainly does not end there future physician but I believe that as long as you show that you care and think before you speak you’ll do just great. Don’t worry about those broken femurs (yes, both the cancer and diabetes patient broke their legs within six months of each other) in our life story just remember to answer questions and be hopeful even when the situation isn’t! If you become someone’s “Dr. S.” you’ll be highly regarded in life and always highly thought of. God Bless and I will pray for you as you embark on this journey!
Letter #11
Rules for a Future Dr from a Cancer Mom :
*NEVER tell the parent, who has been waiting in ER for hours on end, that her child has cancer right there in the ER hallway at 4 a.m.
*NEVER tell that parent that the ultrasound shows missing bone and that there is a "spot" on her child's lung, while she is leaning against the hallway wall...she might pass out...so suggest she sit before you tell her more info that will make her head spin and make her vomit.
*NEVER use your teeth to pull the cap off the end of a syringe...especially when the mother of the patient is watching.
*NEVER argue with another Dr. in the presence of any patient.
*ALWAYS smile...even when the day totally sucks...remember the kid with cancer is always having a worse day than you.
*REMEMBER that you are only human. It's okay to let us know that.
*ALWAYS have hope.
-Our onc was a fellow who genuinely cared. We were lucky. My daughter now babysits for his children and he wrote letters of recommendation for college and scholarships for her.
-Our family Dr. found out about my daughter and came to the hospital armed with tons of cancer info in layman's terms that she pulled from the internet.
-Everyday info, tiny bits of info about you help your young patients see you as a real person.
Good luck- your profession is not an easy one. Breath deep each morning and want for each patient as you would for your own.
Marey
Mom of Ali, teenage leukemia survivor, now off treatment for 2 years 11 months
http://caringbridge.org/ca/ali
*NEVER tell the parent, who has been waiting in ER for hours on end, that her child has cancer right there in the ER hallway at 4 a.m.
*NEVER tell that parent that the ultrasound shows missing bone and that there is a "spot" on her child's lung, while she is leaning against the hallway wall...she might pass out...so suggest she sit before you tell her more info that will make her head spin and make her vomit.
*NEVER use your teeth to pull the cap off the end of a syringe...especially when the mother of the patient is watching.
*NEVER argue with another Dr. in the presence of any patient.
*ALWAYS smile...even when the day totally sucks...remember the kid with cancer is always having a worse day than you.
*REMEMBER that you are only human. It's okay to let us know that.
*ALWAYS have hope.
-Our onc was a fellow who genuinely cared. We were lucky. My daughter now babysits for his children and he wrote letters of recommendation for college and scholarships for her.
-Our family Dr. found out about my daughter and came to the hospital armed with tons of cancer info in layman's terms that she pulled from the internet.
-Everyday info, tiny bits of info about you help your young patients see you as a real person.
Good luck- your profession is not an easy one. Breath deep each morning and want for each patient as you would for your own.
Marey
Mom of Ali, teenage leukemia survivor, now off treatment for 2 years 11 months
http://caringbridge.org/ca/ali
Letter #10
Dear Future Physician,
Thank you for choosing this career and life path. I will be forever grateful to the physicians who cared for my daughter as she fought leukemia.
What would I want you to know? That sometimes, in the blink of an eye, life can change. One day, you are going about your business, doing all the important day to day things that you usually do and then WHAM! you hear words that change your life. These words are delivered by physicians. These words are words you wish you never had to hear. These words, in our case, were "your daughter has leukemia".
I'd want you to think about the fact that it's mind numbing and dizzying to hear words like this. I'd want you to know that there is never any way, ever, that someone can be prepared for such news. I'd hope that you'd be straightforward yet compassionate in delivering news like this. Remember, oncologists treat cancer but general physicians and pediatricians are the ones who have to break the news to people that they have cancer.
If you are treating someone (or someone's child) who has a life threatening illness, I'd ask you to be understanding and kind and informative. I would hope that you would answer even the dumbest of questions without talking down to us. I would hope that you would, in addition to treating our child, help us as we learn the "medspeak" that is Greek to us (at least at the start of the journey). Please don't put down information that we have learned from others, especially other parents who have traveled this road before us. Please do remind us that support groups, especially ones with parents who are also in our situation, can be a life saver.
Please don't take for granted that we know what you are talking about or understand what you are saying when the protocol is first laid out. Sometimes, news is so overwhelming, either emotionally or beyond our limited understanding of medicine, that we are simply unable to grasp what is being said. Please don't dismiss our fears or our questions.
Please also realize, that those of us who have been at it a while, may have a huge understanding of the medical protocol being used to treat our child. As a parent of a child who underwent more than 2 years of chemotherapy, I gained quite a bit of knowledge as the treatment progressed. I would ask that you understand that a parent who is experienced with the protocol feels belittled when medical personnel talk down to them. After a year of being on the front line of a war going on in your child's body, you have gained enormous insight into the medical ramifications and complications of treatment.
Lastly, I'd want you to remember that you are only human. You will make mistakes, everyone does. Own them, but don't let them own you.
Thank you,
Marie
Thank you for choosing this career and life path. I will be forever grateful to the physicians who cared for my daughter as she fought leukemia.
What would I want you to know? That sometimes, in the blink of an eye, life can change. One day, you are going about your business, doing all the important day to day things that you usually do and then WHAM! you hear words that change your life. These words are delivered by physicians. These words are words you wish you never had to hear. These words, in our case, were "your daughter has leukemia".
I'd want you to think about the fact that it's mind numbing and dizzying to hear words like this. I'd want you to know that there is never any way, ever, that someone can be prepared for such news. I'd hope that you'd be straightforward yet compassionate in delivering news like this. Remember, oncologists treat cancer but general physicians and pediatricians are the ones who have to break the news to people that they have cancer.
If you are treating someone (or someone's child) who has a life threatening illness, I'd ask you to be understanding and kind and informative. I would hope that you would answer even the dumbest of questions without talking down to us. I would hope that you would, in addition to treating our child, help us as we learn the "medspeak" that is Greek to us (at least at the start of the journey). Please don't put down information that we have learned from others, especially other parents who have traveled this road before us. Please do remind us that support groups, especially ones with parents who are also in our situation, can be a life saver.
Please don't take for granted that we know what you are talking about or understand what you are saying when the protocol is first laid out. Sometimes, news is so overwhelming, either emotionally or beyond our limited understanding of medicine, that we are simply unable to grasp what is being said. Please don't dismiss our fears or our questions.
Please also realize, that those of us who have been at it a while, may have a huge understanding of the medical protocol being used to treat our child. As a parent of a child who underwent more than 2 years of chemotherapy, I gained quite a bit of knowledge as the treatment progressed. I would ask that you understand that a parent who is experienced with the protocol feels belittled when medical personnel talk down to them. After a year of being on the front line of a war going on in your child's body, you have gained enormous insight into the medical ramifications and complications of treatment.
Lastly, I'd want you to remember that you are only human. You will make mistakes, everyone does. Own them, but don't let them own you.
Thank you,
Marie
Letter #9
Dear Future Physician,
I married you. I thought long and hard about a life married to a
physician. Remember how hard I tried to talk you out of following your
dream to become a doctor? It's because I was greedy and wanted your
time. I love being with you. I love your strong arms around me. I
love how you pull me into you at night. I adore you.
Sometimes I feel like a single mother with financial support. I go to
our children's programs, alone. We eat meals alone. We put so very
many things on hold because of your schedule. Although you try, you
really try to make it to every recital and awards assembly.
Your days are long and difficult. A 12 hour day is routine for you.
Calls at night. Needing to snap out of a sound sleep and instantly be
able to dispense critical advice is required of you. And when you have
to go in -- in the middle of the night, it breaks my heart that you
still will be required to put in a full day after a night of little
sleep.
I wonder what this profession is costing you. What did it cost our
family?
And yet, I wouldn't have it any other way. You have protected us and
nurtured us the best way you know how. Your kindness and generosity
towards your patients is the same kindness and generosity you give your
family. It is you. I wish there were more hours in the day for us.
But I know you are doing so very many things right when we can't walk
down the aisle of the grocery store without people reaching out to
touch you. You can't walk through a parking lot without someone
stopping to tell you something. Being a doctor is who you are.
I smile when you bring samples of medicines to people's homes when they
can't afford them. I find it amazing when people invite you to their
homes to show you something important to them. I enjoy your stories --
we didn't know what dry wheat farming was until you had a patient that
was a farmer. I sincerely enjoy the tomatoes, zucchini and berries
your patients bring you from their gardens. I am grateful for your
skills when I am in the hospital, and your knowledge saved me from that
procedure. I know you are an extraordinary doctor. I know you have a
brilliant mind. I know you are kind and gentle when delivering the
scariest news, because your patients tell me of their gratitude and
your kindness.
But I miss you. I'm still greedy and I still wish I had more of your
time.
Cindy
Wife of a Doctor specializing in Internal Medicine
I married you. I thought long and hard about a life married to a
physician. Remember how hard I tried to talk you out of following your
dream to become a doctor? It's because I was greedy and wanted your
time. I love being with you. I love your strong arms around me. I
love how you pull me into you at night. I adore you.
Sometimes I feel like a single mother with financial support. I go to
our children's programs, alone. We eat meals alone. We put so very
many things on hold because of your schedule. Although you try, you
really try to make it to every recital and awards assembly.
Your days are long and difficult. A 12 hour day is routine for you.
Calls at night. Needing to snap out of a sound sleep and instantly be
able to dispense critical advice is required of you. And when you have
to go in -- in the middle of the night, it breaks my heart that you
still will be required to put in a full day after a night of little
sleep.
I wonder what this profession is costing you. What did it cost our
family?
And yet, I wouldn't have it any other way. You have protected us and
nurtured us the best way you know how. Your kindness and generosity
towards your patients is the same kindness and generosity you give your
family. It is you. I wish there were more hours in the day for us.
But I know you are doing so very many things right when we can't walk
down the aisle of the grocery store without people reaching out to
touch you. You can't walk through a parking lot without someone
stopping to tell you something. Being a doctor is who you are.
I smile when you bring samples of medicines to people's homes when they
can't afford them. I find it amazing when people invite you to their
homes to show you something important to them. I enjoy your stories --
we didn't know what dry wheat farming was until you had a patient that
was a farmer. I sincerely enjoy the tomatoes, zucchini and berries
your patients bring you from their gardens. I am grateful for your
skills when I am in the hospital, and your knowledge saved me from that
procedure. I know you are an extraordinary doctor. I know you have a
brilliant mind. I know you are kind and gentle when delivering the
scariest news, because your patients tell me of their gratitude and
your kindness.
But I miss you. I'm still greedy and I still wish I had more of your
time.
Cindy
Wife of a Doctor specializing in Internal Medicine
Letter #8
Dear Future Physician:
I applaud you for taking the many steps necessary to become a physician. The costs are tremendous—of education, of time, of family. Yet, the benefits are many. You will have the opportunity to make a difference in the life of another, every single day. What an honor that will be for you.
While I prefer to know that the physicians treating my family are knowledgeable, the traits I most value are integrity and courtesy. Having six children has afforded me considerable visits to clinics, to hospitals and to emergency rooms. The only visits that stand out in my memory are those that were excellent and those that were horrific. Since I have little recollection of the ordinary, may you strive to be extraordinarily memorable.
I believe that your best efforts will come from the life lessons you have already mastered:
1. Read your patient’s file carefully before entering an exam room.
2. Leave arrogance at the door. Better yet, have no arrogance.
3. Introduce yourself and greet your patient by name.
4. Speak as a peer, unless your patient asks you to simplify.
5. Ask questions.
6. Be interested in the answers.
7. Ask whether your patient would like the procedures explained up-front.
8. Be realistic, with a healthy lean towards optimism.
9. Thank your patient, whole-heartedly, for your visit.
We, the patients, love to know that our physicians know us well enough to recognize us in different settings, to know the nicknames we have, to consider our health issues as they read new journal studies. We love to know that our physicians are thinking of our us and discussing our symptoms with appropriate healthcare colleagues. We love to know that while we are our own and our children’s best advocates, our physicians are our next-best advocates.
Please remember that the best medicine is not always medicine. Laughter, an escape from hospital confines, a change of scenery, a favorite snack---these are the essence of what a parent will find for a child. Please find them for your patients.
My husband and I have each had several broken bones. I have delivered six children. Our oldest daughter was diagnosed with an anaplastic astrocytoma at age four and died at age five. Our first son has had numerous stitches and a broken arm. Our second daughter has had stitches. Our third daughter has many stitches, four broken bones and a subsequent bone scan. Our fourth daughter and second son have had simple well-child exams. A lengthy list, by no means, makes me an authority on health issues. Still, each physician visit has presented the chance for me to determine what makes an excellent physician.
I wish you the very best and thank you for making an extraordinarily memorable difference in the life of another, every single day.
Regards.
Bridget
I applaud you for taking the many steps necessary to become a physician. The costs are tremendous—of education, of time, of family. Yet, the benefits are many. You will have the opportunity to make a difference in the life of another, every single day. What an honor that will be for you.
While I prefer to know that the physicians treating my family are knowledgeable, the traits I most value are integrity and courtesy. Having six children has afforded me considerable visits to clinics, to hospitals and to emergency rooms. The only visits that stand out in my memory are those that were excellent and those that were horrific. Since I have little recollection of the ordinary, may you strive to be extraordinarily memorable.
I believe that your best efforts will come from the life lessons you have already mastered:
1. Read your patient’s file carefully before entering an exam room.
2. Leave arrogance at the door. Better yet, have no arrogance.
3. Introduce yourself and greet your patient by name.
4. Speak as a peer, unless your patient asks you to simplify.
5. Ask questions.
6. Be interested in the answers.
7. Ask whether your patient would like the procedures explained up-front.
8. Be realistic, with a healthy lean towards optimism.
9. Thank your patient, whole-heartedly, for your visit.
We, the patients, love to know that our physicians know us well enough to recognize us in different settings, to know the nicknames we have, to consider our health issues as they read new journal studies. We love to know that our physicians are thinking of our us and discussing our symptoms with appropriate healthcare colleagues. We love to know that while we are our own and our children’s best advocates, our physicians are our next-best advocates.
Please remember that the best medicine is not always medicine. Laughter, an escape from hospital confines, a change of scenery, a favorite snack---these are the essence of what a parent will find for a child. Please find them for your patients.
My husband and I have each had several broken bones. I have delivered six children. Our oldest daughter was diagnosed with an anaplastic astrocytoma at age four and died at age five. Our first son has had numerous stitches and a broken arm. Our second daughter has had stitches. Our third daughter has many stitches, four broken bones and a subsequent bone scan. Our fourth daughter and second son have had simple well-child exams. A lengthy list, by no means, makes me an authority on health issues. Still, each physician visit has presented the chance for me to determine what makes an excellent physician.
I wish you the very best and thank you for making an extraordinarily memorable difference in the life of another, every single day.
Regards.
Bridget
Letter #7
Dear Future Doctor,
I am sure that you hear this all the time but why not I am going to say it again. Thank you so much to dedicating your life to medicine. I know what a huge devotion of your time, effort, blood, sweat and family time is it to be a physician. I am currently in college to be a PA.
As my summer job I am an assistant at a physician group at home and have seen first hand how much they give up and sacrifice in order to help patients.
When I saw the request for this I couldn’t help but write. I have been blessed my whole life with great health that is until now.
As soon as I arrived at college from Winter Break I began feeling not right at all and went to the student health center where I was greeted by a doctor who told me that I was fine with a simple bladder infection and to go rest in my dorm and promised I would be fine. After working in healthcare the fact that he promised something that he couldn’t guarantee should have set off red flags but it didn’t.
That inner soul we all had told me something was wrong with that but me being 19 years old went along with that, my mother thank god didn’t. As many mothers will confirm to you they know when their child is sick even if they are 2 hours away. So that right there is my first piece of advice trust your instincts but even more trust your patient and their families instinct.
She called my physician at his office told him what was going on and within 15 minutes of that he called me himself. He stayed cool, calm and collected in what was a scary situation for me told me exactly what I needed to do then made the choice that it was best for me to drive home. The next am he came into the office bright and early to see me. At that time I was scared to death he could tell and the thing he said that made me relax was “You’re here and OK and its time for me to worry that’s why I am your doctor”. That right there made not only me relax but it made my family be calm as well. After examining me he said OK you do need to be admitted to the hospital but here is why… That was huge it showed me he had reasoning to back up why I needed to be in the hospital
I ended up being directly admitted to the hospital from his office with a case of Acute Pyelonephritis and spent the next 5 days in the hospital. As you know this isint a good illness to rest and wait this is a illness that needs immediate IV antibiotics. If I had done what the health center said I wouldnt be here to write this letter to you.
When I finally got to the hospital I was quickly admitted and put on meds to stabilize me. My dr came everyday even on the weekend and was easily able to talk by phone if needed during the day. The residents of the hospital were good for the most part but they forgot one thing... It is that before you examine a patient come in their room talk to them about anything but what is wrong with them. It is just another way to show you care about more then just the etiology of their illness. I found that a lot of the residents forgot that and treated me more like a science experiment then anything else.
When I finally did get discharged I went and saw my doc for a follow up before I went back to school. He gave me a medical excuse note for missing class and a card with the phone number for his office directly so that if this happened while I was at school again I didn’t have to go back to the health center. All and All that man is my new hero. He made a highly stressful situation so much easier to manage. My final piece of advice is that if any of you go into private practice please take note of your staff including nursing, receptionnests, techs or whatever. If they are rude and nasty to the patients you will lose patients. It doesnt matter how good of a doctor you are if the girl who makes appointments is rude or hangs up on people !
Thank you all so much for dedicating your life to medicine and remember your patients are people too they are someone’s mother, wife, husband, father, sister, brother, daughter or son. Treat them as you would wish your mom or child would be treated and all will work itself out in the end.
Good Luck,
Sarah
I am sure that you hear this all the time but why not I am going to say it again. Thank you so much to dedicating your life to medicine. I know what a huge devotion of your time, effort, blood, sweat and family time is it to be a physician. I am currently in college to be a PA.
As my summer job I am an assistant at a physician group at home and have seen first hand how much they give up and sacrifice in order to help patients.
When I saw the request for this I couldn’t help but write. I have been blessed my whole life with great health that is until now.
As soon as I arrived at college from Winter Break I began feeling not right at all and went to the student health center where I was greeted by a doctor who told me that I was fine with a simple bladder infection and to go rest in my dorm and promised I would be fine. After working in healthcare the fact that he promised something that he couldn’t guarantee should have set off red flags but it didn’t.
That inner soul we all had told me something was wrong with that but me being 19 years old went along with that, my mother thank god didn’t. As many mothers will confirm to you they know when their child is sick even if they are 2 hours away. So that right there is my first piece of advice trust your instincts but even more trust your patient and their families instinct.
She called my physician at his office told him what was going on and within 15 minutes of that he called me himself. He stayed cool, calm and collected in what was a scary situation for me told me exactly what I needed to do then made the choice that it was best for me to drive home. The next am he came into the office bright and early to see me. At that time I was scared to death he could tell and the thing he said that made me relax was “You’re here and OK and its time for me to worry that’s why I am your doctor”. That right there made not only me relax but it made my family be calm as well. After examining me he said OK you do need to be admitted to the hospital but here is why… That was huge it showed me he had reasoning to back up why I needed to be in the hospital
I ended up being directly admitted to the hospital from his office with a case of Acute Pyelonephritis and spent the next 5 days in the hospital. As you know this isint a good illness to rest and wait this is a illness that needs immediate IV antibiotics. If I had done what the health center said I wouldnt be here to write this letter to you.
When I finally got to the hospital I was quickly admitted and put on meds to stabilize me. My dr came everyday even on the weekend and was easily able to talk by phone if needed during the day. The residents of the hospital were good for the most part but they forgot one thing... It is that before you examine a patient come in their room talk to them about anything but what is wrong with them. It is just another way to show you care about more then just the etiology of their illness. I found that a lot of the residents forgot that and treated me more like a science experiment then anything else.
When I finally did get discharged I went and saw my doc for a follow up before I went back to school. He gave me a medical excuse note for missing class and a card with the phone number for his office directly so that if this happened while I was at school again I didn’t have to go back to the health center. All and All that man is my new hero. He made a highly stressful situation so much easier to manage. My final piece of advice is that if any of you go into private practice please take note of your staff including nursing, receptionnests, techs or whatever. If they are rude and nasty to the patients you will lose patients. It doesnt matter how good of a doctor you are if the girl who makes appointments is rude or hangs up on people !
Thank you all so much for dedicating your life to medicine and remember your patients are people too they are someone’s mother, wife, husband, father, sister, brother, daughter or son. Treat them as you would wish your mom or child would be treated and all will work itself out in the end.
Good Luck,
Sarah
Letter #6
Dear Future Physicians,
My experiences with physicians have for the most part been very positive. I know not everyone has the same experiences that I have. So I'd like to highlight some of the things that made my experiences so important and life changing for my family.
My husband and I were expecting our second child everything was going along just fine as expected. We went in for our 20 week ultrasound and our world came crashing down. We were told our unborn baby had something terribly wrong. My OB didn't want to speculate on what it was but he told us there was something wrong with the baby's kidneys. He set up an appointment for us to have a level 2 ultrasound 2 days later. The Perinatologist was amazing. We were terrified. After some research we new this could be very bad but didn't really know what our options were. After completing the scan he told us our baby was going to die. The baby had one missing kidney and the kidney that was there wasn't functioning. A condition referred to as Potter's syndrome. He was a very nice and compassionate man that was visibly upset at the news he had to deliver to us that day. My husband still trying to process the information asked “What Now?” The choice the Dr made next has always been the reason he has my up most respect and always will. He presented us with our options but did not talk us into one or the other. Our options were to terminate the pregnancy or carry to term. Since my experiences with this pregnancy I have had so many people tell me they were bullied into terminating their pregnancy because there was something wrong with the baby and that continuing the pregnancy was never offered to them that is just appalling.
Please let your patients make their own choices. Give them all the options all the possibilities and allow them time to process and make a choice. If they ask your opinion give it but don't bully them into doing something you feel is the right or simple choice. It may not be for them.
Our choice that day was to not make a choice right then. We went home discussed our options how we felt and processed the information that the baby we had longed to have join our family would only be with us a short time.
We chose to continue the pregnancy. My OB called me personally to discuss what would happen and how we would handle the rest of the pregnancy. We made a plan and with both my OB and Peri my care was impeccable. Everyone handled our situation with the up most respect and care. Everyone took their time to answer all of my questions and concerns. The hospital staff was spectacular in offering everything and anything I needed or wanted. Even offered to do things that I hadn't thought of. But the most amazing thing my OB did was he kept me grounded he allowed us to hope that the outcome would be different then expected but didn't let me live in a fantasy world thinking this baby was going to be fine.
On the morning I went into labor my regular OB was not on call. Something I had always been worried about the entire pregnancy. The on call OB called him at home told him I was in labor and he showed up at the hospital 20 minutes later to deliver our very special child. He came because he knew I would be more comfortable if he was in the delivery room. Our sweet baby girl was with us for 2 ½ hours.
The doctors that cared for her and me treated her like a person and me like a new mom. No one ever treated her like a non viable fetus. When dealing with pregnancy and infant loss this is the most important thing. This is a child not a statistic or medical procedure.
I went on to have one more child after our loss. This by far was the most difficult pregnancy. Medically everything was fine. Emotionally I was a basket case. Both my OB and Perinatologist were great through the entire journey. They never brushed of my worries as a crazy hormonal pregnant woman. They listened reassured me but still kept me grounded not letting me live in a fantasy land of nothing will go wrong, because we all knew differently. I will always remember the pure joy that they both shared with my family the moment we all knew this baby had two working kidneys!
Kim
Mommy to
Alex, My Mirror
^Amanda^ 7/13/04, My Angel
Allison, My Rainbow
http://www.Stuchel.com
My experiences with physicians have for the most part been very positive. I know not everyone has the same experiences that I have. So I'd like to highlight some of the things that made my experiences so important and life changing for my family.
My husband and I were expecting our second child everything was going along just fine as expected. We went in for our 20 week ultrasound and our world came crashing down. We were told our unborn baby had something terribly wrong. My OB didn't want to speculate on what it was but he told us there was something wrong with the baby's kidneys. He set up an appointment for us to have a level 2 ultrasound 2 days later. The Perinatologist was amazing. We were terrified. After some research we new this could be very bad but didn't really know what our options were. After completing the scan he told us our baby was going to die. The baby had one missing kidney and the kidney that was there wasn't functioning. A condition referred to as Potter's syndrome. He was a very nice and compassionate man that was visibly upset at the news he had to deliver to us that day. My husband still trying to process the information asked “What Now?” The choice the Dr made next has always been the reason he has my up most respect and always will. He presented us with our options but did not talk us into one or the other. Our options were to terminate the pregnancy or carry to term. Since my experiences with this pregnancy I have had so many people tell me they were bullied into terminating their pregnancy because there was something wrong with the baby and that continuing the pregnancy was never offered to them that is just appalling.
Please let your patients make their own choices. Give them all the options all the possibilities and allow them time to process and make a choice. If they ask your opinion give it but don't bully them into doing something you feel is the right or simple choice. It may not be for them.
Our choice that day was to not make a choice right then. We went home discussed our options how we felt and processed the information that the baby we had longed to have join our family would only be with us a short time.
We chose to continue the pregnancy. My OB called me personally to discuss what would happen and how we would handle the rest of the pregnancy. We made a plan and with both my OB and Peri my care was impeccable. Everyone handled our situation with the up most respect and care. Everyone took their time to answer all of my questions and concerns. The hospital staff was spectacular in offering everything and anything I needed or wanted. Even offered to do things that I hadn't thought of. But the most amazing thing my OB did was he kept me grounded he allowed us to hope that the outcome would be different then expected but didn't let me live in a fantasy world thinking this baby was going to be fine.
On the morning I went into labor my regular OB was not on call. Something I had always been worried about the entire pregnancy. The on call OB called him at home told him I was in labor and he showed up at the hospital 20 minutes later to deliver our very special child. He came because he knew I would be more comfortable if he was in the delivery room. Our sweet baby girl was with us for 2 ½ hours.
The doctors that cared for her and me treated her like a person and me like a new mom. No one ever treated her like a non viable fetus. When dealing with pregnancy and infant loss this is the most important thing. This is a child not a statistic or medical procedure.
I went on to have one more child after our loss. This by far was the most difficult pregnancy. Medically everything was fine. Emotionally I was a basket case. Both my OB and Perinatologist were great through the entire journey. They never brushed of my worries as a crazy hormonal pregnant woman. They listened reassured me but still kept me grounded not letting me live in a fantasy land of nothing will go wrong, because we all knew differently. I will always remember the pure joy that they both shared with my family the moment we all knew this baby had two working kidneys!
Kim
Mommy to
Alex, My Mirror
^Amanda^ 7/13/04, My Angel
Allison, My Rainbow
http://www.Stuchel.com
Tuesday, February 12, 2008
Letter #5
Dear Future Physician,
I am the mother of 3 precious children, all of whom were born prematurely. My twins were born at 24 weeks gestation in 1992. The odds of survival for 24 weekers 15 years ago were slim to none, but because of some very dedicated health care professionals, I have 2 healthy, perfectly normal teenagers.
I had always respected the role of a physician, but it wasn’t until my babies were born early and their lives lay in the hands of these men and women that it became clear what an important relationship we would have.
We spent 3 months in the NICU, not knowing if these babies would live or die. I was taken completely unaware when I delivered 16 weeks early. No time to prepare, no time to wrap my head around what was happening. Being first time parents, my husband and I had no idea how to even begin to be parents – much less parents of 2 critically ill babies. For a long time, I don’t think we felt like we were parents. The physician’s that stick out in my mind were those who, despite the fact we didn’t feel like parents, treated us like parents. They asked us how we thought the babies were doing, consulted with us on treatment plans. Did we notice any changes, have any concerns? They gave us some semblance of control in a world which, at that time, was completely out of control.
As physicians, try to be honest without being alarmist. As parents, we want the truth, but consider our fragile psyches. Those physicians who took the time to sit with us and talk, offer an encouraging word or even an acknowledgment that this was a difficult time were invaluable. We look to you for guidance, for advice, for answers. It’s OK to say “I don’t know”. We respect that you are human. You don’t need to know all the answers.
I wish you the best of luck as you pursue a career in medicine. I applaud your choice of professions and my hope for you is that you are able to take away from your relationship with your patients as much as you give to them.
Yours truly,
Sara
Mom to Ryan & Elizabeth, 24 wks., 10/1992
and Sophia, 34 weeks, 09/2002
I am the mother of 3 precious children, all of whom were born prematurely. My twins were born at 24 weeks gestation in 1992. The odds of survival for 24 weekers 15 years ago were slim to none, but because of some very dedicated health care professionals, I have 2 healthy, perfectly normal teenagers.
I had always respected the role of a physician, but it wasn’t until my babies were born early and their lives lay in the hands of these men and women that it became clear what an important relationship we would have.
We spent 3 months in the NICU, not knowing if these babies would live or die. I was taken completely unaware when I delivered 16 weeks early. No time to prepare, no time to wrap my head around what was happening. Being first time parents, my husband and I had no idea how to even begin to be parents – much less parents of 2 critically ill babies. For a long time, I don’t think we felt like we were parents. The physician’s that stick out in my mind were those who, despite the fact we didn’t feel like parents, treated us like parents. They asked us how we thought the babies were doing, consulted with us on treatment plans. Did we notice any changes, have any concerns? They gave us some semblance of control in a world which, at that time, was completely out of control.
As physicians, try to be honest without being alarmist. As parents, we want the truth, but consider our fragile psyches. Those physicians who took the time to sit with us and talk, offer an encouraging word or even an acknowledgment that this was a difficult time were invaluable. We look to you for guidance, for advice, for answers. It’s OK to say “I don’t know”. We respect that you are human. You don’t need to know all the answers.
I wish you the best of luck as you pursue a career in medicine. I applaud your choice of professions and my hope for you is that you are able to take away from your relationship with your patients as much as you give to them.
Yours truly,
Sara
Mom to Ryan & Elizabeth, 24 wks., 10/1992
and Sophia, 34 weeks, 09/2002
Letter #4
Dear Future Physician,
First of all, I want to thank you for choosing this difficult and admirable career path. You have the capacity to make a huge difference in people’s lives. You will be able to give hope where there is none, and answerers to critical questions.
My husband was diagnosed with Crohn’s Disease when he was 14. He grew up in a home where his parents did not teach him how to manage his illness. By the time we got married, his Crohn’s Disease was out of control and in effect, controlling his life and my life. My husband was angry at his Crohn’s disease. He did not want to hear the advice of doctors. Therefore, the job of managing his illness fell to me.
In our search for a good doctor, we met several who were unwilling to listen to our needs. I say “our” because his illness affected not only him, but me as well. I believe that as a physician, it is critical that you listen to the needs of your patient. We met several smart doctors, but the quality of their care left a lot to be desired. Chronic illness, whether it is life threatening or simply chronic, is life changing for the entire family. It is important to realize that sometimes as a physician, you must treat the patient, but you will have to deal with other family members who will be in charge of the care. Please give them the respect that they deserve. Those family members may be just as scared as the patient. They need to develop an alliance with the doctor as well.
We have since found a doctor who does listen to our needs. My husband has finally realized that if you control the illness then it does not control you. Life is good again. But I realize the unpredictable nature of his illness and its potential for serious complications. The time may come where we will once again be faced with new doctors and decisions that we don’t want to make. I can only hope when or if that time comes, we have compassionate, knowledgeable doctors who care about our needs.
I wish you much success in your chosen career path.
DeAnn
First of all, I want to thank you for choosing this difficult and admirable career path. You have the capacity to make a huge difference in people’s lives. You will be able to give hope where there is none, and answerers to critical questions.
My husband was diagnosed with Crohn’s Disease when he was 14. He grew up in a home where his parents did not teach him how to manage his illness. By the time we got married, his Crohn’s Disease was out of control and in effect, controlling his life and my life. My husband was angry at his Crohn’s disease. He did not want to hear the advice of doctors. Therefore, the job of managing his illness fell to me.
In our search for a good doctor, we met several who were unwilling to listen to our needs. I say “our” because his illness affected not only him, but me as well. I believe that as a physician, it is critical that you listen to the needs of your patient. We met several smart doctors, but the quality of their care left a lot to be desired. Chronic illness, whether it is life threatening or simply chronic, is life changing for the entire family. It is important to realize that sometimes as a physician, you must treat the patient, but you will have to deal with other family members who will be in charge of the care. Please give them the respect that they deserve. Those family members may be just as scared as the patient. They need to develop an alliance with the doctor as well.
We have since found a doctor who does listen to our needs. My husband has finally realized that if you control the illness then it does not control you. Life is good again. But I realize the unpredictable nature of his illness and its potential for serious complications. The time may come where we will once again be faced with new doctors and decisions that we don’t want to make. I can only hope when or if that time comes, we have compassionate, knowledgeable doctors who care about our needs.
I wish you much success in your chosen career path.
DeAnn
Letter #3
Dear Physician of the Future:
There's so much I want to tell you, so much that is so very important that you will only be able to learn on the job from other physicians and most importantly, from your patients. I don't envy your learning curve, and I don't envy the heavy responsibility you bear in the lives of others. But I greatly admire that you've chosen this path, and I wish you the very best in your career. What a privilege you hold to come alongside the sick and to be a partner in alleviating suffering.
I say partnership because medicine -- the actual donning of your white coat and meeting with another human being who is looking to you for help -- must be rooted in this notion of partnership. As I walk through my mother's last days with cancer, I feel grateful to those many who have communicated truth and kindness to her (from doctors to nurses to phlebotomists to those individuals who sign her in and type up her ubiquitous bracelets that allow her to receive chemo treatment), but those professionals who have listened, really listened, between-the-lines listened -- those people? They have quite literally saved her life. Instead of seeing an elderly woman who has quite frankly, a really crappy cancer (multiple myeloma, stage 3), they have seen a fighter, a mother and grandmother, a wife, a sister, a best friend. They have heard the woman who wanted more summers to spend at Lake Erie with her husband and who wanted to live long enough for her three young grandchildren to have her indelibly imprinted in their memories. They have seen a person with great humor and a wide range of ever-changing emotions -- from concrete hope to almost complete despair at times. And they have helped her navigate the minefield of those emotions, as she suffers through treatment that sometimes feels worse than the disease. Did she necessarily explain all of the above-mentioned situations in so many words? No, but the best physicians she has encountered, have chosen to respect her and to believe her and to partner with her.
You will learn that there is as much art as there is science in this gig.
The best doctors know that their patients are their best resources, and they don't resent a patient's desire for more knowledge. They welcome patients who scour the internet trying to learn, and they understand that some patients want less information. Please -- never have your hand on the doorknob when a patient is asking another question. Speaking from personal experience, please don't talk to my husband about hockey while I'm trying to explain the intricacies of how my thyroid symptoms have changed. You don't need to cite every horrible statistic (as my mom's first oncologist did) as to the many and horrific ways she could possibly die, but you need to be honest when she asks a specific question, because if she's asking, then she damn well wants to know the truth. Believe your patients -- oh God, how we want to be believed when we're sick. Maybe you have never seen our particular symptoms present in this particular way, but believe us, and you will learn from us.
I recommend joining the conversation as to what doctors and patients do for one another -- Dr. Jerome Grooopman's, The Anatomy of Hope, and Dr.Atul Gawande's books, Complications and Better, should have a part inside your very crowded, and I'm sure over-taxed, brain. Groopman's book, in particular, gives pitch perfect perspective on how to walk the tightrope of communicating truth alongside hope. After my mom was diagnosed three years ago (and given an incredibly poor prognosis, incredibly poorly delivered), I e-mailed Groopman to ask him about how to find hope amid hopelessness. He e-mailed me back within 45 minutes, not with some big secret key as to how to sustain hope, but with compassion and gentleness. 45 minutes. Be that kind of doctor.
In truth, you will fumble all of this many times, I'm sure. Because you, too, are only human. You can only do your best and like any of us, you don't get any do-overs. But if you let kindness guide you, if you remember that any particular patient is the most important person in the world to someone -- you will succeed far more than you fail. You will heal. You will give life where life might have seemed impossible. You will be a good doctor.
Thank you for your time.
Beth
There's so much I want to tell you, so much that is so very important that you will only be able to learn on the job from other physicians and most importantly, from your patients. I don't envy your learning curve, and I don't envy the heavy responsibility you bear in the lives of others. But I greatly admire that you've chosen this path, and I wish you the very best in your career. What a privilege you hold to come alongside the sick and to be a partner in alleviating suffering.
I say partnership because medicine -- the actual donning of your white coat and meeting with another human being who is looking to you for help -- must be rooted in this notion of partnership. As I walk through my mother's last days with cancer, I feel grateful to those many who have communicated truth and kindness to her (from doctors to nurses to phlebotomists to those individuals who sign her in and type up her ubiquitous bracelets that allow her to receive chemo treatment), but those professionals who have listened, really listened, between-the-lines listened -- those people? They have quite literally saved her life. Instead of seeing an elderly woman who has quite frankly, a really crappy cancer (multiple myeloma, stage 3), they have seen a fighter, a mother and grandmother, a wife, a sister, a best friend. They have heard the woman who wanted more summers to spend at Lake Erie with her husband and who wanted to live long enough for her three young grandchildren to have her indelibly imprinted in their memories. They have seen a person with great humor and a wide range of ever-changing emotions -- from concrete hope to almost complete despair at times. And they have helped her navigate the minefield of those emotions, as she suffers through treatment that sometimes feels worse than the disease. Did she necessarily explain all of the above-mentioned situations in so many words? No, but the best physicians she has encountered, have chosen to respect her and to believe her and to partner with her.
You will learn that there is as much art as there is science in this gig.
The best doctors know that their patients are their best resources, and they don't resent a patient's desire for more knowledge. They welcome patients who scour the internet trying to learn, and they understand that some patients want less information. Please -- never have your hand on the doorknob when a patient is asking another question. Speaking from personal experience, please don't talk to my husband about hockey while I'm trying to explain the intricacies of how my thyroid symptoms have changed. You don't need to cite every horrible statistic (as my mom's first oncologist did) as to the many and horrific ways she could possibly die, but you need to be honest when she asks a specific question, because if she's asking, then she damn well wants to know the truth. Believe your patients -- oh God, how we want to be believed when we're sick. Maybe you have never seen our particular symptoms present in this particular way, but believe us, and you will learn from us.
I recommend joining the conversation as to what doctors and patients do for one another -- Dr. Jerome Grooopman's, The Anatomy of Hope, and Dr.Atul Gawande's books, Complications and Better, should have a part inside your very crowded, and I'm sure over-taxed, brain. Groopman's book, in particular, gives pitch perfect perspective on how to walk the tightrope of communicating truth alongside hope. After my mom was diagnosed three years ago (and given an incredibly poor prognosis, incredibly poorly delivered), I e-mailed Groopman to ask him about how to find hope amid hopelessness. He e-mailed me back within 45 minutes, not with some big secret key as to how to sustain hope, but with compassion and gentleness. 45 minutes. Be that kind of doctor.
In truth, you will fumble all of this many times, I'm sure. Because you, too, are only human. You can only do your best and like any of us, you don't get any do-overs. But if you let kindness guide you, if you remember that any particular patient is the most important person in the world to someone -- you will succeed far more than you fail. You will heal. You will give life where life might have seemed impossible. You will be a good doctor.
Thank you for your time.
Beth
Letter #2
Dear Future Physician,
I want to say thank you for all to the years of training you are about to endured. Congratulations are in order for those have made it through the many years of training and exams, and are reading this letter as a doctor themselves.
I have had many different encounters as a patient in the medical community, even though I am only in my 20’s. I wish I could say they have all been great, but I guess life is not always perfect. I want to say what is really important to me when going to see a doctor is one that you can tell from the start cares. This comes I believe in many different ways, from the time you step foot into the reception area, to the time in the exam to the closing goodbye from the receptionist. I believe being a good doctor is two parts, one being focused on yourself, and how you portray yourself. Also the other would be to hire and work with people that portray and show your professional beliefs, in that people matter, not just the profit.
My ankle surgeon was the best doctor I have ever visited in my entire life. His bedside manner was quiet but yet in his body language, eye contact, and hand shake every time he walked in or out of the room, is how I could tell he cared, and wanted the best for me. There has been many times my case has not been the norm, and he was not ashamed to admit that. He referred me personally to his professor at medical college to make sure he was making the right step with doing the evasive surgery. He is always willing to call me back personally whenever I called his office and left him a message. I never felt like a bother even when calling or making after office visits to fix a tight cast, or loose bandage. I remember one time when I was puking my guts out, and I had a super tight cast, I called his office, he was super busy and behind schedule (not unusual because he spends so much time with every one of his patients, he was always behind schedule, but that never matter to his patients cause they know he cares), so his receptionist said he said to go straight to the ER and he would call the ER with instructions for them. My parents packed me in the car, and off we went. I was wheeled back, and low and behold my surgeon was standing in the room waiting for me. This was 10pm at night (yes I waited 3 hrs in the ER waiting area) in a busy ER during flu season. My doctor showed up because he not only cared about my ankle, but he cared about me. He knew I was concerned about others messing things up so he was there to take the cast off and put a new one on. In my book anyone could have done that same exact thing, even maybe an ER assistant. However my surgeon took the time to come to the ER and do it himself. The thing that rings in my ear all the time, is when my parents went to thank him for his troubles, and how sorry they were he had to come and do this so late at night, his comment was like no, don’t be sorry, I am glad I can do this, and it is what I am here for, anytime, he shook our hands and left. I want to say I am pretty good at telling when a doctor really cares, or just pretends to care. I think for one to be a good doctor you really need to show concern and compassion, and be human. Biggest is treat everyone like you would want to be treated. One does not need come across that you possess all the answers, so don’t ever lie or pretend to answers, but instead tell the patients, you are human and willing to find the answers. That means you follow through, no empty promises, even if that results in hours of research, or many phone calls to fellow collogues. Another is being available to your patients, either via phone, email or physical contact. There is so many times I had questions whether or not to have surgery, or other stupid post surgery questions or concerns and my doctor was always willing to call me back personally to make sure I had all the answers and information I needed. If you want your patients to trust you, and listen to your advice, you need to listen to them and trust them when they confide in you with their concerns or questions, even if means you need to spend 5mins on the phone with a concerned mother at the end of a busy day.
The last thing is hiring people that share the same professional beliefs as yourself. Nothing is worse then walking into a medical practice to a nasty not helpful over stressed very snappy receptionist. Another bad thing is when nurses walk you into exam rooms take vitals and never make a sound, or gossip to you about the doctor or others personnel in the practice the entire time. My ankle surgeon I spoke of before have some of the best medical staff, ones that even after a few visits you feel like you known them forever and know you on a first name basis. Ones that make you feel welcomed into the waiting area, and leave you feeling good too, even if you might be in a leg cast and on crutches and feeling blue. They should be helpful and happy to be providing a service for you even if it is horrible stressful day. One needs to remember even with insurance, the patient is a customer and one should be treated with the utmost respect in every aspect of the visit, not just in the exam room with the doctor.
In closing, you might not be a perfect doctor for everyone. However I believe if you truly care, and trust your patients you then you will be doctor that people can trust, and respect. Then in the end people will WANT to be your patient and the word will spread about your character amongst others. Continue to strive for trust, and compassion and not wealth and statue and you will be greatly rewarded in the end.
Krystal
I want to say thank you for all to the years of training you are about to endured. Congratulations are in order for those have made it through the many years of training and exams, and are reading this letter as a doctor themselves.
I have had many different encounters as a patient in the medical community, even though I am only in my 20’s. I wish I could say they have all been great, but I guess life is not always perfect. I want to say what is really important to me when going to see a doctor is one that you can tell from the start cares. This comes I believe in many different ways, from the time you step foot into the reception area, to the time in the exam to the closing goodbye from the receptionist. I believe being a good doctor is two parts, one being focused on yourself, and how you portray yourself. Also the other would be to hire and work with people that portray and show your professional beliefs, in that people matter, not just the profit.
My ankle surgeon was the best doctor I have ever visited in my entire life. His bedside manner was quiet but yet in his body language, eye contact, and hand shake every time he walked in or out of the room, is how I could tell he cared, and wanted the best for me. There has been many times my case has not been the norm, and he was not ashamed to admit that. He referred me personally to his professor at medical college to make sure he was making the right step with doing the evasive surgery. He is always willing to call me back personally whenever I called his office and left him a message. I never felt like a bother even when calling or making after office visits to fix a tight cast, or loose bandage. I remember one time when I was puking my guts out, and I had a super tight cast, I called his office, he was super busy and behind schedule (not unusual because he spends so much time with every one of his patients, he was always behind schedule, but that never matter to his patients cause they know he cares), so his receptionist said he said to go straight to the ER and he would call the ER with instructions for them. My parents packed me in the car, and off we went. I was wheeled back, and low and behold my surgeon was standing in the room waiting for me. This was 10pm at night (yes I waited 3 hrs in the ER waiting area) in a busy ER during flu season. My doctor showed up because he not only cared about my ankle, but he cared about me. He knew I was concerned about others messing things up so he was there to take the cast off and put a new one on. In my book anyone could have done that same exact thing, even maybe an ER assistant. However my surgeon took the time to come to the ER and do it himself. The thing that rings in my ear all the time, is when my parents went to thank him for his troubles, and how sorry they were he had to come and do this so late at night, his comment was like no, don’t be sorry, I am glad I can do this, and it is what I am here for, anytime, he shook our hands and left. I want to say I am pretty good at telling when a doctor really cares, or just pretends to care. I think for one to be a good doctor you really need to show concern and compassion, and be human. Biggest is treat everyone like you would want to be treated. One does not need come across that you possess all the answers, so don’t ever lie or pretend to answers, but instead tell the patients, you are human and willing to find the answers. That means you follow through, no empty promises, even if that results in hours of research, or many phone calls to fellow collogues. Another is being available to your patients, either via phone, email or physical contact. There is so many times I had questions whether or not to have surgery, or other stupid post surgery questions or concerns and my doctor was always willing to call me back personally to make sure I had all the answers and information I needed. If you want your patients to trust you, and listen to your advice, you need to listen to them and trust them when they confide in you with their concerns or questions, even if means you need to spend 5mins on the phone with a concerned mother at the end of a busy day.
The last thing is hiring people that share the same professional beliefs as yourself. Nothing is worse then walking into a medical practice to a nasty not helpful over stressed very snappy receptionist. Another bad thing is when nurses walk you into exam rooms take vitals and never make a sound, or gossip to you about the doctor or others personnel in the practice the entire time. My ankle surgeon I spoke of before have some of the best medical staff, ones that even after a few visits you feel like you known them forever and know you on a first name basis. Ones that make you feel welcomed into the waiting area, and leave you feeling good too, even if you might be in a leg cast and on crutches and feeling blue. They should be helpful and happy to be providing a service for you even if it is horrible stressful day. One needs to remember even with insurance, the patient is a customer and one should be treated with the utmost respect in every aspect of the visit, not just in the exam room with the doctor.
In closing, you might not be a perfect doctor for everyone. However I believe if you truly care, and trust your patients you then you will be doctor that people can trust, and respect. Then in the end people will WANT to be your patient and the word will spread about your character amongst others. Continue to strive for trust, and compassion and not wealth and statue and you will be greatly rewarded in the end.
Krystal
Letter #1
I'm very encouraged to hear so many of you agree that Megan has thought of a wonderful project, and plan to help out by contributing. Letters can be sent directly to her at megankmd@gmail.com If you'd like your letter to be posted here for others to read (and why yes, I'm nosy enough that I love reading them) you can use my e-mail link on the right under "Ways and Reasons to Contact Me" --- please note my low tolerance for online pharmaceutical solicitation. :) Or, more simply, I'm at kristieokc@cox.net
And now, it gives me great pleasure to present our first letter, from Katie, who is most certainly the winner of our Speedy Fingers Award. She had this letter sent to Megan (and was kind enough to cc me --- again, with my nosy-ness issues) in like, three and a half minutes after I posted the request.
Thank you, Katie! I know Megan appreciates it also, and I hope many more of you will follow suite. Again, who is considered a suitable candidate to write a letter? Pretty much anyone who is BREATHING, because I know at some point or another, you've seen a doctor, or taken your child, or spouse, or parent, to see a doctor. Or taken your dog to see a vet, and just pretend. So compose your note and (one last pitiful plea because I'm so .... er .... inquisitive) send them to my e-mail as well!
***************************************
Dear Future Physician,
First, I'd like to sincerely thank you for all you do. Your profession is one that has certainly cost you both time and money, but is also one that allows you to make a difference in many lives. Without your dedication to your patients and science, there's no way to know what our future would be.
As a patient with a somewhat rare but serious medical condition (Arnold Chiari Malformation, type 1), I have been around my share of doctors. My Chiari was diagnosed by an Opthamologist who read me my radiology report and told me that couldn't explain to me what Chiari was, but that it was serious and that I needed to "get to a neurologist as soon as possible." After living through that experience and the insanely scary two weeks thereafter trying to get into see a neurologist, I have come to realize that one of the crucial traits a doctor needs is the ability to admit it when they're out of their element. There was nothing wrong with the fact that my Opthamologist wasn't well versed in Chiari, retrospectively I'd have been more surprised if he had been, however, his inability to admit that he didn't know what was going on fostered more anxiety and left me without any resources. It's okay if you don't have all the answers, but then it becomes important for you to find someone who does.
The last few years since that diagnosis have been a whirlwind of activity bouncing from doctor to doctor, seeking pain management, second opinions and finally settling into a watch-and-wait phase. When my condition worsened to a point where we could no longer just wait and see, we decided to proceed with the surgery. One of the neurosurgeons we saw, who is hailed as the best neurosurgeon in the city, spoke to me like I was a total idiot. Well, that's not true, most of the time he didn't talk to me at all, he talked to my Fiance who is a medical student. As a doctor it is undeniably important that you treat your patients well. Talk to them, not at them, and don't assume that they're totally unaware of what is going on. I had legitimate questions for this doctor and I was well-informed, but he didn't even give me a moment to ask them, instead he assured me that my hair would grow back nicely and offered my Fiance a spot on a neurosurgical rotation. In no way does our knowledge compare to yours, however, respecting us and the care and time we put into our own healthcare will get you far.
We did find a great neurosurgeon who did a fabulous job. He, in some ways, was the opposite of the Opthamologist. He's an optimist and as such, sometimes doesn't take concerns as seriously as I might want him to. It's not that he's not listening, it's that he's trying to protect me from the anxiety and the realities that could be ahead of me. It's a noble idea, but one that doesn't work in real life. Bad things happen and sometimes it's best to just hit them head on. Sugar-coating has its place, but honesty does too and when it comes to health, it's important to take patients seriously, even when the problems seem simple to you. What is clearly an issue of benign suture rejection to you, is stitches shooting out of the back of my head to me. Taking the time to think of the concerns from the perspective of a patient can be a big asset in giving them the best medical care. Understanding and listening to their concerns, no matter how small, can foster an awesome sense of trust between a patient and a doctor which is needed when your health is at stake.
Physicians have an ability to help masses of people and that job doesn't come without its share of challenges. Knowing your limits, listening to patients and taking their concerns seriously may seem like small things, but to a scared, sick patient, they can mean the world.
Katie
Suboccipital Craniectomy, C-1 and C-2 laminectomies and Synthetic Duraplasty, November 27, 2007
http://overflowingbrain.blogspot.com
And now, it gives me great pleasure to present our first letter, from Katie, who is most certainly the winner of our Speedy Fingers Award. She had this letter sent to Megan (and was kind enough to cc me --- again, with my nosy-ness issues) in like, three and a half minutes after I posted the request.
Thank you, Katie! I know Megan appreciates it also, and I hope many more of you will follow suite. Again, who is considered a suitable candidate to write a letter? Pretty much anyone who is BREATHING, because I know at some point or another, you've seen a doctor, or taken your child, or spouse, or parent, to see a doctor. Or taken your dog to see a vet, and just pretend. So compose your note and (one last pitiful plea because I'm so .... er .... inquisitive) send them to my e-mail as well!
***************************************
Dear Future Physician,
First, I'd like to sincerely thank you for all you do. Your profession is one that has certainly cost you both time and money, but is also one that allows you to make a difference in many lives. Without your dedication to your patients and science, there's no way to know what our future would be.
As a patient with a somewhat rare but serious medical condition (Arnold Chiari Malformation, type 1), I have been around my share of doctors. My Chiari was diagnosed by an Opthamologist who read me my radiology report and told me that couldn't explain to me what Chiari was, but that it was serious and that I needed to "get to a neurologist as soon as possible." After living through that experience and the insanely scary two weeks thereafter trying to get into see a neurologist, I have come to realize that one of the crucial traits a doctor needs is the ability to admit it when they're out of their element. There was nothing wrong with the fact that my Opthamologist wasn't well versed in Chiari, retrospectively I'd have been more surprised if he had been, however, his inability to admit that he didn't know what was going on fostered more anxiety and left me without any resources. It's okay if you don't have all the answers, but then it becomes important for you to find someone who does.
The last few years since that diagnosis have been a whirlwind of activity bouncing from doctor to doctor, seeking pain management, second opinions and finally settling into a watch-and-wait phase. When my condition worsened to a point where we could no longer just wait and see, we decided to proceed with the surgery. One of the neurosurgeons we saw, who is hailed as the best neurosurgeon in the city, spoke to me like I was a total idiot. Well, that's not true, most of the time he didn't talk to me at all, he talked to my Fiance who is a medical student. As a doctor it is undeniably important that you treat your patients well. Talk to them, not at them, and don't assume that they're totally unaware of what is going on. I had legitimate questions for this doctor and I was well-informed, but he didn't even give me a moment to ask them, instead he assured me that my hair would grow back nicely and offered my Fiance a spot on a neurosurgical rotation. In no way does our knowledge compare to yours, however, respecting us and the care and time we put into our own healthcare will get you far.
We did find a great neurosurgeon who did a fabulous job. He, in some ways, was the opposite of the Opthamologist. He's an optimist and as such, sometimes doesn't take concerns as seriously as I might want him to. It's not that he's not listening, it's that he's trying to protect me from the anxiety and the realities that could be ahead of me. It's a noble idea, but one that doesn't work in real life. Bad things happen and sometimes it's best to just hit them head on. Sugar-coating has its place, but honesty does too and when it comes to health, it's important to take patients seriously, even when the problems seem simple to you. What is clearly an issue of benign suture rejection to you, is stitches shooting out of the back of my head to me. Taking the time to think of the concerns from the perspective of a patient can be a big asset in giving them the best medical care. Understanding and listening to their concerns, no matter how small, can foster an awesome sense of trust between a patient and a doctor which is needed when your health is at stake.
Physicians have an ability to help masses of people and that job doesn't come without its share of challenges. Knowing your limits, listening to patients and taking their concerns seriously may seem like small things, but to a scared, sick patient, they can mean the world.
Katie
Suboccipital Craniectomy, C-1 and C-2 laminectomies and Synthetic Duraplasty, November 27, 2007
http://overflowingbrain.blogspot.com
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