Tuesday, September 25, 2012

Letter to a Future Doctor

So I've been feeling really unbalanced lately. Almost like I've been missing something. Throughout the entirety of my college career, I balanced my studies in the science-y genres with my Christian Ministry minor and Religion major classes in the humanity genres. But for the past 5 weeks I've been solely doing science--and quite a bit of science at that!

So today, I poked around until I found an email that I saved over 2 years ago just in case I would ever need it. This email contained a letter from the founder of Church Health Center to future doctors. Many of you already know about Church Health Center (CHC). But if you don't, here's a quick run-down:

CHC is a non-profit in Memphis, TN which provides medical care to the working uninsured of Memphis. In addition, they have a preventative health/wellness center with all of the amenities that you would of expect of a YMCA on steroids. They have childcare (where I worked for a total of 6 months), physical therapy, a sports court, exercise classes, healthy living classes, healthy cooking classes, outreach programs, and much, much more. This place forever changed my life and the people there also have greatly impacted who I've become. Well anyway, Dr. Morris (the founder) believes that Christians are called to preach, teach and to heal and that we, as a church, don't do so well with the healing part. Essentially the CHC crew works to help patients and members to be healthy in mind, body and spirit.

Recently I've noticed how much I've been missing the "spirit" portion of my education since starting medical school. I understand that I'm hear to learn the "hard science"part of medicine, but I still feel drained. This letter was just what I needed to "fill my bucket" amidst the grind of anatomy.

Dear Future Doctor, 
Congratulations on entering medical school. I know it has been a long, difficult path to get to this point, but you have made it to the beginning of a life-changing experience. What I hope is that it doesn’t change you too much. 
Most students just starting out still identify more with being a patient than a physician, but the moment they place that white coat on your shoulders, you will begin the transition, both intellectually and spiritually, that will make you a doctor. The part of this path that teaches you the skills to care for people is a good thing, but there is a negative side of this transformation that I hope you will fight. 
This will begin the day you walk into the anatomy lab. It is a surreal experience to be in a room with a collection of dead bodies that you and your classmates will cut and dissect over several months. Someone will make a joke about how creepy it is, and then the bodies will be given nicknames that will make you laugh. But remember that your cadaver was once a real human being who cared enough about your medical education to give you his or her body to learn from. What a remarkable gift! This lifeless corpse was once someone’s father or mother, who had dreams and aspirations, just like you. They loved and cried but, when you do your dissection, you will not find the source of these vital parts of life. We need to offer the body the greatest respect. God’s gift of this mortal coil is part of what makes us human. All too often, however, medical students in anatomy class lose reverence for the body, and for some students, this begins to erode a sense of awe for life itself. Don’t let it happen to you. 
For the next two years, you will spend endless time in a classroom and feel great pressure to accurately regurgitate information that you have memorized. You will see the students in classes ahead of you as mentors, but remember they have only a little more experience than you. Do not try to impress your teachers with how familiar you are with the practice of medicine when, in reality, it is all still very new to you. 
When I was a second year student, my partner in our physical diagnosis class began a presentation to the attending by saying, “This was not a very interesting patient. She only has diabetes.” I have now been a practicing physician for 25 years and, even now, I learn new things about diabetes. Surely, one of the first times you are seeing a patient with this disease it should be interesting, but even more so, objectifying the person in your care to only their disease is wrong. This is not a way to become a healer. 
Some teachers will tell you that you should not allow yourself to get close emotionally to your patients. In order to keep your mind clean, they will say, you must stay objective and learn to keep your distance. Nothing is further from the truth. We do not need to teach people how to keep their distance from other people. We do that naturally. We need to teach how to become close to another person in a professional manner. To practice the art of medicine, we must learn how to care for people. 
Still, no matter how hard you try, at some level you will be converted to the religion of medicine and, trust me, it is a religion unto itself. There are fundamental beliefs that cannot be violated; holy places and sanctuaries of learning; prophets and high priests of the profession; and a way of seeing the world that changes how you see yourself and others. Many medical students and residents get to a point that they cannot talk about anything except medicine, so when they go to parties, they either gravitate to the other true believers like themselves, i.e., other medical students, or they bore other people with self-centered monologues. I urge you to continue to have a life outside of medicine. Learn to listen to other people’s stories and pay attention to what matters to them. It will make you a better physician. 
Still, medical school will change you. One day, as a third-year student, I was doing CPR on an elderly woman and the resident came into the room and began taking orders for pizza when the “code” was over. A person’s life was literally underneath my hands, and while I was doing chest compressions, I was thinking about whether I wanted mushrooms on my pizza. In that moment, I knew medical school had changed me, and I am embarrassed today to admit that I had those thoughts. When I realized what was happening, I promised myself to never let it happen again. 
When you graduate from medical school, you will no longer identify yourself as a patient. Now you will see yourself as a “doctor.” This is a good thing – something to be proud of and to build on. But, during these arduous four years, my prayer for you is that you do not lose your love and reverence for life along the way. Remember that God has given you the ability and the skills to become a physician in order to keep life holy. Being a physician will allow you to more fully answer the call to discipleship – to preach, to teach and to heal.
You are on a spiritual journey, and medical school is giving you the skills to help you and others live life in the fullness that God intended. These four years, though difficult, constitute the beginning of your own full and well-lived life. 
With great hope for your future, 
G. Scott Morris, M.D., M.DIV

I'm feeling better about my bucket being filled and my spirit being renewed. I am so thankful for the great people at CHC to remind me of such things from afar. I am also glad that Dr. Morris addresses that fact that none of us know what we're are doing. Today we had our very first standardized patient. These patients are trained to know how to evaluate the skills which we are supposed to be practicing and such. Today we were just supposed to work on patient histories. I didn't interview anyone today, but it was a really great experience seeing several of my classmates go through the process. We were all scared, we were all nervous, and none of us knew what to do. But it was okay, actually it was a good sign. It meant that we took it seriously--that we realize how much of a responsibility it is to be in charge of the care of a real human being. These standardized patients are a great way for us to practice in a safe environment so we are fully prepared when we are actually in the clinical setting. I'm nervous and anxious for my standardized patient next week! Until then, I will continue to learn about the thoracic cavity and rejuvenate my spirit. 


"Be aware of wonder. Live a balanced life--learn some and think some and draw and paint and sing and dance and play and work every day some." 
Robert Fulghum

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