A love letter for medics.

My dearest Romy, 
Last night I started writing you a funny note to cheer you up. You know, because you were sitting beside me on the bed trying to learn every muscle in the leg. (Who knew there were so many?!) 
But then I thought I’d write you an actual letter. Because letter writing is a dying art, which saddens me, letters are pretty rad.
But also because I’ve been thinking about medicine, about doctors, about you.

You have embarked on something extraordinary. Something noble. Something heart wrenching. You will see the best and worst of humanity…beauty and brutality. Your heart will simultaneously break and sing at the damning and glorious things you will see.

You’re going to have to tell people they’re dying. You’ll have to sit with them, tight chested, with sorrow resting on your shoulders and force yourself to look them in the eye and tell them they have a year, a month, a week, days…hours.

You will see things you will never be able to banish from your mind.
Prayers dropping, tumbling from feverish lips that float up through hospital ceilings. Hands, wringing in despair and devastation, clasped in desperate pleading. Eyes, brimming with unshed tears. Heads, bowed in silent grief.

A woman refuses treatment for breast cancer because she believes in spiritual healing. She dies, leaving a six year old boy motherless. 
Jehovah’s witnesses refuse to let their nine year old son with leukemia have a blood transfusion. He dies in agony.
 A woman has two of her fingers cut off by a cruel and jealous husband.

All of these people are real. I know or knew them. These are true stories and you will witness many more like these. But you won’t be merely a witness…..

You will become a recurring and memorable character in many people’s lives, as you deliver life changing information. 
Similarly, many of your patients will stay with you , but you cannot keep them all. Their faces will haunt you and others you’ll hold onto with fondness. Some will be easy to forget and some it would be easier if only you could forget. You’ll meet people from every spectrum of humanity, you’ll carry their stories slung across your back, stories that belong in novels and poems. 
Reality, you’ll find, is stranger and more magnetic than fiction.

People will meet you with anger, sorrow, confusion, joy. 
You will become a punch bag, a saviour, and to many, a friend.
Some patient’s words will batter you, especially when they’re scared and need to lash out. Others words will be fervently kind and grateful, balm to your soul. 
Your words will be even more important to them.
You’ll have to make your patients laugh as they attempt to swallow sobs. You’ll have to explain, persuade, cajole and sometimes, even apologise. 
There will be times where you’ll want to scream and times where you’ll need to be brutally blunt. Times where your bluntness will potentially save a life if it steers them back on course. “You will die if you do or don’t.”
You’ll have to quell people’s fear, put them at ease, convince them not to worry, or actually to worry, make them feel safe, protected, cared for, even loved. They will remember your words.

You’ll listen to ugly things, shameful confessions, people battling addictions and demons. You’ll also get to hear some incredible stories, inspiring, redemptive, beautiful ones, the dreamiest prose.
All our human parts, body and soul, will be laid bare to you at some point or another in the course of this career you have chosen.

You will bring babies into the world in that particular baptism of blood and water. You’ll hear that first cry, that living psalm declaring life. You’ll cradle and gaze in awe at these babies with their slippery skin, tiny starfish hands and perfect shell ears. You’ll see women with faces blanched in agony transform into mothers falling into a love they will never recover from.
You’ll marvel at how each birth is unique and special. You will rejoice with parents who are ecstatic in their joy. The ones who have been waiting. The ones experiencing a miracle. 
You will want to weep as you unwillingly release some of these, your most delicate and vulnerable patients to homes where they aren’t wanted. You’ll see babies born with alcohol foetus syndrome and others with heroine or nicotine addictions. Babies will be born with still hearts.

Your heart will be wrung and possibly broken.

You’ll weep for the forgotten and abandoned who die alone, the beep of a machine their only company. You’ll see bitterness, sorrow and regret at deathbeds. You will also have the privilege of seeing how passionately and desperately and deeply people are and can be loved in life as they lie dying.How sad and beautiful a valediction can be, as they swap exquisite joy for exquisite grief. 
You’ll notice the subtle change of a body after death, how it becomes merely a shell. You’ll meet Death over and over. He will always be lingering in the wings, you will always be fighting Him.
 But for you, you have the hope and comfort of One who conquered death.

You will meet elderly patients who struggle to find a word, who are confused and bewildered, living…lost, somewhere further up Time’s shore, dimly aware of a tide that is gently ebbing and flowing and filling up their horizon. Some will be serene, some will feel anchorless and many will feel very, very lonely. Their life lines are fading and you must hold their withered hands and somehow make them feel safe. They are as fragile as the newborns. Life’s beginning and end renders us so.
Gentleness, tenderness even, is never wasted on any ward. Even if they’ve forgotten you before the echo of your footsteps has faded away.

You will witness extraordinary courage and sacrifice and a million tiny miracles. You will know exhaustion and exhilaration to their limits. You will be overcome with profound relief and experience euphoric moments when you battle and triumph with a patient over a disease. You will defeat disease in cases you thought were hopeless, such is the unpredictable and miraculous nature of medicine.

But there will be times when you’ll have to admit you’re wrong and hang your head in defeat. You’ll be furious with yourself for not spotting something or for making a careless mistake. You’ll lose people you thought would be fine. 
You will want to save everyone. 
You will learn not everyone wants to be saved.

You will be perplexed, distressed, frustrated, nauseated, and sometimes, simply numb. You will have moments of such acute tiredness that you will waver between hilarity and hysteria.

You will learn the importance of language. You will learn about the confrontation between scientific and every day language. You will have to learn to translate complex conditions and procedures into a map that patients can follow. Many will feel helpless and sometimes you will too, when even you can’t follow the map and fix them immediately. People won’t understand what is happening to them, why it is happening to them, and if there is a God, where is He in all of this?

Suicide. Birth. Burns. Broken bones. Addictions. The common cold. Chicken pox. Diabetes. Cancer. It will go on, and on and on.
Bedsores, bedpans, catheters, drips. The ill have little dignity and many will hold onto the scraps they can with tight fists and angry tearless sighs.
The smells of blood, sweat, vomit and disinfect will become natural ones to you. You’ll wonder at the sometimes sheer impossibility of the Hippocratic Oath.

You will also collect hilarious stories, stories you’ll hold onto for comic relief, stories to recount to your family and friends. You will come across many colourful, weird and wonderful characters. Doctors always have the best stories. People are weird and often you’ll get the privilege and fun of meeting the weirdest of the weird.

You won’t be embarrassed by anything anymore. You’ll be astonished at the faint hearted who can’t stand the sight of blood. Any remnants of squeamishness will vanish. You’ll have seen too many naked bodies, stool samples and other delightful things for that. You’ll coolly and casually discuss the goriest things, often at mealtimes.
(What am I saying? You already do this)

You will be shocked at the things you will learn to laugh at. You will laugh when the only alternative is tears. You will learn to make light in unthinkably dark situations. You will need your sense of humour otherwise you will drown. Hold onto it. But don’t let it make you callous.

You will guard your own loved ones a little closer; your ear will be tuned a little sharper at the complaint of pain or illness. But your worries will also be dispelled with swifter relief as you find nine times out of ten it’s not something serious, but something that would have someone less knowledgeable worried.

Finally

Are you ready? You will have to make quick decisions and snap judgements. You will be forced to make difficult decisions, some of which you will question after. There will be immense pressure darling, but you know this.

You will wonder….as I have, at the sheer diversity of human nature, how 
people can face the same thing and react so differently.
 As a writer, I freely admit, I’m jealous of your future access to humanity. Share some stories with me, will you? You will breathe, burn, dance, weep, laugh and bleed with your patients. 
Remember to recount your experiences….when you are able. They are more precious than you could realise. Every doctor has a book in them, so find someone who will be able to help you, so that your memories, “masked in utility aren’t missed” and don’t “give the scribe the slip.”

This will require all your courage, humour, faith and fortitude. And you will do it so well. You are going to be a wonderful doctor.
This is just me pretending I know what it’s like to be a doctor. I don’t. 
I only have an imagination. I will try and capture thousands of lives, but I will never save one.
Ultimately, I hope, more than anything, this somehow conveys just how extraordinary I think you are.

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