A Letter

I penned this letter while finishing up a rotation at a different institution from which I spend most of my time.

A brand new intern, only a few weeks into her training, had taken her life. We hear, way too often, of physicians and medical students utilizing a permanent answer for what it is often a temporary problem. This one was close. I share this with utmost respect to all those affected.

Dear Intern Class of Anywhere, USA — Pediatric Medicine,

The realization that this one was close was followed by the sickening feeling of loss and helplessness. That which we all dread had happened, five weeks into what is supposed to be the fulfillment of a calling manifest. This intern class, full of the brightest and most accomplished our society has to offer, however, will not be able to hide from this by degrees of separation. It was one of their own. And it is to you, the intern class who I write this for.

I come to you as somewhat of an observer. I have the privilege of working with you and learning from you the finer art of acute pediatric doctoring. I’ve become used to the high frequency of hopelessness in adult acute care and acclimated to working towards peaceful exits to what is often a life fully lived.

The flicker of potential with the most disheartening pediatric cases is refreshing and renews the spirit, I know the attraction of pediatric medicine. I think back to myself, starting intern year, and how hard it was dealing with the weight of actually being called doctor and the responsibilities thereof. I had a secret weapon though, one that can only be gained through a long and circuitous route, a pop-top release valve borne of a certain understanding.

Somewhere along the way I learned to forgive myself.

And I have had to forgive myself more times than I like to recount since I started residency. Certain times have been more difficult than others but I think I might not have made it through intern year had I not had this ability.

This is a frightening self realization. I argue that hard truths become palatable once in the light; that the sting is taken out when discussed and examined.

While I don’t pretend to understand the specific circumstances of any one person, I do think I’m beginning to understand why we, as physicians, are at an increased risk. A system that has done all but completely destroy the patient-doctor relationship leaves us all wondering why; why we feel so disillusioned, scapegoated, tricked, defrauded, taken-advantage-of, disregarded, discounted, squeezed, scorned, and of course — burnt out.

I’m sorry that this is how your first month of residency ended and I’m heartbroken for the family. I’m hopeful that this life of brightly burning potential will live on for all of us as an agent imploring us to treat each other in a fashion that shatters the patterns of the past, breaking the bonds of the cycles of abuse.

I’ve seen glimpses of the love outpoured and people taking action to support one another — may this not be in passing but become a rallying cry for change.

I implore you to forgive yourself. I know us; I know that varied people are attracted to medicine, I also know that we all have a few things in common, not the least of which is a self drive which can, at times be relentless and yes, unforgiving.

I know that many of us are inclined to forgive one another before we elect such considerations for ourselves. Furthermore, a cognitive understanding that mistakes will be made does not necessarily equate to that understanding in the heart, and from an observer’s point of view, pediatrician’s have heart.

As the years go by and our careers and endeavors take us across the country and around the globe just know that I’ll always have you, this intern class, in mind. I will be hoping that wounds have healed but also wondering how this changed you, and what you did to ease the pain of those who come after us.

Please, take care of yourselves.


A Family Medicine Friend