A letter to new medical students

Dear new medical student:

Congratulations! You are about to embark upon an exciting, life-altering experience, one you will never forget. You are about to join an elite group of people who will now be your peers going forward.

You will be continually fascinated, and not a single day will go by from now until you retire that you aren’t challenged by something you have never encountered before. You will be solving problems and thinking, using your brain for the good of your fellow human beings.

It will be difficult though. Some days you will scream, some days you will cry, some days you will want to crawl under the covers and never get out of bed. Some days you will eat too many donuts or chocolate, some days you will drink too much coffee, and some days you may have one too many glasses of wine.

You will be challenged to your fullest, but you will rise to the challenge. An important thing to remember is to take care of yourself.  Adopt work-life balance as your mantra, even when there are unceasing demands on your time. It is very important to take time away, to give your mind a rest, and to restore your soul. You will be involved in some completely heartbreaking cases. You will have to learn how to process these without completely shutting off your emotions, or being overwhelmed by them.

It takes time. Be kind to yourself.  Make some good friends who are doctors. You will need them for support as you go through your career. They will be the only ones who really understand the different pressures you will face in your life; sometimes they will be the only ones you can talk to about certain experiences.

Pay attention to details; they may hold the key to a diagnosis. Never fake data when you are presenting in rounds if you don’t know it. Think beyond the obvious. Never assume your diagnosis is correct until it is confirmed. Always have other ideas in your differential diagnosis and a plan B for treatment if plan A is not working.  You will make mistakes. You could even contribute to someone’s death. Again, be kind to yourself. Everyone makes mistakes and the system is set up so that hopefully someone will catch your mistakes before they reach the patient. Thank them profusely when they do.

Never think you know it all or become arrogant. Remain humble, remain open to learning, and above all, become a team player. Respect the nurses and ask their opinions. They spend hours at a patient’s bedside and you will only spend minutes. They are skilled observers; you need the information they can give you. Treat them right.  Remember that people will be watching you constantly and judging you. The nurses will be trying to decide if they’d want you to be their doctor. Try to be the kind of doctor they would want for themselves or their families, and the kind of doctor you would want for your loved ones.

Kindness counts, both towards your patients and towards the rest of the health care team. Remember that your reputation will follow you, and actually in many cases it will precede you. Do everything you can to maintain a good one.

Share your knowledge. People will appreciate you for it, especially the nurses. Learn to talk with patients and their families in ways they can understand, and in ways that show you care. It’s okay to hold your patient’s hand and to cry with your patients. Don’t let anyone tell you otherwise.

Medicine has become very high tech, but it all really harkens back to a basic principle: First, do no harm. Don’t do tests or procedures if they aren’t needed. Don’t experiment on your patients. Don’t be callous or rude, because this can harm the spirit. And when our technology fails to give us the tools to provide the cures our patients are seeking, what we have left to give is ourselves and our time. The most important thing we can do is pledge to accompany our patients on their journeys, wherever it may lead them, even if it is to their grave. Be not afraid, you can handle it. It takes time and practice, but you will grow into it.

Being a doctor is a huge responsibility, and unfortunately sometimes shouldering that responsibility will take a personal toll on you. I for one think it’s worth it because we have chances every day to make a positive difference in the lives of our patients and their families. Develop relationships with them. Care about them. Try not to let the tough ones burn you out or turn you off. Have compassion. As I hope you already know, not everyone has had the advantages in life that you have. And some people just plain have bad luck.

With much admiration for your courage in selecting this career,
A seasoned doctor

Sue Hall is a neonatologist.

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