Sage advice to new medical residents

A letter to my nephew, who is just starting residency.

There will be days ahead when patients will bring you their most prized and flawed possessions — their broken bodies, their flagging spirits, their waning hope.  They will wonder: “Can I get back to my loved ones, my life, my dreams?  Will you help me? Do you care?”

You will not have all the answers, though you will have read a forest of papers, a mountain of textbooks. You will not cure all their ills, though you will have memorized every step in the surgical dance. That’s OK; you are not alone on this journey; you will learn, you will grow, you will try again the next day.

There will be days when questions will rain down on you like perpetual hail. You won’t see a bathroom for eight, maybe ten hours.  When you finally do, your pager, zone phone, and cell phone will gather in a pack and come find you. Just smile and say, “How can I help?”

There will be days when a patient’s story will break your heart.  You will heal her by listening to her words, as much as by pinning her bones. She will be lucky that you were the one who cared about her, while you cared for her.

There will be days when your floor will hold all your clothes, your fridge will hold only former food, your bank account will hold nothing. You will go to work anyway. It will all work out; I promise you.

Your team, with it’s kaleidoscope of faces, will fill you up with endless carbs, will crack you up with dark humor, will hold you up when you can’t stand. Handle them gently. Their armor looks tough, but their hearts are spun of beautiful, breakable glass. It’s why they care for patients too.

There will be days when you won’t remember the last name of your last patient, the last place you parked your car, the last time you went to a movie. When you leave the hospital on those days – drive safely. You are the brightest star in our constellation, and we need you to last.

There will be days when you will do everything right, and no one will say thank you. You will be OK.

There will be days when you will do everything wrong, and a child will smile at you. That will make it OK.

There will be days when you are tapped out, empty. You will have given everything you have and so much more. On those days, nourish your body. (Venti iced mochas and Diet Cokes don’t count.) On those days, feed your soul, pet a dog, get lost in art or nature, share a good bottle of wine with a true friend.

There will be days when you will see humanity at her cruelest, harshest, most shameful worst. There will be days when you will see her at her bravest, kindest, most selfless best (sometimes on the same day). She can teach you either way: Choose wisely.

There will be days when your body is beyond exhaustion, your brain is beyond coherent thought, your patience is lost in the rear view mirror.  It is OK to say you need five minutes. It is OK to say, “This sucks” to your team, your friends, your family. It is not OK to lose your cool with a patient, a nurse, a student. Especially since you are the coolest.

There will be days ahead, I am sorry to say, when you will hurt someone. You are the most perfect of imperfect humans, but even you cannot skip this part. You will hurt someone who trusted you to make them better, to stop their pain, to keep them among the living. The stories of these patients will haunt you and be tattooed on your soul. That man or woman or child might not forgive you, but you will have to forgive yourself. When you look at your mistakes, be honest but not brutal.

On those days you will wish you could put down the heavy, heavy yoke that comes with picking up a stethoscope and a scalpel. You will wish your life could be easier. You will wonder if you should have chosen to be a doctor. You will find yourself back in that bathroom, sitting on the floor, frustration and sadness pouring from your eyes. On those days – call me. We will get through those days together.

Then there will be days when a patient shakes your hand and says, “You changed my life. I don’t know how to thank you.”  Your head will know he didn’t need to; your heart will know he already has.

There will be time, later, for all of these days.

But today, take time to rejoice, reflect and breathe. You are a doctor.

Kim Walker is a physician.

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