Dear Dr. Wible,
I am writing to you with great sadness, but with relentless determination to ignite change. I am a doctor with a disability. Two years ago I began residency training in pediatrics. The privilege was overwhelming as I stood a doctor in the very halls where I had been wheeled in as a patient with a brain tumor. I couldn’t believe that I had actually made it, that I was alive, and that I would be given the great gift of caring for others. I fulfilled my dream and my promise to my neurosurgeons — that one day I would walk through the doors of this hospital as a doctor.
But my dream has slowly been taken away from me. I fought to complete my pediatric training, but my program fought harder to discriminate, retaliate, and punish me for my differences. Early on I began experiencing significant difficulty with sleep deprivation. I was threatened with termination for requesting formal ADA accommodations and told I would be fired if I proved unable to endure 80 to 90 hour work weeks, 28 hours of continuous work without sleep, and up to 14 days without a break. My body was resilient as I had survived two brain tumors and three brain surgeries, but was left with permanent (yet mild) physical challenges. My residency program was well aware of my needs but chose to label me as weak. I was humiliated and criticized as unfit to practice medicine. I tried to tough it out and power through the grueling schedule I was forced to work. I would be fired if I didn’t.
I recall arriving home one day after a 28-hour shift and being unable to walk up the stairs to my house. My body was shutting down, my morale was nearly gone, and I needed someone to understand. My oncologist became increasingly alarmed that I was being bullied for my disability, yet it was one of the graduate medical education administrators who took my situation into her own hands as she went over the heads of my program. After being denied formal ADA accommodations for two years, I was finally granted a work-hour adjustment.
Then all of the sudden I experienced an abrupt shift in my evaluations. Suddenly, my performance was well below average with a knowledge base of “sand, not stone.” I was warned that I was too polite, too nice, and that I needed to become more arrogant if I was going to make it as a doctor. My program director explained to me that she “didn’t care how residents conducted themselves as long as they didn’t kill anyone.” I was told to “turn off my moral compass” and that “you do not have to be a good person to be a good doctor.” My program was searching for any way to push me out through completely absurd claims regarding my performance. All of these complaints began when I started working a “humane” 60-hour work week. The constant shaming and harassment was unbearable. No longer willing or able to tolerate discrimination, I resigned at the beginning of my third year.
Residency programs are not interested in training physicians to be humanists. They are interested in creating machines. I am not a machine. I am a human being who wants nothing more than to devote my life to this University as my doctors at this hospital are the reason I am alive. I want to be the kind of doctor that could tell a child in pain that I understand because I have felt this pain. Being a patient has made me a better doctor. I want to be a walking example of the amazing work of my pediatrician, neurosurgeons, and oncologists. My program has taken all of this from me. The irony of my story is palpable: I pursued pediatrics — to care for those who are vulnerable and suffering — and my program has not been able to care for their own doctors.
It is indescribably crushing that the same system that gave me my physical life back has now taken away my life’s purpose. My superiors have belittled me for the very deficits that inspired me to become a doctor — my compassion, love, and dedication to my patients. In trying with all that I have to give back to the institution that has saved my life and to devote myself to making the lives of children better, my dream has been destroyed, my time as a patient has been devalued, and my heart has been broken.
Erin S. Kalan, DO
Erin agreed to have her letter published. She joins the long list of doctors who are daily subjected to the same bullying and discrimination tactics by U.S. hospitals that put profit over people and fail to comply with ADA laws. Recent cases include Stephanie Waggel who was fired by her hospital for having cancer and Svetlana Kleyman who was not allowed to complete her surgical training after a spinal infection.
Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Physician Suicide Letters — Answered and Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor. She hosts the physician retreat, Live Your Dream, to help her colleagues heal from grief and reclaim their lives and careers.
Image credit: Pamela Wible