Dear Nadia,
Congratulations! You’ve graduated. As you stand, reciting the Hippocratic Oath, I must tell you: you have no idea the world you have just entered.
Medical school, the toughest thing you’ve accomplished till now, will be a piece of cake by the time you’re done.
Mom and Dad sacrificed a lot to bring you to Canada. So you will work hard, learn more, reach further, live larger to make it all worthwhile.
Because even if life isn’t always fair, Mom and Dad taught you: a little bit of luck and a lot of hard work can still go a long way.
And you are lucky. You are a doctor. This profession — it’s extraordinary. Beautiful. Heart-rending.
A year from now, you’ll lose the first patient to whom you give a piece of your heart. An elderly man with anasarca. You’ll walk into the internal medicine ward and the nurses will stop you, “He passed away at dawn.” You’ll keep the pendant his daughters gifted you.
Over the years, you will meet more such patients, all of whom hold pieces of your heart. Many of them will live; some will die. Many of them you’ll fix, change, stabilize, sometimes even save; some you won’t.
The three year old who was in a car accident that broke his face and body whom you’ll intubate while his mother sang to him. The newborn with severe hypoxic-ischemic encephalopathy whom you palliated while being pregnant yourself. The fiesty world war II vet who showed you that old age is not for the faint of heart. The 12 year old who died of an invasive infection whose mother’s wails still haunt your dreams. The 101 year old lady, a working woman back when such a thing was inconceivable. The 75 year old man who called you instead of 911 while having a heart attack “because you know him best.” The newborn, born dead, who came back to life after a minute of CPR — you still feel the give of her tiny chest under your fingertips. The 40 year old man who died of influenza pneumonia whom you could not bring back to life; you still hear his wife whisper, “But we just got pregnant.”
Life isn’t always fair. And this profession — the work, the worry, the wonder — will be nothing you imagined and more than you’d believed.
Your son will give you a Mother’s Day card where he writes, “Mom’s favourite thing: WORK.” It will be a wake-up call. So, you will set boundaries. Carve out more time for your children. And you’ll know it’s right because the next Mother’s Day card will read, “Mom’s favourite thing: Me.”
Your husband will sacrifice his career to support you and your children. You’ll look at him, perplexed, and see the answer in his eyes: Love. Twenty-two years with this man. How did you get so lucky?
So you will work harder to be worthy.
You will watch the world turn. Technology, world leaders, celebrities will rise and fall. Medicine will not be immune — it too will transform and the knowledge you’ve just gained will be outdated by the time you stand where I am.
You will be sued. Years of second-guessing yourself, and you will one day realize, they are wrong. You are a good doctor. You’re smart. Skilled. But sometimes, despite your wit and talent, luck does not hold and you are not enough to protect a patient from a poor outcome. That will be the hardest lesson of all.
You will be criticized. Berated. Betrayed. But you will realize that what you are and what others see does not always align.
In your darkest moments, you will wish you had never become a doctor. You will get sick. You will burn out. And you will recover. Make peace. Find a new balance. Remembering again how much you love medicine.
You, a small town doc, a quiet mom of four, will speak out when your profession is under attack. You will write. Tweet. Appear on TV and radio. You will stand across powerful men and women. And you will be seen as a leader by thousands of doctors across the province.
You will know your true friends. The ones who stand with you for you, not for your name.
Then when you return, relieved, to your quiet life, you will be startled each time another doctor turns to you, gifts you their loyalty and thanks you for what you did for them, for the profession: “You say jump, and I will jump. For you.”
You will never get used to how others see you. But you will work harder to be worthy.
Because you know that extraordinary as others think you are, there are thousands of doctors equally extraordinary.
So stay humble. Be grateful. Be brave. Be limitless. And always remember, use your strength in service to others.
Warmest,
Nadia
(First published in The Medical Post on April 27, 2020)