Healthcare has become a maze of insurance companies, regulations and lack of access to providers. Part of what makes it so complicated is all the charting and coding doctors must do. All of this takes away from patient care. Doctors spend more time on their computers than with patients. In my opinion, it has caused medicine to become dehumanized.

I read a wonderful article by a physician who trains interns, Dr.Suzanne Koven (http://www.nejm.org/doi/full/10.1056/NEJMp1702010). She had her students write letters to themselves at the beginning of their internships. At six months they read their letters.

She and I have been in medicine for about the same amount of time. When we started training, our individual feelings and hopes and dreams were not a concern to those who we trained under. We just dove in and kept going. Inspired by her students, Dr. Koven decided to write a letter to her younger self. I was so moved I decided to write one as well.

When you see your doctor, you probably are not privy to his or her more personal side. The road many of us have travelled in medicine has not been easy, but for me it sure has been exciting. I hope in sharing my experience it will help patients to understand where we have been and how far we as physicians we still have to go. Read and enjoy this letter I wrote to my (much) younger self.

Dear Robin,

Right now you are energized, excited to launch your medical career and full of idealism. You will be able to maintain some of that energy and excitement throughout your career. However, there will be times when things get tough. You will work so hard, get so tired and become so discouraged that you will feel you can’t keep going.

One day, during your internship, when you feel unqualified, overworked and underpaid, you will consider walking away from it all. Something will stop you. Your love of patients and the fun you have figuring out what is wrong with them will keep you in the game.

The other thing that will inspire you and keep you going is the women you will meet along the way. They are an amazing group of residents who are brilliant, compassionate, and the most incredible role models you will find. As you keep moving through your career, you will remember them and continue to be inspired by them.

Eventually, when you do your fellowship you will be absorbed in research and when that happens, you will lose your way with patient care. But, eventually you will realize that your passion is caring for people. You will get back to direct patient care and find your true path. You will be witness to your patients’ most profound and poignant moments. You will help their babies to be born, and sit with them when they die. You will help people to become well and some you will not.

Your creativity will allow you to step out of the box and help people to help themselves. You will design a career that will shape the medicine around you and you will find yourself. In doing so, you will make a difference.

You will never be entirely comfortable when you cannot find the answers to patient’s problems. However, what you will learn is that your true value as a physician is to listen to their stories, to provide comfort and solace and you will realize that getting them to laugh and giving them a hug is the best form of medical therapy you can provide.

I hope this has given you a bit of insight into how my career has progressed which may mirror the career of others as well. Most of the physicians I work with care deeply for their patients. Unfortunately that is something their patients may not realize due to lack of time and all the hoops we have to jump through.

The role of a clown and a physician are the same – it’s to elevate the possible and to relieve suffering”

~ Patch Adams