Thank you: a letter from the heart

THERE are many challenges to face in your first year as a junior doctor: learning how to prioritise jobs, developing procedural skills, managing deteriorating patients, all of which medical schools do their best to prepare us for through years of placement and practice.

One of the integral parts of being of doctor is learning how to deliver bad news. Unfortunately, this is a skill unable to be practised in vivo until that title appears in front of your name. I anticipated having difficult conversations with patients and their families and went through the motions of scenarios set for us by our tutors and our peers, unaware of how important this skill would become to me.

Ten weeks into my internship, I had the first of many heartbreaking conversations throughout that year – I had to call my little sister and tell her that our father had just been diagnosed with pancreatic cancer.

My father is also a doctor, a paediatrician, and my mother is a neurosurgeon, so the wave of impending doom that comes with a diagnosis such as pancreatic cancer hit us all immediately. Between us, we navigated informing family members and friends, trying to convey the seriousness of the situation without being too fatalistic. I tried to fall back on the lines I had said so many times in practice but soon realised how much harder they were to say about my own father.

In the weeks that followed, my family and I had many long discussions about life and death, about cancer and about karma – and one thing that we had all experienced in our careers, although mine was so short in comparison, was that there’s no fairness in cancer. Gender, race, religion, socio-economic status, doctor or not; cancer doesn’t discriminate.

Although it’s easy to see this ugliness and unfairness in the pain and the tragedy of cancer, something beautiful did come of it. Too often in medicine, we see loved ones going too soon, too suddenly, to appreciate how truly cared about they were. But a diagnosis such as pancreatic cancer walks this line; and it became quickly apparent just how many people cared about my father. From day one, when our house resembled a flower shop, and every day after, we were completely overwhelmed by the love and support of our family and friends, and particularly by that of the medical community. It was their small actions; the kind things we as doctors do without a second thought that made the most difference to me and my family and too often it is these actions that go without thanks.

So, thank you:

• to my medical team whose eyes welled with mine as I received that first phone call and covered me without question for as long as I needed;
• to every colleague I told who nodded with grave eyes and knowing silence as I choked up saying “pancreatic” and offered their endless support;
• to the general surgeon who gave us clarity and direction while we sat in his office for our first experience on the other side of that desk;
• to the specialist surgeon who answered a work call on his family holiday and cleared his schedule to assist with the Whipple procedure;
• to the oncologists, radiologists, pathologists and surgeons who met at a day’s notice to discuss his case, offer their expertise and assist in any way they could;
• to the intensive care doctors who let us come in past visiting hours while Dad was still intubated just so we could hold his hand;
• to every nurse who cared for him at his weakest and every physiotherapist who walked patiently by his side holding his drains;
• to every colleague and friend who stopped by his room after their own long days working at the hospital just to sit and chat and take his mind off the pain for a while; to the junior doctor on my first weekend back who pretended to arbitrarily assign the patients we would each see, while clearly assigning the four patients dying of pancreatic cancer on the ward to himself, and the one who was thriving to me;
• to my father’s dear friend, a cardiologist, who drove 2 hours to see him every week during his chemotherapy to offer a small silver lining as it got harder and harder to drag himself to each session;
• to my mother, who guided us through all of this and still had the strength to support her own patients through the devastating diagnosis of brain cancer; who continued to perform life-saving surgeries to give her patients and their families the gift of time, all while having to watch the love of her life suffer through the same fate.

And finally, thank you to the kindest, strongest doctor I’ll ever know: my father. Your dignity and humility as a doctor, and now, as a patient, is inspiring to everyone you meet. Thank you for studying with me late into the night, for practising OSCE stations, for discussing interesting diagnostic dilemmas, for debriefing with me after tragic cases, but mostly, for supporting me and countless others to achieve our dreams.

Thank you to all of you. What I have seen in the past 12 months is the shining light that we can provide when patients and families are in their darkest times, and what we as professionals, as doctors, as carers, daughters, sons, fathers and mothers need to be reminded of.

Being surrounded by your passion for medicine and for helping others has fostered my own love for this profession, this community, of which I now couldn’t be more proud to be a part.

Dr Caitlyn Withers graduated from the University of Queensland Medical School in 2017 and is currently completing her residency at the Sunshine Coast University Hospital.

 

 

The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.