An Open Letter

      This letter is for all the young students of Medicine. I just wanted to share my thoughts on your journey. I can only say that if I were given the opportunity to go back in time and study Medicine again I would do so with utter happiness and utmost enthusiasm! So here goes…..

      All of you are living your dream. Your dream of becoming a physician and a healer! It is your dream that will continue to propel you forwards in your career. And in the end, that is the only thing that matters. You will eventually become part of a very illustrious lineage of healers from Charaka and Sushrutha to the more contemporary Dr. Anandi Gopal Joshi, Dr. B. C. Roy, Dr. A. L. Mudaliar and Dr. V. Shantha to name a few. 

      Dear students, I realize that I can call you that only until your graduation when you’ll become our colleagues after crossing the threshold that separates us. In a way, the only things that differentiate us, your seniors, from you is a whole lot of experience, both good and bad, wisdom accrued because of the experience and a whole lot of grey hair! This is probably an opportunity to give you all some of the distilled wisdom from us.

      A gift, in a sense.

      At the core or crux of your future career is the doctor – patient relationship. Don’t you find it most humbling and amazing that a random and absolute stranger walks into your consultation and literally entrusts his or her life into your hands and shares the most intimate details of his/ her life with you? This is an immense responsibility and by that token this space becomes sacred as does the relationship. Try not to let technology come in the way of listening to your patient with compassion. Try not to use short cuts in a physical examination.

      This brings to mind a piece of writing by Dr. Abraham Verghese, an infectious diseases specialist who teaches at Stanford, USA. A very competent, humane and empathetic physician. He starts off by narrating the story of a 40-year-old lady who comes to the emergency room with drowsiness. Her blood pressure reads 230/170 and after stabilization she is immediately sent for a CT scan of the lungs to rule out clots in the blood vessels of the lungs. The scan does not show any clots but reveals breast masses on both sides and sadly it turns out that the cancer has spread all over her body. Her past records show that she had visited the hospital multiple times in the past year and nobody had examined her thoroughly. If only someone had taken the time to examine her properly, her fate would have been different.

      Dr. Verghese goes on to say, and I quote, 

      “The most important innovation in the next 10 years is the power of the human hand – to touch, to comfort, to diagnose and to treat.”

      Not cutting-edge technology, mind you, but the human touch. This is most important for the patient as the message going out is that the doctor will be by his or her side all through the illness and also during the transition from life to death.

      Most of us doctors feel that we can reverse or arrest most diseases but we eventually learn otherwise. Life itself is a terminal condition and so when a patient comes to you fearful, the least you can do is hold his hand and alleviate that fear by giving him a patient and compassionate hearing.

      To my mind, there are a few essential characteristics of an outstanding physician. I call them the 6 essential ‘E’s:

•       Enquiry – question the patient with patience and compassion. In the words of Sir William Osler, “Listen to the patient. He is telling you the diagnosis.”     
•       Examine the patient thoroughly and completely. Many unnecessary investigations and scans can be avoided by just doing a thorough examination. 
•       Ethics – always do what is right by the patient. Ethics is doing the right thing even when no one is watching.

      We are living in troubled times and almost every day we hear of doctors being beat up by irate mobs. Almost every medical association is up in arms about the safety of the medical fraternity but here is where we need to introspect about ourselves. Are we being ethical and moral or are we giving ourselves up to rampant commercialization? Do we need to change something in our own selves?

•       Empathy – the ability to put yourself in the patient’s shoes and experience what he/ she must be feeling. Empathy is communicating that incredibly healing message of “You’re not alone.” (Brene’ Brown)
•       Equanimity – which literally means ‘presence of mind’ or imperturbability. For those of you who like to read I would recommend that you read ‘Aequanimitas’ by Sir William Osler, an utterly beautiful piece of writing.
•       Excellence – which finally is a corollary of meticulous training and striving for perfection coupled with experience.

      Over time, by honing these attributes, you will develop a very strong capability to ‘think without thinking’ as Malcolm Gladwell says in his book ‘Blink.’ I would like to call it intuition, the ability to make correct choices and decisions in a split second. I have learned all these lessons from my teachers and wanted to share these life lessons with you all.

      I truly hope each one of you, in some measure, will lead an extraordinary life as a physician and healer with immense respect for life while learning to value human dignity. To become the kind of doctor that you’d like to take your parents, partner and children to!

      So, good luck to each and every one of you, god bless you and may the great masters guide you at all times on your journey as a healer.

      Image credit: iStock

      My pranams at the lotus feet of Gurudev 🙏.