A Letter to My Doctor
2019; Elsevier BV; Volume: 64; Issue: 2 Linguagem: Inglês
10.1016/j.jadohealth.2018.11.004
ISSN1879-1972
Autores ResumoTears rolled down my cheeks as I left your office last week, and I have been overcome with emotions since. I cannot quite pinpoint the origin of these tears. This was just a typical doctor's appointment with you. But you are definitely not a typical doctor. When I first met you, about a year after being diagnosed with type 1 diabetes, I could tell you were no ordinary physician. First, you had me add your cell phone number to my contacts. You then proceeded to take a photo of my mollescum on your iPhone so that you could easily reference it later. I do not know of another physician that links his or her office voicemail to a cell phone and texts patients thoughtful responses within minutes, at all hours, including on weekends and holidays. Time and time again, you make me feel like I am your only patient. Clearly, I know this is not true—you are the director of one of the country's most prominent diabetes centers and are often referred to as a leading world authority on diabetes. You are constantly traveling the globe for research and teaching purposes (and my appointments constantly get cancelled because of this!), yet you still give me boundless attention. From casually mentioning that you discussed me with a researcher when you met for lunch in Paris, to putting me in touch with geneticists in California, to reciting my complex medical history to me like it is your own daughter's, to spending an hour in my examination room at each appointment, it is evident that you truly care. I have always respected you greatly, but it is only recently that I realized how loving and compassionate you truly are. This is a bit ironic, as I would not describe you as warm and fuzzy. In fact, your remarks that stand out to me most are rather harsh and depressing:“You are very strange. We have known this for a long time.”“I do not think going away to school in another part of the country is a wise idea.”“You make a very interesting case study. When you're a patient, being very interesting is not a good thing.”“Unfortunately, we still have so much to learn. There are many conditions that we do not currently have treatment for.”“You are so vigilant about controlling your blood sugar. I know you say you feel better when it's lower, like being in control, and want to avoid later complications, but what happens when you don't wake up one morning from a low blood sugar? At that point, there won't be time for later complications.” I believe it was your talk about mindfulness that set off my tears last week—acknowledging the limitations of western medicine, admitting that our traditional notion of science cannot currently cure me, but believing that I can keep striving to live the highest quality life that I can. In this moment, I was overcome with your humility and humanity. In When Breath Becomes Air, Kalanithi [[1]Kalanithi P. When breath becomes air.1st ed. Random House, New York, NY2016Google Scholar] speaks of learning to treat his “paperwork as patients, and not vice versa.” You have gone above and beyond this, treating me not only as a patient, but as a person. You listen emphatically. I cannot tell you how important this is. When struggling with enormous autoimmune complexities, there is nothing worse than feeling alone. There is nothing better than being listened to, heard, and validated. You know I am suffering. You acknowledge my difficulties. You convey that you are sorry, that you wish things were better. You treat me as a whole person. You are an endocrinologist, and your job is to treat my type 1 diabetes. But you spend more time thinking critically about my stomach problems than any gastroenterologist has, find flaws in tests and medications ordered by other departments, and regularly address my mental health. When asked for my primary care physician, it is your name that I unconsciously write down. Through all of this and much more, you bring me immense hope. In such difficult times, hope is everything. I hate to say it, but you have not treated me with any medication, other than insulin, that has alleviated any of my autoimmune issues. While I feel like my physical health is deteriorating, the mental strength you provide me is invaluable. Our relationship embodies the power of the doctor-patient connection, and I certainly hope that stories like mine can help shape the future of clinical care. After grappling with the source of my tears, I have concluded that, above all else, they were tears of gratitude. Gratitude for having a doctor who is not simply a physician, but a caring, listening, and contemplative human being. A true healer. I certainly hope that I do feel better soon. But, either way, I look forward to future research collaborations. I aim to treat other chronically ill adolescents with the values that you have instilled within me. Perhaps, it is fitting that the only picture we have together is from the Juvenile Diabetes Research Foundation (JDRF) gala. Rather than your typical white coat and my sweaty workout clothes, we are sporting elegant attire. We are dressed up and smiling big on a Saturday night, not as doctor and patient, but as equals. As two compassionate souls who care about each other deeply. Thank you from the bottom of my heart, Love, Melissa
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