Medicine from the heart . . . Katie Lee's patient

On Thursdays, the Daily Voice showcases selected Thursday Morning Memos, reflective essays about clinical experiences written by faculty, alumni, residents and students of the Department of Family Medicine & Community Health and, occasionally, contributors from other departments. Thursday Morning Memos is UMass Medical School’s homegrown version of narrative medicine, in which the authors process their experiences through writing. To learn more, visit: http://www.umassmed.edu/news/articles/2011/personal_stories.aspx.

At the end of this month Kathryn Lee, MD, leaves Hahnemann Family Health Center to become the director of the Adolescent Clinic in Milford. I want to use this time of transition for Katie to reflect on the power of transitions for medical providers. Having moved from one practice to another, like many of you, it is a time to hear from patients whom we have cared for and a time to revel in the "success stories" we have been a part of. This memo is a letter that was sent to Katie that I wanted to share with all of you as a reminder for what we do for our patients in family medicine every week, every day, every hour. This letter is a very beautiful and powerful statement.—Hugh Silk, MD

A letter to Dr. Lee
I have had all day to contemplate the up and coming change and I have so much I need to tell you.

First of all, I am not a very trusting person. It takes a long time and an exceptional person to earn my trust. I have been burned throughout my life and lost my ability to trust anyone. Every time I trusted, something was expected of me or I was let down. Hence no reason to try and trust. But with you, it was so easy and so natural.

The child part of me that has the most issues with trust just seemed to connect so easily. I didn’t feel like something was expected of me. I also felt cared for and protected. I feel and felt like you had my best interest at heart and you never betrayed that. I felt like you would make the best choices for me and you would go out of your way to keep me safe, another thing I had little experience with.

Then there is the defiant-attitude adolescent part of me that tries to be so tough and not have anything bother me and that thinks I can do everything myself. This part of me is quite strong, sometimes too strong. This is the part of me that doesn’t want to trust, doesn’t think I need anyone in my life, that I can do everything myself, that says #*%@ all adults, I am going to do what I want, when I want and no one is going to tell me anything else (as like all teens, I know best). This hard-core part of me doesn’t let anyone in. It is a wall that I surrounded myself with so that I wouldn’t be hurt again. This part wants to be in control and is willing to hurt myself before anyone else can as a way to keep in control. So before I get hurt, I cause myself hurt because then it feels like I am in charge in a world that I have no control over.

The adult part of me understood and felt understood. For the first time in my life I felt like a “being” and not a “doing.” You were so instrumental in helping me see that maybe I have value even if I am not doing anything but just being. You seemed genuinely caring and I didn’t have to do anything (not even bake you cookies) for you to care and that hurt so much because it was so foreign to me. But I was learning!! You are/were good for all of me not just my physical health but my whole being.

I cannot sing your praises any louder. YOU HAVE BEEN THE BEST and I am not ready to lose what I have held so dear.

I am thrilled that teens (even though they aren’t my teens) are getting the best of the best. I am jealous of what they will get and I will lose. I know you will be great for them as you were great for my teen. You are such an exceptional doctor, woman, person and role model. I know that you will be able to communicate with the young people and let them know that they matter and that is so important.

I have learned that being a good doctor is a lot more than just the medical part; it is a core, fundamental desire to heal the human spirit along with the body. It is not making off that you are better [than your patients] but more knowledgeable in a certain area. It is your willingness to be part of a team and allowing the patient to play in the game and not sit on the side lines. It is being there as a strong force when the patient can’t do it for herself and needs support.

You have been all of this for me plus so much more that I am not able to verbalize as there doesn’t seem to be words for what I am feeling. Hopefully they will come and I will be able to express them soon.

Yes, I would love for you to be at my side through each and every hurdle and I so want you to be at the finish line not just rooting for me but crossing it with me as it has been a journey for you as well, and I want you to be proud and happy with your accomplishments.

When times were so low for me both physically and emotionally, I wanted to give up. I didn’t like the limitations (still not so crazy about them), but you kept reminding me of how far I had come. You held on to the hope that I couldn’t see. Your constant reminder that the glass was half full kept me believing.

I hope you are proud of yourself because certainly someone, or lots of someones, sees the specialness you hold within. I have been so blessed . . . you came into my life at the right time and it wasn’t coincidence. It was, I believe, a divine intervention. I have to hold on to the fact that God has something wonderful in store for you and hopefully me too.