Dear Self,
It is not enough that you came to this place. Your knowledge was insufficient, your education far from complete; in fact, your contribution to these people, to that hospital was well short of minimal. Rest not on your laurels, for they aren't achievements after all. Your travels mean little to these patients, insofar as altering the trajectory of their lives. As my colleague put it, you've experienced the best that medical tourism has to offer.
That said, me (you) being the swell individual that I (you) am (are) [this addressing of one's self is a grammatical nightmare...apologies], I'll give you an opportunity to repay your debt. All I ask is that you take lessons learned from the best and worst you've experienced here, and apply them in your practice, indeed, your life.
Care for your patients
I'm not talking about dressing wounds, or dosing pain meds: these are standards of care to which we all must adhere. Indeed, you can and should go further.
Clean your patients following a procedure, for it signifies devotion to de-tail, and restores some dignity to the flesh you just probed, incised, violated in your quest for diagnosis or cure. Learn their names and use them, as it's the easiest compliment to pay someone. Take pride in your work: your lazy suturing is a lifelong scar for them. Treat them as though they were your own and you'll never truly fail them.
Don't just rely on lab tests
Join that great fraternity of time-honored healers and actually pay attention to your patient's signs and symptoms. Look at them, touch them, smell them. The human body, even its clothed state can scream clues to you. Much like that bilateral eyelid droop you carelessly overlooked in that six-year old.
Research your patients' illnesses
You didn't have your textbooks, you said, or you would have known what that HIV fusion inhibitor drug was. Bollocks. You had plenty of time in the internet cafe the day before to research HIV and its treatment. It's Africa, for crying out-loud, you knew you were going to see HIV patients. Don't get caught with your pants down again, lest I disown you.
Research your patients
Note the difference between this and the former point. Your patients are the product of a very specific lineage. Their father's father is responsible for that broad, flat nose, and their mother's sister contributed their skill at quilting. We all, in fact, are merely a collection of those persons and things that came before us. Our attitudes, beliefs, values, and morals have been forged sharply in the fires of family culture, shaped bluntly by the regions from which we come. Come to know these and you'll come to know your patients. Other ignorant, unmindful physicians will be prohibited from gaining this, your unprecedented access to the patient. It simply will allow you to heal more thoroughly.
Use the mothers
If you end up in pediatrics, use the mothers. No amount of schooling or experience will tell you more than a mother's intuition. Now that you're ready to argue this point (after some thoughtful consideration, of course), go back and read it again. I'm sure your mother would concur, and you've not made it a habit of challenging her in the past, so why start now?
Take time for you
This is a taxing profession, filled with seemingly endless hours of frustration. It will call for a level of diligence and concentration that seems beyond human capabilities at times. You will take this all in stride, however. If you fall off the horse (this will happen), you will stand up, brush off your backside, and mutter to yourself, again. You will be surrounded by a horde of whitecoat-clad colleagues with a similar mindset. Do yourself a favor and make friends outside this profession. They will keep you grounded, providing a sense of normalcy otherwise stolen by your career. And, for God's sake, take some time for yourself. Read a book, cook an elaborate dinner, nap, write more letters to your future self...frankly, I don't give a damn what you do, just do something other than this work. It is not all that you are, and besides, an investment of time into yourself will only allow you to be better at your job when you return to it.
Lay hands on your patients
Nothing reaffirms more the shared human connection between individuals than that of touch. Take a pulse if you have to; at least they'll know you have one, too.
Learn all you can
Medicine or otherwise. No matter how smart you think you are, you aren't, really. You won't be able to collect books as fast as you'll run into people that can run mental circles around you. Ignore your prideful, jealous nature and learn from these people. Keep your eyes open and your ears perked, you never know when you'll encounter a teaching moment, and I'm not talking solely of medicine or the hospital.
Teach, teach, teach
Never forget how you felt when someone took you under their wing and forcefully fed you as much knowledge as you could feasibly stomach. Never forget what it was like to be ignorant, still viewing the world as flat. In this life and in this profession, you have an obligation to pass on knowledge, for none of it is truly original. Don't hoard it, instead hand it out indiscriminately, as though running through town tossing out candies for the children. Abhor pretense and seek the truth. All else is a disservice to the world.
Lead by example
No amount of appeal or protestation will motivate others to work as though you feel they should. Waste not your time in devising clever ways to "out" them or shame them into correcting their (in)action. Pick up the yolk and plow some more. Trust me, it won't go unnoticed by everyone.
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