This ‘Letter to My Daughter’ first appeared in a recent issue of a medical journal.
My daughter had just finished first year Medicine, so I wrote to her telling her about one of the pitfalls of being a doctor—making mistakes.
I hesitated before posting this: I don’t want to downplay doctors’ mistakes—some have had serious repercussions on their patients, and I know there are rogue doctors out there.
But I know the other side, too—the many conscientious, caring, and brilliant doctors who have also erred. We try very hard to be perfect, but we’re human*, and when we screw up, believe me, there follows much soul-searching, questioning and berating, usually in the middle of the night.
Congratulations on completing your first year of Medicine. I can tell it suits you—you’re the chirpiest you’ve ever been, overflowing with new knowledge. You’ve made friends, found like-minded people, possibly for the first time in your life.
I’m reminded of my own early days at Medical School—the delicious Latin; the voluminous texts; learning the intricacies and workings of a body I’d always lived in but never understood.
By the way, I can’t believe you’re allowed to see patients in First Year. What happened to those dry pre-clinical years with nary a patient in sight?
And your father’s not impressed with the timetable. Where are the nine-to-five lectures? And Chem pracs until six on Friday evenings? He’s not too sure about this online learning either—moodles, Facebook groups, podcasts. Sounds too social to be called ‘study’.
Now, I want to have a chat to you about a serious topic. I don’t want to dampen your enthusiasm, but there’s something important you need to know:
You will make mistakes.
I know you read that and didn’t believe it. You’re thinking that you won’t make a mistake. That you’ll be so good and conscientious a doctor, you won’t miss a diagnosis or prescribe the wrong treatment.
I’m sorry to tell you, but you will. You will make mistakes. Despite everything you will learn, everything you will know, and all the exams you will have passed, you will still make mistakes.
I know what else you’re thinking: you’re thinking that the only doctors who make mistakes are the inept ones, the negligent ones, the ones who make the news. But you won’t be like them—you’ll be a much better doctor. You’ll be conscientious and thorough and meticulous.
You will still make mistakes.
Most of the time, no one will know—your patient won’t suffer, or if they do, it will be minor.
Hopefully, that is all that will happen.
When you do make a mistake, at first you’ll be defensive. You’ll say something like, ‘But the scaphoid was clear on X-Ray and it was only a minor fall onto their outstretched hand.’ Or, ‘They said their chest pain wasn’t that bad, and they wanted to drive to the Emergency.’
But, you’ll feel terrible. Because you made a mistake. You’ll feel stupid. And you’ll take yourself off to a private room, shut the door and cry.
Because. You’ve. Been. So. Stupid.
No other doctor would have missed it. Just you. You should give up Medicine right now, because you’re hopeless.
You won’t forgive yourself even if the mistake happened at the end of a double shift, or if it was an obscure presentation you’d never seen before.
Sometimes, too, you’ll have to face the patient or their relative, because they’ll want to see you. Make sure you apologise. Always.
Sometimes, you’ll have to face a colleague and his or her wrath— someone who’s forgotten that they make mistakes, too.
But sometimes there’ll be the doctor, someone you hold in high esteem, who’ll call you aside and tell you not to let it get you down. They’ll tell you about their own mistakes, and before you go, they’ll remind you that you are a good doctor and even good doctors make mistakes.
You’ll return to the ward, and you’ll see your next patient, who might be a husband who thanks you for diagnosing his wife’s breast cancer.
Or it might be a mother who thanks you for spotting the rash that was their child’s meningococcal infection.
Or it might be someone who thanks you just for squeezing him in when you were busy.
And that will be enough.
Love From Your Mum.
*I use ‘we’ although I no longer practise Medicine. I tried to write ‘they’ but that didn’t sound right either. I guess part of me will always be a doctor.