By Kyle Leggott, MD
(November 2019) In June, I graduated from the University of Colorado Family Medicine Residency program. As those years of training came to an end, I began a process that every doctor goes through at some point: saying goodbye to my patients.
Unexpectedly, this was one of the most difficult experiences of residency for me. Some of my patients had been with me since my first few days after medical school. For many of them, being their primary care physician meant I had been their main connection with the health care system for three years.
When I let the first few patients know I was leaving, I told them that it had been a pleasure to take care of them and that they would be in good hands when the next resident took my place. Some thanked me, others were upset I was leaving, and some were worried about what would happen to them once I left.
I left those encounters feeling emotionally exhausted and unsatisfied with the exchanges. I couldn't put my finger on why, but I knew I hadn’t conveyed my thoughts and emotions when saying those first few goodbyes. After seeing two of my oldest patients, a medically and socially complex couple I had taken care of for three years, it clicked. I told them thank you.
Thank you for smiling with me and letting me share in your success when you overcame an illness or disease.
Thank you for crying with me when sometimes that illness or disease got the better of us.
Thank you for sharing your most intimate fears and worries in the office and hospital.
Thank you for understanding when I didn’t know an answer or needed help.
Thank you for trusting me to make decisions and recommendations on your health and well-being.
Thank you for teaching me how to navigate difficult conversations and talk about life and death.
Thank you for letting me place my stethoscope on your chest and hear a murmur for the first time.
Thank you for allowing me to perform invasive and uncomfortable procedures, sometimes for the first time.
Thank you for helping me grow as a physician and healer for the past three years. There was no better teacher than you, my patients.
The road to becoming a practicing physician is long: four years of medical school followed by at least three years of residency training. We spend countless hours in lectures, read innumerable textbooks and research articles, and take myriad exams.
Throughout our medical education, we have amazing physicians who act as educators, mentors, and supervisors. But it is our patients who are the best teachers. They help us take all our book knowledge and put it into context with what we experience in the exam room. It is through their shared experiences, their illnesses and their diseases that we become physicians.
During the course of three years, every family medicine resident will see at least 1,650 patients in clinic, 750 patients in the hospital, 250 patients in the ER, 250 children in the hospital, 250 children in clinic, and many more. We see thousands of patients in three years; this is how we learn.
There is no lecture that will teach you how to feel whether an anterior cruciate ligament is torn, but after working in a ski clinic for a month and taking care of dozens of patients with knee injuries, the exam maneuvers become muscle memory.
You cannot learn from a book how to talk to a patient and their family during their darkest moments when their health is failing.
There is no substitute for caring for patients and learning from them.
So, for every patient who has been a part of my medical training for the past seven years, thank you. You’ve taught me more than I could have imagined and made me into the physician I am today.
Kyle Leggott, MD, is a family physician doing a fellowship in health politics and policy at the University of Colorado.
This column was originally posted in the AAFP Fresh Perspectives blog in August 2019.