Nothing human is strange or repulsive ...

For daddy…
in response to the hand-written message he wrote on the inside cover of my Merck Manual …





Dear Dad,

I’m looking forward to seeing you in a few weeks for Christmas. It will be good to be back home for a few days, to spend some lime with you and Mom (and the dogs, of course!)
I’rn in the last week of exams here, so things are winding down, and I’m starting to think more carefully about the rnonths to corne in the clinics and more importantly about what I want to do after medical school. I’m looking forward to finaily being in a position where I will be meeting people every day and helping them solve their health problems.
In fact, this is why I’rn writing you this letter today, because I’ve given a lot of thought about why I wanted to study medicine in the beginning. 0f course you were a great inspiration to me, seeing the effect your surgical care had on the lives of your patients, and their gratitude for your care.

What aiways irnpressed me the most, however, were your stories of the consultations you had with some of your “best customers”, your patients with whom you had long-standing relationships. These were the people who you had not only helped by performing surgery, but also through the management of basically ail their problems. You would teil me with great enthusiasm of how you had to cali haif a dozen different consultants to try to get the best care for your patient. You talked of some patients who seemed to have great difficulty in understanding the severity of their ilness, and the need for surgery, and how you would patiently taik them through ail the details and help them to accept their fate more easily. It was easy for me to see how you would find great satisfaction in these interactions, since this is where you were really giving the greatest benefit to your patients.

For me, these stories of patient interaction touched and excited me much more than the stories of the combined Whipple-colostomy operations, or even the great camaraderie in the surgical biock. This is why I’ve finaily decided that I want to specialize in Family Practice and not Surgery. Despite the fact that you have aiways told me that I should do what I want to do in life, I know that you have hoped perhaps that I would follow your footsteps in Surgery. I hope you will see my decision to do Family Practice as a confirmation of the great effect you have had on the lives of those patients for whom you really took into your own hands the totality of their care.
I’m looking here at the hand-written message you wrote on the inside cover of the Merck Manual which you gave me when I entered First Doc. It says,

“The true physician has a Shakespearean breadth of interest in the wise and the foolish, the proud and the humble, the stoic hero and the whining rogue. To the physician, as to the anthropo1ogist, nothing human is strange or repulsive.” You said that you took this out of the introduction to Harrison’s Internai Medicine, and if for me the Harrison has become my Bible of medicine, this message has become a touchstone of reflection for me and my role as a family physician. I’m interested in more than just piecemeal care for the organs of my patients. I want to be the one that can give them the maximum benefit of what the heaith system has to offer, and be abie to guide them through their difficuities. I think the biggest challenge for me wili be in the management of the myriad specialized medical services avaîlabie now - trying to choose what is the best plan of action for my patients individually.

In any case, I’m looking forward to spending a few months with your Canadian coileague in September, and I’m sure that I wiil learn a great deal with Mm. After ail, I’m sure I’il be sending some of my patients to surgeons over the next forty years!.Thank you again for ail your support throughout these last five and haif years. It has made the going ail the more easier knowing that you had gone through the same thing before me, and that you have been there ail along. See you soon for Christmas!

Pierre


PS . Dear Dr Vanwelde,Thank you for your kind reply and for your efforts in giving us a comprehensive introduction to real medicine!I will most likely do the exam in English as well. Yours truly, Pierre M Johnson 3ème doc. 1999-2000