Margaret Mitchell
Boston, Massachusetts, United States
I wrote thank you notes after matching in my residency program, though I found I was thankful for things I had not anticipated.
I began working with Dr. Langerman in my first year of medical school, both in clinical settings and research. In his letter, I wrote, “Thank you for helping me find what I was so passionate about early on. It made the tough times in medical school much easier, giving me a light at the end of the tunnel to look forward to.”
I tried to remember what this surgeon had done to guide me to find my passion and wondered how I may emulate this in the future. Because I was able to spend so much time working with him, he had given me more autonomy than most medical students experience, both in the operating room and clinic, showing me how to hold surgical instruments and allowing me to connect with patients by hearing their stories firsthand. As I reflected on those experiences, I found that he had helped me with two key aspects of self-realization. First, he helped me develop a sense of identity. I had worked with him once a week during my first year of medical school, and by second year I was introducing myself to a resident who responded, “Oh, Megan? Langerman’s Megan?” Even when I had stopped working in his clinic by third year, but still stopped by to give updates on research projects, residents and attendings would see me and wave. No one ever asked why I was there.
As a medical student, there is a constant struggle for a sense of belonging. Residents and attendings already belong, having been formally granted access into a profession. But because of this surgeon, I had a sense of acceptance and inclusion from my earliest days in medical school. He treated me with respect, and expanded my autonomy as I grew. Every time I walked in, he would exclaim, “Hey Megan! How are you?” I felt like part of a community—even though it was a community dominated statistically by men—but I never questioned whether I could belong. I was also able to imagine what it might be like to be an otolaryngologist. Even in the depths of isolation studying for exams and the stress of grades, honor societies, and expanding my CV, I had a more realistic sense of what was on the other side. This tangible, concrete vision of the future is one of the best gifts I have ever received.
I played high school sports with the daughter of another surgeon in the department, Dr. Werkhaven. My note to him included, “Thank you for being a familiar face.”
Medical school can seem like a never-ending treadmill of new people assessing you every week. Each day you introduce yourself to new residents, attending physicians, nurses, and patients. It is draining and a constant reminder that no one knows who you are. And the usual questions follow: “Where are you from? Where did you go to undergrad? What field are you interested in?” Walking into a room, hearing my name, and seeing someone who already knew the answer to those questions was a relief. He could skip these formalities and ask about my family—meetings with him were a piece of home.
Another note included, “I am so grateful that among your responsibilities, not only at this institution but also on a national level, you take time to invest in medical students.”
Dr. Garrett was a surgeon with national and institutional leadership roles and responsibilities. But even with so much on her plate, she still spent a significant amount of time interacting with medical students in her clinic, involving them in research, and meeting with them personally. People don’t have to care about you in medical school. The bottom line of the modern healthcare system is focused on patient outcomes, dollar signs, and productivity. There may be smaller incentives to mentor and teach, but there is no objective measurement nor incentive for attending physicians to really care about you. And yet, while being an incredibly well-known woman in her field, she cared. She did not have to, and that meant a great deal to me. She loved her field of otolaryngology so much that she wanted to help students enter into it.
My final note ended with, “Thank you for including me in the wonderful things you do.”
Dr. Netterville had a goal of making head and neck surgery safe in Kenya. I traveled with him for two weeks during his annual educational course to teach Kenyan head and neck surgeons. During this trip, I was reminded of why we do surgery in the first place. In the US, we are so bogged down with documentation and defensive medicine that we are sometimes unable to see what helping someone with their health can really do. We do surgery not just because we enjoy the tactile challenge, but because when the anesthesia wears off, we have helped someone. This surgeon was using what he knew how to do to change lives around the world. As a medical student, I had internalized so much of what I could not do: I could not put in orders. I could not write the official patient note. I could not be the primary investigator nor corresponding author on research projects. But working with this surgeon made me realize what I could do with this career. While Dr. Langerman gave me a vision of my future, this surgeon gave that vision meaning.
While I will always be thankful for their formal academic assistance—letters of recommendation, inclusions in research publications—my gratitude to them goes far beyond any individual act. Inspiring someone is more than a single step. For me, the process involved first realizing a sense of identity, belonging, and acceptance in this field accompanied by the opportunity to meaningfully engage with patients in the operating room and clinic. The people who inspired me loved what they did and used their abilities to change healthcare delivery around the world.
The late Kobe Bryant once said, “The most important thing is to try and inspire people so that they can be great in whatever they want to do.” Kobe shot basketballs; we hold scopes and scalpels. But I think he was right—that is what these people did for me, and that is what I am thankful for.
MARGARET B. MITCHELL, MD, MS-HPEd, is a current resident at Harvard Medical School/Massachusetts Eye and Ear Infirmary in Otolaryngology-Head & Neck Surgery and a recent graduate from Vanderbilt University School of Medicine with a Certificate of Distinction in Biomedical Ethics. She also completed a Masters of Health Professions Education from Mass. General Hospital’s Institute of Health Professions, and has a Bachelors in Economics from her undergraduate studies at Vanderbilt University. Her professional interests include surgical ethics, health economics and policy, as well as medical education.
Acknowledgment
The author would like to thank the residents, attending physicians, nurses, and other staff of the Department of Otolaryngology-Head & Neck Surgery at Vanderbilt University Medical Center for their support in her career.
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