Compassion in Healthcare 2018 Essay Contest - Second Place


Dear 17-year-old me,

You don’t know this yet, but five years from now, you will enter medical school to become a pediatrician, your childhood dream. I know this is surprising to hear based on where you are in your life right now. But I want you to know what I wish I knew then: all the pain you’re going through is actually preparing you to be a better doctor. I know it feels like the opposite, like all the bad things that have happened and that are currently happening to you preclude you from achieving your goals. That’s why I’m writing you this letter, to tell you that one day you will be thankful for your experiences. Because they will bring you closer to the heart of patients, where you will find true healing happens.

Right now, I know you feel like you are breaking from the inside out, like a shattered ceramic bowl barely held together with the thinnest glue. I know your foster father beats you, molested you when you were 7. I know that you have not told a soul. I also know that you will not tell a soul until you are 27. You will hold that grief and terror within you for a decade longer, letting it fester in the safe space that’s supposed to be your mind. And the 10 years that await you before you finally reach out for help will come close to breaking you, just like the previous 10 years almost have. But I’m here to say you will survive. And you will be stronger for it.

The secret to your resilience is actually the thing that feels scariest to you right now: caring for others. You’ve wanted to be a pediatrician ever since you met Dr. Vaster when the social workers knocked on your Mama’s door to take you away. The neighbors reported her because they kept hearing screams every few nights. But you won’t figure this out until you’re 18, when you finally obtain your medical records yourself.

Dr. Vaster completed your physical assessment that day when you were separated from the only home you knew. He took note of the round silvery mark you have right under your left collarbone, the spot you told yourself was fairy dust that angels sprinkle only on special children. Dr. Vaster wrote, “Patient has a circular scar the same diameter as a cigarette.”

But you don’t need to read his note to know this. You remember that night when you were 5. Mama came home smelling of fumes (your foster father smelled the same way after downing gulps of Jim Beam, slugging straight from the bottle). She came home, slouched in that ugly brown wicker chair with the loose strands of straw poking out. She lit a Camel Menthol while you curled up at her feet, happy to know she was there with you. Just as you were starting to fall asleep, you smelled the burn first. And then a split second later you felt the scorch right above your heart. And you screamed. It’ll take years of therapy before you’re willing to think about this memory again. For now, that mark is fairy dust.

You remember the look that Dr. Vaster got on his face while he examined you. A look of leather that’s been soaked in the rain and then dried out in the humid summer sun. One day when you’re almost 40, you’ll look at yourself in the mirror and realize you have the same look on your face. And you’ll feel glad that there’s a part of Dr. Vaster that lives on in you. Because he was the first adult who touched you in a way that made you feel safe.

When you are 27, you will start your first year of pediatrics residency. On your very first day, you will meet a patient you will never forget. You will thank her every night before you go to sleep because she is the one who will help you find your calling.

Your encounter with this patient will go something like this:

Patient in room H303A is a 16-year-old girl named Maggie. The medical student says Maggie’s here just for a routine checkup. She’s required by the local high school to get a physical before she can play for the basketball team. You enter her room with a pert knock, thinking to yourself that this encounter will be fast. The first thing you notice about Maggie is her dark hair. It curtains all over her shoulders and across half her face. Then you notice she’s wearing two hoodies, one on top of the other. And you feel something ping at the back of your mind. A little voice goes hmm. But for now, you proceed like everything is normal.

You confirm that she’s here just for a physical, that she hasn’t had any health concerns since her last exam. And then you ask, “Maggie do you mind taking off both of your jackets so I can measure your blood pressure?” Maggie swallows, trembles slightly in a way you won’t quite piece together until after you figure out her story. She removes one jacket and then the next, slowly baring her right arm for the blood pressure cuff.

As you slide the cuff up, you notice a murky purple blotch on the outside of her upper arm. You ask, “What happened there?” And Maggie says something about getting hit by a ball during basketball practice. But as you’re adjusting the cuff on her arm, you catch a glimpse of the inside-out sleeve of her jacket, the one that was flush against her skin.

There’s a smear of brown on the terry white lining.

You know immediately what it is. Foundation makeup. She’s trying to hide the mark. You know this in a split second because you did the same thing in high school. For gym class, you had to wear a short-sleeved uniform. And every day in the locker room, you smeared globs of skin-colored fluid on your forearms to try and hide the bruises from where your foster father gripped and dragged you.

You let the cuff loosen on Maggie’s arm, like a wilted dandelion sagging to the side. You don’t touch her. In fact you take the tiniest step back. And then you say, “Maggie, you know you can tell me anything, even hard things going on at home. I’m here to care for you.”

She looks at you, and you catch your first glimpse of her face. She’s been looking down this whole time. And when the two of you make eye contact, she has a wide look, like a stunned squirrel not sure which way to run.

And then her shoulders start shuddering. She’s crying.

“Can I hug you?” you ask softly. You know that sometimes it’s hard to see physical touch as care when it’s been the cause of so much pain. Not everyone wants to be held.

Maggie nods her consent though, so you hold her close, making sure not to apply too much pressure because who knows how many bruises there are or how deep they go. You cradle her head against your chest, her left ear right on top of your special fairy dust spot. And you let her tears soak through your white coat, through your shirt, all the way to your skin.

Six months after Maggie, you will start seeing a therapist. It’ll be a long road, almost till the end of residency, before you can go through a session without sobbing for most of the hour. But every time, you will think of Maggie. Of how good it felt to hold someone while they cried, to be there for them when they were hurting in a way you knew all too well.

After residency, you will specialize in Child Abuse Pediatrics and become an expert witness. You will provide written reports documenting all the scars, bruises, and hurts that you find on the outside, and inside, of your patients. You will even testify in court a few times. And with each case, you will feel your vertebrae restacking, aligning in a way that lets you stand a little taller, a little straighter, a littler broader.

And one night, you will realize that before you go to sleep, you no longer turn on your nightlight, that crescent-shaped plastic plugin that you bought from the Target kids’ section years ago when you were in college.

And that’s when you will know it’s time.

The next day at work, you will call up Valerie. She will answer and say, “What’s the case this time?” a slight sigh in her voice because no one actually enjoys talking about broken children and the adults who do the breaking.

And you will say, “It’s me.” And you will thank Maggie.


Your 47-year-old self

Candice Kim.JPG

Candice Kim is a third-year medical student at Stanford School of Medicine who is currently taking a research year in stem cell biology. She received her BS and MS in biology from Stanford University. Kim has a strong interest in the medical humanities, performing on stage for the live storytelling event The Nocturnists, organizing creative writing events for medical students, and working on her own personal essays in her free time. Her essay, “A Letter To My Younger Self” was chosen as a top essay in Intima’s 2018 Compassion in Healthcare Essay Contest in partnership with the Schwartz Center for Compassionate Healthcare - theschwartzcenter.org - judged by Haider Warraich, MD, author of Modern Death: How Medicine Changed the End of Life