I’m making a job change.  I have worked at the same institution for nearly 23 years straight (plus med school before that- was only way for my year on internship- they did it that way back then!).  Clearly this was a cause for reflection.  This is an edited version of the thank you letter I wrote to my colleagues in the emergency department:

I drove away from the ambulance bay after my last official Jacobi Saturday, and my second to last clinical shift, I had some tears, but was truly overwhelmed by gratefulness.  Twenty-two years, 10 months and 6 days after entering Jacobi’s halls as a nervous resident I will walk out as I move towards a new stage in my career and life. I won’t necessarily leave forever, but by definition as I take this new job, any time I return it will be a different experience.  I am overcome with sadness.  I feel confident that my new role is a good fit for me, but am sad at what I leave behind. You are my family.

I have watched all of you.  I have been honored to be among you as we are spit upon, vomited on, bled on and changed diapers and left our shifts exhausted.  And I have been with you as we walked in again for our next shift, expecting the same. I have seen such astounding things with you.  We have delivered babies.  We have been the hands that those passing on have held onto in their last moments.  And then sometimes, truly through our conjoined efforts and the gifts we share we have brought someone back with the grace of god from that brink, to live a bit longer.  We have tried to comfort families on the worst day of their lives, never to see most of them again.  We have been there for each other when it is our family who is moving towards death.  We have lost some of our own, whom we will never forget. We have been there for each other’s’ joys.

I am honored to have seen the kindnesses you have given to those society throws away.  You have helped me be a kinder person.  As I see you take the time in your overwhelming day to show small and big acts of kindness- never with the intention of having it witnessed, but instead just because it is the right thing to do- I have worked to follow your example.  I have seen us come together with goodness in our hearts to give comfort every day to our fellow man and woman.

I complimented one of the residents once on his kindness to a patient and he said, “well, my mother just raised me right.”  I am astounded to work among a group who had either mothers or fathers or aunts or neighbors who “just raised them right.”  In a world at times filled with such profound pain and hurtfulness, it is amazing to feel every day how we each work to just do it right for someone in need.  Their need might not be the stated reason they have come to the ED, but it may be a completely different need- to witness compassion, to hear a kind word, to feel a hand upon their arm- that is fulfilled by their time in the ED, by you- my friends and family here.  By your modeling your patience and simple kindnesses you have helped me rise to be a better caregiver and doctor, and I thank you.

To the residents:  I am incredibly grateful to have had the opportunity to work with you. You have been an astounding group to work with, learn from and stand beside in trying and joyful circumstances.  I don’t know if you yet realize it- individually you are incredibly powerful, but as a group of young, bright seeking minds you are downright intimidating.  And yet every day I see signs of your astounding humility.  I believe humility is the defining characteristic of the truly great ED doc, combined of course, with intelligence, decisiveness and kindness. Humility allows us to admit when we don’t know the answer and learn from others.  I am humbled in your presence every day. I am incredibly grateful to have had the opportunity to become better at what I do because of you.  You have taught me both directly and indirectly.  The indirect teaching is when I work harder to learn just that little bit more to share with you.  I have appreciated your wisdom- for some who are often so much younger than I am, you have a host of life experiences that have often provided a level of insight I needed to hear.

I remember wanting to go into medicine because, like many of you, I wanted “to help people”.  Something I didn’t fully have insight into at the time is that by definition it meant that I was going to work with lots of other people who want “to help people”.  And even in our striving to be the best we can be, being among so many altruistic souls only elevates that desire. Indirectly those we help most are each other.  We stand next to each other through tragedy and joy.  We use gallows humor to get through the shift.  But we support each other with the common goals we share.

I understand there are people out there who go to jobs every day that they don’t like or work with people they do not enjoy.  I am overwhelmingly appreciative that I don’t know what that feels like.  During the hardest times of my life, through the deaths of those close to me, the exhausting new mother experience (physically and emotionally) and when I had my own injuries and illnesses you, as a group, have been the reason I came to work, and came joyfully.  You have been this island of wonderfulness.  I now leave the island, as many of you will.  But remember there are boats that can take us to meet again.

With respect, love and gratefulness-

Marianne Haughey