Dear Dad,

I often think about the night you passed away.  I was caring for you while you were dying from metastatic colon cancer.  Every hour I woke up to give you Dilaudid so you wouldn’t feel pain and Ativan so you wouldn’t be scared.  You had only just been diagnosed eight months before.  Despite aggressive chemo, radiation, abdominal surgeries, and all the hope and prayer in the world, the cancer still spread.  Little did we know, when I started my internship in family medicine, you would be gone before the year was over.

I hadn’t been there for you during most of your battle with cancer.  When the emergency room discovered the mass in your colon, I was miles away rounding with my inpatient team, a month into my residency.  When you were told it was probably curable, I was asleep after a long night shift in the pediatric emergency department.  When you were crying in pain from chemotherapy in the middle of the night, I was on labor and delivery helping a brand new father cut the umbilical cord of his first child.  When we found out your cancer had spread all over your liver, I was curled up in the corner of my call room listening to your doctor read your devastating CT results over the phone.  When the surgeon told us your bowels were blocked by tumors, and you had little time left, I was crying over the steering wheel of my car in the hospital parking lot.  I was there the night you died, but there was so much that I missed; it pains me thinking about it.  I hope you can forgive me.

I am astounded by the tremendous sacrifices we make for a career in medicine.  Physicians miss so many meaningful moments in life; so many opportunities to appreciate what is truly important.   We work in a world where people compete with one another, where we are encouraged to view patients as diseases and not as people.  We juggle student loan debt, fear of lawsuits, demands from hospital administrators, and unforgiving time constraints.  We are often forced to practice in ways that prevent us from being the doctors we once dreamed of being.  And too many of us are burned out.

Dad, one week before you passed away, you asked me if I was happy.  I said what I knew you wanted your only child to say: I was.  But I’m not always sure that is true.  Even though I feel lucky to be where I am, I sometimes cannot help but wonder why I signed up for this; why I agreed to something that in the end kept me away from you when you needed me the most.

Dad, I want you to know that I refuse to let medicine dehumanize me.  When life and work tear me apart, I will not lose my empathy or let my soul disintegrate.  When my patient mourns the loss of a loved one, I will be there to hold her hand.  When someone has an anxiety attack in my office, I will sit there lovingly without judgment.  When a woman has a difficult labor, I will stay by her side until her child is born.  If a patient cannot afford medications, I will do everything I can to find more affordable alternatives.  From the moment I give my patient a cancer diagnosis, I will be present and compassionate every step of the way, regardless of the outcome.  I will devote my life to serving my patients and their families.  I am a proud future family physician with nowhere to go but forward.  But I will never forget that I am also a wife, a friend, a daughter, and most importantly: a person.

I love you, Dad.

Kristina Dakis is a family medicine resident.

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