III.  Lessons from Family

There may come to be new people in our lives that are second spiritual families – closer to us in some ways perhaps than our original families.  But the family of origin is the limbic tie.
-Adapted from Eudora Weltly, On Writing,
Modern Library Edition, 2002, xi.

When Suzanne suggested that each of us take one of the three sections and write an introductory essay, I readily volunteered to write about families and the many varied relationships physicians have with them.  I figured I had ample experiences on which to draw both from the perspective of being the sibling and son of doctors as well as being a family member with more than its share of ill members.  My father is a cardiologist, my oldest brother is a cardiologist, and my second oldest brother is a radiologist; all my life I have been involved with a “medical family.”  Moreover, my father has diabetes, my mother has suffered from over twenty-five years of hypertension that recently led to a crippling stroke.  My oldest brother has had kidney stones and melanoma and more recently suffered the devastating and pervasive loss of a child less than forty-eight hours before a planned C-section.  My oldest sister has had a disabling closed head injury inflicted by a drunk driver.  My middle sister had scoliosis, a condition that changed her life and taught me my first and single most enduring medical lesson: that being a superbly technically competent physician has nothing to do with healing, which – after all – starts and ends with empathy.  My youngest sister had post-partum depression so severe she required ECT to break the associated psychosis.  And currently, my youngest brother has suffered two broken legs in a hit-and-run accident, and then had a subsequent depression that is so severe at least two professionals have suggested to me he might not make it despite numerous psychiatric hospitalizations and powerful psychiatric medications.  Yet as I thought about these experiences, I came to the conclusion that much as they form the basis for my own story, drawing generalizations about families and physicians would be hazardous at best.

To be sure, many themes recur in these writing that are common to both the families of physicians and families of patients: themes that resonate with my own experiences.  The themes include medicine as the jealous mistress; the surrogate family role that physicians and patients often play with each other; generational physicians; the conflicted role of a daughter as both family member and new physician; the struggle of physicians and patients who must confront the heroic, the bitterly disappointing, or worse in families; and the universal theme of loss and transience.  Yet delighted as I would be to expound upon these themes, I would like to make a simple suggestion to you, the reader, that I think will serve you better.

What I suggest is that you grab a cup of hot tea, coffee, or even a glass of wine, put on some music and read these stories and poems in an otherwise quiet place, alone.  Whether or not you find that they hit all the right literary notes, what I think you will find is the honest voices of physicians-to-be who describe their own dual roles as family members and physicians.  Then, read them again with an eye towards the inescapable underlying force families exert on these physician-to-be writers.  If you are anything like me, you will find these pieces deeply moving, maybe even to tears.  I plan on doing just this veyr soon again and I thank the writers for their willingness and openness in sharing their stories of family with all of us.

James Wendt, MD