(A little bit of) What the Great North taught me.
Dear North, where in recent years I always return to. One of my rocks in this big wide world. To you, I say thank you. Thank you, for all you have taught me. You taught me a different medicine. An intuitive medicine, based on listening and clinical evaluation. I began my Nordic practice much like I had learned medicine in the South, with almost no laboratory tests and X-rays to guide my diagnosis and care. A “bush” medicine some may call it. You taught me how to manage everything while being isolated in hundreds of kilometers of winter snow, wind and blizzards. But most of all, you taught me to listen.
Every day, you show me things I have never seen before in my life, making me deal with diseases I have never encountered throughout all of my medical studies; you have taught me uncertainty. The uncertain nature of everyday life. You taught me to live with this uncertainty that sometimes makes up 90% of my days. The uncertainty of the diagnosis, the uncertainty of the patients evolution before my eyes, the uncertainty of the weather. (Can my patient be transferred somewhere else, or will the unsuspected weather make him prisoner to our small isolated clinic for days?). It is a challenge everyone faces, the uncertainties of life. The uncertainty that for years I was afraid to face. With months and years, it becomes less invasive, leaving more room for intuition and confidence.
With the kind of inertia that only you know, you have taught me that time helps us. It helps us clarify things when nothing is clear. You taught me to be patient. This is not one of my innate qualities. This patient, who comes (again) for an abdominal pain, 140 kg obese, who has already seen several nurses and another doctor before me. As often in the North, it is unconventional and imprecise. In the South, he would have had a CT scan right away. Here, we have to trust our judgment, detect signs of something disturbing, a small bomb that could explode during the night, a thousand miles from any surgeon.
You taught me to follow my intuition, but you especially taught me to trust it. Yes, knowledge is necessary to any doctor, but I know now that intuition guides us, when we trust and listen. This intuition tells us when a patient does not look good, that there is something wrong, that a transfer is necessary, for a reason that is not necessarily obvious.
Above all, you taught me a more human form of medicine. A medicine where patients are more satisfied when they are held in someone’s arms than when they are given tests and a diagnosis. A medicine where I sometimes allow myself to feel sympathetic, when normally we are taught never to cross the line between empathy to sympathy. A medicine where we come closer to better help. A medicine where listening means caring. A medicine where I too can cry.
You taught me this, and so many other things. Till next time.