What you will find below is an email I sent to the incoming class of medical students at the University or Virginia School of Medicine back in August 2017. To say I remember how all the words came into being would be a frank lie. It was, indeed, a bit of a spiritual experience.
While most of you reading this introduction are not medical students or have no affiliation with medicine or medical training, my intention of sharing this message is ACTUALLY FOR YOU.
Yes FOR YOU.
Because, let’s be honest I already shared it with the medical students.
So why am I sharing this with you?
Humanity's language of caring is universal and while the words below may have been initially intended for my medical colleagues, there is a meaning and message embedded that is meant for every soul interested to explore its mystery.
So if you are willing and curious, let’s start the exploration together.
Welcome to Charlottesville and the UVa SOM!
By now you have probably received an epic number of emails and are perhaps overwhelmed with all of the information being thrown your way.
It's okay. It's completely an entirely okay.
You are also probably also wondering now who is sending us this random welcome email?
My name is Rob Abbott and am a first year family medicine resident with VCU Shenandoah Valley in Front Royal, Va having just graduated with the UVa SOM Class of 2017.
With those details out of the way I can tell you who I really am.
I am a student, a human being, a medical trainee just like you, seeking to relieve other’s suffering all the while serving something greater than myself.
It is hard to imagine that just some few years ago I was spending time in the anatomy lab (the old, not so clean and nice one) identifying brain structures with my classmates and learning all of the amazing biochemical machinery necessary to make ATP from 1 molecule of glucose.
And while time does go quickly, it also doesn't. 4 years is a long time, and for some like myself who took 5 years total, it is even longer, and for others doing PhD and research work it can take a decade or more. It's a long time.
Thinking months and years ahead is wonderful (even if it seems like graduation is so far away) and having an intention and vision for yourself is incredibly powerful, but the future is not years ahead. The future is actually just the summation of the present- what we do each and every day.
Want to be a kind and compassionate physician? Be kind and compassionate each and every day. Want to eat more vegetables and less processed food, eat a couple vegetables and put down the doritos each and every day. Yes, these may seem like obvious or silly examples, but they are remarkably relevant and true.
In a more abstract sense, I like to think that we are all people transitioning between states of “being,” “becoming” and more “being”. If we simply remain in states of transition, expansion and growth ("Becoming") or thinking about who/what we want to become (skipping the challenging becoming process and going straight to some "new" state of being), we completely miss the present moment, our current state of being, the opportunity to enjoy the present and simply be.
Medical school will be full of opportunities to become- you will be evaluated constantly as part of this challenging process of becoming. Learning something new every day is becoming, studying for a summative is becoming, gaining more clinical insight during your 3rd year clerkships (at 5 AM) is becoming. Becoming is okay, we need becoming, but we also really need being.
I spent most of my early life becoming, and only becoming, because I was good at it. If you are receiving this message now you are also very likely to be quite adept at becoming. But it wasn't until I took time away from this becoming, to rest and discover how to truly be, that I could ever make peace with the becoming process.
What does being look like? For me it's engaging in creative exploration through writing, recording podcasts for my webpage, spending time in nature, meditating, practicing yoga, reading non-medical literature, growing my Christian spiritual faith and sharing a hot beverage with a close friend. There are tons of ways to be, but often, these ways of being can fall away to make room for becoming and only becoming.
I know this may sound strange or impossible given the fact that I haven't met any of you in person, but I genuinely care about all of you. I want you to happy, healthy and free from suffering. I want you to succeed and be surrounded by joy. I know medical school is challenging, but I also know it can be incredibly rewarding.
You may get to a point during your training where you feel hurt, depressed, depleted, tired, burned out, exhausted, disillusioned, physically sick, or broken.
4.5 years ago I was depressed, hurt, sick, depleted, simply done. It took a long time for me to finally ask for help, but I did. I simply asked for help. I finally accepted it was okay to be vulnerable, to say I didn’t have the answers.
There are so many people in this community here to support you. Deeply and truly support you.
By this point, you have probably received a message from two of my close friends and current students Anja Miller and Corinne Roberts regarding the interdisciplinary group Compassionate Awareness and Living Mindfully (CALM): an inter-professional group dedicated to supporting your well being though the practices of mindfulness, self care and the cultivation of resilience.
Back in 2013, upon my return to medical school, I was fortunate to start this group with the help of a few amazing colleagues and friends.
I had never "gone to school," for mindfulness, self care or inter professional communication.
I had no formal training.
i had no idea what to really do.
But I started the group because I perceived a deep need in our community to remain healthy and build resilience through mindfulness practice and simply being.
I didn't care if only one person started meditating with me or if no-one came to any of our events. I just wanted people to know we cared about their well-being. I understand meditation or mindfulness practice would not and may not be your thing, it's okay, we are all okay.
Over the past 4.5 years I've seen tremendous strides made in the UVa School of Medicine to prioritize your well-being, to promote and provide you with opportunities to renew and simply be. I helped to grow partnerships with the School of Nursing to hold retreats, FREE retreats, and days of self care to promote your flourishing. Once again, it’s amazing to see all that can happen in 4.5 years.
When I first came to school I hadn’t even heard about yoga, meditation, reflection, or mindfulness. If you had asked my first year self if sitting still for 5 minutes to pay attention to my breathing or pausing outside of a patient's room to set an intention for the encounter would make any difference I would have likely laughed you off the face of the Earth.
And when I first started practicing at the urging of a colleague and dear friend, I didn't fully believe in it. I wasn't really convinced. But I just started practicing.
Just practice, even if you don't believe.
I cannot guarantee you will find the practices of mindfulness and meditation to be helpful. Nothing is right for everyone, and everything is certainly not right for everyone, but SOMETHING is right for everyone, and you should seek to be exposed to a buffet of SOMETHINGS as part of your medical training, all for you to consider, practice and incorporate into your life.
To say I am excited for you would be a tremendous understatement.
But THIS is only the beginning, and YOU ALL are the lights to help change the lives of your patients, and to hold spaces for each other to learn and be nourished, to become and to be.
As you will soon discover, a collective stress bucket will develop in your medical school class, a figurative and sometimes literal bucket of worry.
I urge you to the best of your ability to TRY and not add to the collective stress bucket, recognizing the sometimes, most likely completely unintentionally, that you will add to someone else’s burden and this stress bucket.
We simply must be aware and take ownership of the energy we carry, the words we use and the spaces we hold. Make a joke about how much work you have left to do, how stressed out you are, or how poorly you will do on a test because you haven’t studied enough, it’s okay, it’s probably funny, but take ownership of it, be willing to accept the consequences of sharing those kinds of words, carrying that type of energy, holding that type of space.
While I may have formally graduated and "left" the medical school, my heart and soul remain in these walls and with this community. You are all amazing people with so much passion, intelligence and drive to change the world and I want to do all that I can to promote your flourishing.
If you have made it this far in this message, I commend and appreciate you.
I am still quite local and active in the Charlottesville community, returning on weekends when I am not busy with residency obligations in Front Royal.
I am more than happy to meet, talk and simply listen to whatever it is you want to share or discover.
You can respond to this email or simply bug Jill Clarke. She knows how to find me.
But in all seriousness I am more than happy to meet and share a conversation over a cup of tea/coffee.
I’ve been there. I get it. I needed help, lots of help and I am willing and open to talk with you if at some point you need help.
No judgment. Complete acceptance.
You guys have an amazing journey ahead of you and some remarkable people with which to share it.
Don't be in a rush.
Remember that if you are alive, you are breathing and if you are breathing, you can stop to take a pause.
Congratulations and welcome again.
I am so glad you have made this choice to pursue medicine.
And I look forward to seeing you flourish in the years and experiences to come.
All the best
It takes 4 minutes and 30 seconds. Unless I trip and fumble for my badge. Then it take 4 minutes and 32 seconds.
4 minutes and 30 seconds.
People run miles faster than this.
But my intention is not to run or to even walk.
My intention is to be, breath and simply be,
It starts with a phone call.
Can you see another for me?
Room 19, 72 year old female, looks like a COPD exacerbation, maybe a new pneumonia. Call me when your done.
“Okay, sounds good, will do.”
For the next 84 seconds I prepare for the pause.
I scour the electronic medical record for vitals, white count, current meds, what did the ED doc do anyway? I even get a a glance at the CXR, seems like another overread.
And then its over.
84 seconds is all its takes for me to realize the real answers I need aren’t in the chart.
They will never be in the chart.
Unless I decide to put them there.
And then it begins.
The 4 minutes and 30 seconds began to tick.
I grab my white coat, pocket my phone, double check for my keys, and scoop up my stethoscope.
I start to walk. I notice the heaviness now of my burdened white coat, stained with the tears and spit up of infants.
Badges of honor I like to think.
Telling the stories of past hugs and cuddles gone awry.
I shrug my shoulders mid stride, and complete the roll of my scapula back to where they should have been all along.
There’s no time for tight trapezii during the pause.
I start to notice the ground beneath my feet, my minimalist shoes gripping my toes like a 2 year old hugging his ice cream cone.
The ground never felt so alive.
I’m nearly 2 minutes in now, 3 staircases down and I’m on to flat ground.
I begin to smell the Subway stench, the half baked bread, and half eaten sandwiches beckoning to the adventurous souls willing to wander from the comfort of the cafeteria.
3 minutes now and I’m in the lobby.
There’s a four maybe five year old kid running towards the gift shop.
He just saw the giant panda.
And it’s about time someone fed him some bamboo.
I start to smile as I round the corner, the chapel calling to my heart, reminding me it’s time to center.
There’s only one minute left.
And I’m still half full.
One deep breath in,
And a heavy sigh out,
I feel the weight begin to lessen
As the space becomes a void
And the void becomes an awareness.
That the emptying has now begun.
My heart erupts to open
As my mind chooses to close
Thoughts start to flee for safety
In the bowels of my unconscious.
There’s no room for petty attachment
In the world of empty freedom.
I feel it churning, burning, yearning to remain unseen
Judgement and hurt never dress for the party, you see.
They found out long ago
That the best way to remain unseen
is to wear no clothes.
The only problem?
Judgement and hurt forgot one thing:
One very important thing.
Naked can see naked
There's no place to run and hide
4 minutes and 30 seconds
And I’m naked at your beside.
My body become a vessel
To receive your heart and fears
It’s what the moment calls for
A pause to find my ears.