Reflections

2013
Naylor, Nancy

I came to this world too early—a premie—screaming, skinny, unable to feed.

I become the smallest in my family, the smallest in my school grade.

The schoolmates tease me. I feel somehow inferior and become very shy.

But at school my teachers loved me so I tried to get good grades to please them. I became passionate about learning—everything.

My aunt is a nurse. I decide that I want to help heal people. I liked her uniform and white cap too. I start to read about doctors, nurses and the human body. Oh my goodness!! I feel my pulse for the first time and I am nine years old! Thrilling! It is the late 1950's and I am ten years old. Television comes to our town. I watch a series about a doctor and he becomes my hero. I want to do that job for my life!

Everyone says, ”You should be a nurse—you're a girl—few women are doctors and those that are can't have children—they're too busy for that!" I think about that and decide that I want to be a doctor anyway. I am afraid to speak this, however, because when I do, everyone tells me I am a girl and I am too shy.

I keep studying hard and getting good grades. I even study subjects I do not like which are prerequisites for medical school.

One day the acceptance comes. I am ecstatic! I go to my first class and there are only five women. Our mentors tell the five of us that we took a man's place therefore we must work the same hours as a man or the position is wasted.

I believe them.

Everything in medical school is fascinating! What kind of specialty should I do? When I work in Ophthalmology, I want to do that. If I work in Pediatrics or Obstetrics, I want that. Then one day I work with a family doctor. It was so different than anything I had been exposed to in my training. His interactions with patients were based on knowledge of them as people, of their families, their struggles, their complete medical and social histories. I saw how much they loved and respected him. I never considered anything but family medicine after I that.

During my residency, I learned two truths that have stayed with me throughout my career. The first: My job as a family doctor includes being a strong advocate for my patients. This was hard. I was shy. I learned to gather courage because my patients needed me to do so. When I was leaving my residency, the team psychologist said to me-"You remind me of the lion in the Wizard of Oz. During this time you have found courage.” The second: I learned that to feel powerless to help a patient was acceptable as long as one walked alongside them and he or she felt listened to, cared for, and respected. This too was a hard lesson. Had I not entered medicine to cure? I started my practice when I was twenty seven years old. I was a mother with a three months old child. I was off work for three months and returned with trepidation. Would l forget everything I had learned? It would have been easier to stay home except for the passion in my heart. I felt guilty leaving my child with a stranger everyday. I finally started to work with a physician who said "You are working too many hours. Wait until your child is in school to do this-she needs you at home." “Do you mean that is OK?" I say.

The practice builds and I love it -- adventures, joys, sorrows. I face my own mortality when a patient in her mid twenties dies. I drive my car many miles that day thinking about her and crying for her, myself and my family.

The practice is comfortable. Then we move to a small Northern Ontario town for my husband's work. The town is a one industry papermill town where families have lived for generations. The town is their family. The town is their pride.

It is lonely for outsiders and almost impossible to become a part of it other than ”the doctor". I feel like I am in a fishbowl. It is a town where people have learned to rely on their own resources. It is a town where doctors need to learn that too.

The scope of my practice expands dramatically—the joy of delivering many children, learning to work emergency by myself, flying unstable patients out to referral centres on cold wintry nights, and learning the differences in approaches of care for our aboriginal people. I am asked to be part of the original focus group for the establishment of a Northern Ontario Medical School. These are exciting times. I work harder to fill the gaps left by doctors who leave. The remaining doctors are also doing this.

After fifteen years, I realize that I need to be closer to my family. One thousand miles from ailing parents is too far. One thousand miles from my children excludes me from their lives in many ways and being able to help them when they need my presence. I return to Southern Ontario and begin working in a practice that I had worked in as a medical student. We became part of a Family Health Team. I felt I was on the cutting edge of a new kind of Family Medicine.

To have the expertise of a social worker, dietician, pharmacist, nurse practitioner, and a chronic disease management RN was a giant step forward for family medicine. Yet I admit to having a little difficulty "letting go" as this had been in my scope of practice for over 30 years. It was difficult not to keep "running my own show" and having to work as a team. But, oh, the benefits for patients!

Then the devastating news last year—"You have an abnormal mammogram." Three surgeries later, I decide to say "goodbye" to my practice. I found it difficult to accept the disfigurement of my body but even more difficult to say "goodbye” to fourteen hundred people I had grown to love and respect. Would they feel abandoned?

I want to tell them how much they have done for me, how I am privileged to know them, to share their joys and victories, their dreams, to understand from them that we all cope in different ways with what life gives us but that regardless of how we cope, we will still always care for each other.

A great sadness comes over me as I think these thoughts. At the same time I know that all I have learned about people and courage in the face of difficult circumstances will be needed for my ”next steps".

 My heart is overwhelmed when I consider the opportunities patients have given me to develop a certain intimacy with mankind that few other professions allow. I am truly a part of all whom I have met and am encouraged to move on to "next steps" because of the person I have become.

Theme: Community | Communauté
Theme: Health Care Delivery | Prestation des soins de santé
Theme: Patients | Patients
Theme: Relationships | Relations

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.

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