A letter to my future physician self

Dear future me (aka Dr. Probably Still Running on 4 Hours of Sleep, DO) …

Hi. It’s me — the baby doctor version of yourself, writing this during your third year of medical school, deep in the midst of studying for the board exams.

You probably don’t have time to read this, unless you’re stuck waiting to discharge a patient because their CT results were not read “stat” 52 minutes ago. Ah, the sweet irony of the word stat in the emergency room. But humor me, because I’ll make it speedy.

Let’s start with the big question: Did we do it? Did we get into our dream residency program with a trauma center and stay for a fellowship in critical care? Because, honestly, you manifested that one hard. You wanted all the things that normal people run from; you wanted the blood, the broken bones, the chaos of running codes and the intensity of fighting the clock. Remember your personal statement? It was inspired by characters like Violet Sorrengail, a teenager forced to navigate a ruthless war college in the book Fourth Wing, who helped you see that with resilience and wisdom in even the most chaotic places — like the trauma bay — you can persevere. I hope you’re not just surviving anymore; I hope you are thriving. I hope you quieted the imposter syndrome that always hit you the hardest at 2 am — you know, the one voice in your head that got louder after you failed COMLEX. But I know you fought through every rejection, every moment of self-doubt, even when you were barely holding it together by a half-decent stitch. You belong in the ER, and I hope you’re living your dream exactly as you imagined it.

I wanted to ask about your life in the hospital. Are you working with everything — from car crash survivors to the little kid with strep throat? Are you treating everyone — the young, the old, the uninsured, and even those who are just scared because they’re sick and don’t know what to do? I hope you are. One of the many reasons you chose emergency medicine is to make a difference and do so with compassion. Your favorite preceptors were always the ones who walked into the room, pulled out a chair and truly talked to their patients. The ones who explained a disease and care plan so thoroughly that fear turned into understanding. Does your practice reflect their influence? I hope so. You were taught to see more than a disease. In fact, it was embedded in your osteopathic education. It was a promise you made to yourself.

Kayla R. Vacarro

You know how the saying goes: home is where the hospital is. Well, actually, that’s not how it goes — but it should, given how much time you spend there! Have you made friends with other staff members? Mom always said you were “friends with everyone, but friends with no one.” You always hated how true that was. But life in medical school was rough, especially when your face was buried inside a book 10 hours a day. You literally got diagnosed with a vitamin D deficiency this year… and you go to school in the Sunshine State. I hope you’ve let someone in. I hope you’ve made some girlfriends. I still can’t believe that barely a third of the field is made up of women! Please tell me it’s changed. And if you’ve made even just one real friend, then I’m proud of you. I hope they enjoy the stale coffee and the hospital gossip just as much as you. I hope they remind you that you are more than just your job. You spent a long time building walls in the name of ambition, but I hope you found your people. I hope you didn’t lose yourself to do so.

Now, if you’re only skimming because your coffee’s cold and you’re 10 hours into a 12-hour shift, here is what I want you to take away:

• Be humble.
• Remember where it all started.
• Heal with kindness and knowledge — always both.

With stubborn pride, a lot of love, and a Red Bull,

Kayla R. Vaccaro, OMS-III

The one who failed, fought and (hopefully) never gave up.

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