Before we begin, let’s start over …
I have read your chart,
I have thought about you before we met,
I did speak to your nurse,
I discussed your case with the team,
You see, I have given your case some thought before we even met.

Before we begin, you must know …
I’ve seen a few patients before you,
Some have been more complex and some less.
I must see some more after you,
Who knows what their complexity entails!
I still think about only you when I am here.

I will speak to your family,
I will speak to your doctors,
I will try to ease your worry and reduce your stress.
I will talk to you.
We will plan together.
I see you even when you don’t see me.

But please, before we begin…..
Try to keep in mind that…
I often am leaving a sick child or family member at home.
I am missing yet another PTA meeting or a school trip.
My child is with a stranger so I can be here with you.
I didn’t see my family this morning,
Or, last night as a matter of fact.
I haven’t seen my spouse in days.
I don’t even know the last time I saw my siblings or parents.
I care for you and your family while a stranger cares for mine.
That guilt sits with me before I enter your room and when I leave,
But when I am with you, I see you and only you.

Please keep in mind that …
At any one given time, I’m hungry.
I’m also likely sleepy, tired and need to use the bathroom.
I hide my emotions, pain and fatigue so I can be super human
I do this to give you my undivided attention.

I can’t have a bad day, yet I am human.
I must always be well put together, yet I am human.
Whether I have mental or physical agony, you wouldn’t know.
This is on purpose, so you know that my focus is on you.
I have cried in the car before I’ve walked in.
I’ve cried in the car when I’ve walked out.
I am human, but I am expected not to behave as one.

Before you say anything, please remember…
I am not that physician who you had a bad experience with.
Although, I do apologize for his/her behavior.
I am not that physician who “missed a diagnosis”
Although I’d like to remind you that we are all human and no one is perfect.
I do understand where you are coming from.
Despite your bad experiences clouding our interaction,
I see you and I understand.
I became a doctor to help.
No one wakes up wanting to do harm.
“Do no harm” is the oath we have taken.
I can’t sleep at night unless I abide.
I just want to help you.

Please see that I became a doctor to help.
I have debt beyond imagination from years of school, but
I come to work with my mind – a clean slate.
I just want to help you.
I hear you and I see you.
Please hear me, please see me.

Razia Jayman-Aristide is a hospitalist and assistant professor and science education at the Donald & Barbara Zucker School of Medicine at Hofstra/Northwell in New York. In her reflective piece entitled “Before We Begin” She writes about work-life balance and shared her poem recently on a listserv for medical educators and encourages us to share it broadly “to build camaraderie and self-compassion through shared experience.”  

The message of “Before We Begin” is particularly poignant during these tumultuous times for physicians, educators and families as we manage the challenge of continued self-care during the COVID-19 pandemic. Please share it.