Medicine from the Heart . . . Hugh Silk

May 05, 2011

Each Thursday, the Daily Voice showcases selected Thursday Morning Memos, reflective essays about clinical experiences written by faculty, alumni, residents and students of the Department of Family Medicine & Community Health and, occasionally, other departments. Thursday Morning Memos is UMass Medical School’s homegrown version of narrative medicine, in which the authors process their experiences through writing. To learn more, visit:



Hugh Silk, MD, founder and moderator of Thursday Morning Memos, reflects onthe role of teaching others to be doctors.

Hugh Silk 


I feel honored to be a teacher. I have wanted to be a teacher for a long time. I remember telling my father that in high school and he thought I was selling myself short. "You can be more than that" he said. When he hears about the teaching I am doing now, his view has changed; he is proud of me.

I have been thinking about my role as a teacher this past month. I often hear my colleagues at our health center talking about past residents and students. One person will reminisce about how a learner seemed to struggle with "x" and now they are an expert in that field! Another will talk about how a graduate of Hahnemann is now in charge of this center or providing care to this group of underserved folks. You can hear the pride in their tone. And it is warranted. It takes a village to produce each medical learner. We were all products of that same culmination of efforts wherever we trained. I have had occasion to talk to a former mentor of mine and hear them taking some pride in my own accomplishments.

So this past month, I have been thinking about a former student of mine from another institution who is getting married. She invited me and my wife to her wedding. That alone is an honor. It speaks volumes to the relationship we built up with her. She was a continuity student of mine for three years. I am acutely aware of her early days in my office when the simplest task of taking an "HPI" or checking a pulse seemed so challenging. I recall her embarrassments and clumsiness. They reminded me so much of my own. (I remember joining a McMaster graduate in my second week of medical school. His family medicine practice was in Guelph, Ontario. I was greener than green with a face that radiated redness on a daily basis. I remember watching the blood pressure cuff slowly peel off of a patient's arm as I inflated it only to have the patient say "you have it on the backwards!" Thank goodness for preceptors who are patient!)

My longitudinal student had much more grace than I did, even in her moments of error. But it is not her errors and awkwardness that I recall. It is her evolution and transformation into a wonderful, caring, compassionate doctor. I can't take credit for that. She comes from an incredible family; she is a musical artist; she is a gourmet cook; and she has a background in volunteerism. However, I watched her take some of my approaches to patients in certain situations; I watched her struggle with a decision between obstetrics and family medicine; and I have watched her take a “primary care” approach to her practice. She has chosen to dedicate herself to the underserved and medically complex in a geographical area where that is not the norm for physicians.

She has kept me up to date with her progress over the years. My family and I have had the occasion to visit with her when we were on a trip visiting others. We can see and hear the humanity that she has hung onto and further developed.

So when the wedding invite came, I felt good about all of that as a teacher. I had made a connection. The connection has continued. It may have occurred in the third year in my office as she came to know my patients; or it may have come at our dinner table as my wife and I laughed with her as she contemplated her future; or it may have come as we stood together at her graduation from medical school wishing her a future filled with satisfaction and reward.

So I'll take my 0.1 percent of responsibility and credit for her positive outcomes. That is what keeps me going as I teach the next set of learners. And I suggest to others in our field to take the same moment of reflection to honor yourself and the impact you have had on others as a teacher in big and small ways. You deserve it.