'Strength in Vulnerability; Growth from Adversity.' By Dr Rachel Molloy

The Third 'Letter from a Caregiver'

Hello, Dear Readers, I hope you’re well. Thank you for choosing to spend some of your precious time with us—a warm welcome to new Carer Mentor subscribers. You can read about me, Victoria, the author of Carer Mentor, here: Who Started Carer Mentor and Why?

Humanity lies in the details, between the lines, and shines a light on our unique caregiving path.

Compared to 2015—the start of my first rollercoaster— I see the caregiving conundrum more clearly. There are an infinite number of ideas and suggestions that flow around us, but no simple, ‘right’ answer for us to hold onto, especially when the only constant is change.

Of course, many people, books, leaflets, etc. will assume they have THE ‘right’ thing that we need to ‘do’, but in a specific moment, someone has to choose, make a decision and act.

Every caregiving situation is unique. I like to think that’s because humans are unique. It’s not just the facts of the matter; the finances, diagnosis, home setup—although circumstances can lead to an infinite number of scenarios (great article, Tina!¹). It’s also about the interpersonal dynamics, relationships, history and the personalities of everyone involved (medics, family, friends)!

One of the reasons I’ve chosen to create a dynamic hub, with anthologies, is to amplify the light and the voices within each experience, each letter. It’s the journey between the lines, the weighing of pros and cons, the human deliberations and reasoning that can help a reader discover their own balance and bespoke path.

A key line from Rachel’s letter today: “And learn to be kind to yourself: retrain your inner critic to be your cheerleader!” With the surrounding context of the letter, Rachel voices how loud our caregiver's inner critic can be. I’d overlay onto her thought that our inner critic is amplified by the ‘caresplainers’ around us.

Caresplainers double down on the antiquated ‘women’s work’ view. They often regurgitate clichés of social conditioning that undermine the real ‘value’ of what we are doing for our loved ones.

This week, Rachel’s letter, like mine or last week’s from Mary Beth, can be interpreted in hundreds of ways. The benefits and takeaways are in the eye of the reader.

As the instigator of this lovely collaboration, I’ve asked the team to NOT write for the reader; the focal point doesn’t even need to be about caregiving. Letters from a Caregiver is about the person who is also a caregiver, sending a letter to their younger selves. We write for ourselves first.

This is not about silver linings or hero narratives. It’s about giving others a window into our decisions and choices; our unique wisdom. This is about sharing our process with the hope it can help someone else.. It’s about acknowledging the pain we’ve experienced and offering ourselves the kindness we deserve.

The Letters Sent so far:

1. The first introduced the series, and I shared my letter to my September 2017 self.

2. 'Acceptance With Grace' with Mary Beth Kaplan

Author Bio: Rachel is a family doctor, just returning to practice after a caregiving break. She writes on Substack about humanity in medicine and cancer survivorship, from both sides of the doctor's desk. She is a midlifer with an emptying nest; a foodie who loves to hike; and an avid reader of anything from historical to speculative fiction, to narrative non-fiction, with a soft spot for medical memoirs. Publication: Time to Care

Strength in Vulnerability; Growth from Adversity.

Rachel of 1995,

9th floor, Hope Hospital Towerblock.

Dear Rachel,

This will seem strange, but I am you in thirty years. Don’t be shocked! There have been many innovations since 1995. The Post Office has done some awful things you wouldn’t believe: that's a story for another day. Time-travelling letters is one of their more positive achievements.

I remember that revolting tower block housing the nursing and medical students. You will be glad to know they pull it down in 2024. No more pigeon-poo-infested balconies, or baths with vents above that cockroaches fall from. I can see you now, in my memory. You are 24. You are sitting on the bed, looking out at the grey sky, feeling lost and fearful. You have been studying Medicine for 6 years and your final exams are looming. And Mum is in the hospice. She’s been in and out of there for the last few months. And each time, she gets home, with restored quality of life for a while. But this time is different. You are struggling with the idea that you are about to qualify as a doctor but you’re not going to be able to save Mum.

You don’t realise yet that you are a peacemaker and a perfectionist. Or that your early experiences have shaped your desire to be a doctor. You don’t yet recognise yourself as a caregiver, but you’ve already been doing it for years. Through a tricky childhood, you learned to scan for emotions, to keep the peace. You witnessed how difficult life could be for Mum, and how hard she worked to maintain stability for you despite this. And as you grew older, you became a support, a confidante to her. And more recently you have supported her in her cancer journey.

These tough times have made you what you are now - someone with the capacity to be resilient, to care for others, to understand their pain.

You will find yourself being a caregiver in many ways: daughter, wife, mother, friend, doctor. There isn't time to tell you about all this here, other than to say that family and friends will, in their different ways, provide a wonderful depth and light to your life. Your wedding is already planned, and I can tell you that you married the right guy. Your children will bring a new kind of joy and gratitude.

Being a doctor is a privilege. You will work long hours, meet ethical dilemmas, the frustration of systemic obstacles and lack of resources, the strengths and limitations of modern medicine. But you will never tire of people's stories, helping to make sense of them and finding solutions. You already know that women carry the lion's share of caring responsibilities. Despite some progress with equality, this is still the case in 2025. As a female doctor, your patients will expect you to be more caring than your male counterparts - there is research that shows this! It comes naturally to you, but you will sometimes feel overwhelmed by this emotional labour, like everyone wants a piece of you.

You know already that you will lose Mum. No wisdom from the future can soften that truth: I wish I could send a hug with this letter. But I can tell you that she dies peacefully, knowing her love and courage shaped you. You will carry that legacy forward, and life will be good again.

Let me reassure you that there is so much fun ahead for you. You work hard and play hard! But the feeling you have now, of anticipatory grief for Mum, will rear its head again in your middle years, when Den becomes ill. You will have a battle to help save him. I want to tell you a bit about this, because it has taken this experience to really come to know me/you.

When faced with his illness combined with my responsibilities at work, I unravel a little. Despite being a senior doctor, I begin to doubt my ability to cope in a failing system. In the face of austerity measures, the NHS struggles increasingly to meet demand, adding many layers to the workload pressure. After three years of juggling, running a medical practice as Den's health deteriorates, I eventually hit a wall and must make a choice: to temporarily step away from my medical career, to be a carer.

Free from the pressure of work for two years, I advocate for Den; provide physical and emotional support. My medical background serves me well, in demystifying and navigating the system for him, and stepping in when he needs someone to fight his corner. And when he improves (yes, he improves!), and my caring role recedes, I am racked with guilt about leaving my medical role, but anxiety about returning.

Turning to therapy helped me understand that perfectionism and people-pleasing are survival skills developed in childhood. Taking these traits into adulthood does not serve you. You overwork in the face of an unsustainable workload, instead of recognising the need for limits. You burn out doing a job you love, because 'Rachel will do it' is the motto at work, and you take misguided satisfaction from this. But trying to please everyone leads to you neglecting yourself.

I wouldn’t change a thing about how life has gone so far. Even though there will be challenges, you will be respected in your professional role. You will lead and teach others. You will know enduring love. And being a caregiver, both in and out of work, will bring great satisfaction.

What I would change is this: it took reaching the limits of what I could cope with, and burning out, to learn the importance of self-care. You can get away with emotionally neglecting yourself for years, but life events will force you to acknowledge your own needs at some point. If you tackle this in your 20s, you will still be able to care for others, but you might not burn out doing it. You won't agonise over your need to step away for a while, to put your family first. It's best to learn early that saying no sometimes, admitting your vulnerability and asking for support is not a weakness. It’s a strength.

Right now, you are worrying about how you will get through your finals and begin work as a junior doctor, amidst losing Mum. But you're stronger than you think. You will be OK. But what I wish I had done, and I am advising you to do, is to find a good therapist in those early years - don't wait until you are in your 50s. Deal with your childhood trauma and grief. Learn about healthy and unhealthy emotions and how to manage perfectionism. Learn to express your emotions rather than bottle them up. And learn to be kind to yourself: retrain your inner critic to be your cheerleader! Walk in nature as often as you can. Keep in touch with your creative side - painting and writing help you notice the beauty around you. Know your limits and find your ‘no’. Accept that being needed is a curse and a joy that you cannot live without. It connects you to your fellow humans and allows you to experience the whole range of emotions that this beautiful life brings.

I don't want you to fear the future - in their own way, the hardest parts have provided you with some extraordinary, joyful experiences you might not otherwise have had. They have enriched your relationships and made you discover what you really value. And I can tell you that at 54 you will be doing OK. After a break from work to care for Den, you will both make it out of the other side of these tricky times, stronger emotionally, and able to return to the work you loved - but with better boundaries in place.

Life is about constantly adjusting to new normals. Being contented is not a normal state - Tim Minchin, a musician/comedian who you will admire in the future, says, 'We didn't evolve to be constantly content. Contented [early human species] got eaten before passing on their genes'.

And as you sit there in that grotty student bedroom, wondering what to revise next, I can tell you this: you are going to pass your finals first time. Especially if you revise the cranial nerves.

With love, for the person you are, and the person you will become - one who IS good enough!

Rachel of 2025

Victoria’s Recommendation: Learn more about Rachel and her publication by reading ‘Please allow me to introduce myself’ and because Rachel has a dual perspective you may want to read: ‘The Doctor/Wife Dilemma. Balancing dual roles when a loved one becomes ill’

The Closing Rapid Fire Questions to Rachel from Victoria:

1. Fill in the blank ‘Empathy to me is’

“Empathy to me is being able to read someone's emotions, imagine walking in their shoes. You know when it happens, as you feel connected to that person, you understand their pain. And this enables you to work with them to help find solutions.”

2. What’s one question you’d ask your future self?

“I've been writing a memoir about our five-year battle for my husband's survival. I'd love to know if it ever gets published and if it benefits others.”

3. What’s one quote/song/movie/book that’s inspired or carried you through to today?

Also Human, by Caroline Elton, which explores the internal and external factors that predispose doctors to burnout. It helped me to understand the interplay of life and work, and see the importance of being kind to myself. And I recommend everyone listens to Tim Minchin's “9 rules of life”²

A prompt for discussion from Dr Rachel Molloy:

Balancing work and care affects many carers, and can be a real struggle. In what ways have you had to choose between your career and being a carer?

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© Carer Mentor, September 18, 2025. This concept is original to Carer Mentor™ VLChin Ltd. If you use it, please give credit and link to the original work. Thank you. www.carermentor.com

1. Tina who writes Dad Lives With Me has shared here thoughts in this article: My Number One Piece of Advice When Considering Where Your Elderly Loved One Should Live. Hint: Caregiving Isn't One-Size-Fits-All.

2. Tim Minchin, the former UWA (The University of Western Australia) Arts student described as "sublimely talented, witty, smart and unabashedly offensive" in a musical career that has taken the world by storm, is awarded an honorary doctorate by UWA. October 8, 2013