Medicine and its Cost
““I haven’t got time to be sick!” he said. “People need me.”
He was a doctor; he did not know what it was to spare himself.”
For more than forty years I have had the privilege of being a physician. I’m one of those rare people who has been lucky enough to be able to work at what I want to do. Early in life I decided that I’d be a doctor. Life is hard and full of obstacles; mine has been no different. But when I look back, I can say that I have no regrets. No greater joy can befall a human being than to be able to become a physician; there is also no greater responsibility.
During my recent vacation I went to lunch at a restaurant. I noticed that one of the rooms was reserved for a prominent local attorney. He has a house in the same complex that we have our apartment. I decided that I’d crash his party in order to introduce myself.
He was very gracious. As I left the room I commented that he shared a name with a former girlfriend of mine. A brilliant; kind; sensitive; beautiful woman. When I decided to leave for the US to study medicine she dropped me. Did not want a long-distance boyfriend.
“She did not know what she was missing,” he said.
Maybe she did.
After I got home I began to think. The “Dear John” letter that she sent me was my first payment to mother medicine. In those days long distance was expensive. I did not have the resources to get on a plane, come home, make things right, and head back to St. Louis. No matter. It did not cross my mind to leave my studies. My classmates could not understand why I just let this matter drop. We got along well; our families liked each other; we had talked about getting married. But I had to be a doctor; I never felt that I had a choice.
Then the floodgate of memories opened. Maybe it was a matter of me being home; closer in touch with my youth. I took stock of other times when mother medicine came first.
The time when one of my daughters, not even a year old, had a seizure and a respiratory arrest while she was visiting my parents. When my father called me with the news (yes, long distance) I had thirty hospitalized patients. My first thought was about my patients; how I could not possibly leave them. It was only after I noticed the shock in my father’s voice when I mentioned how busy I was that I realized that I had to get on a plane, get her out of the ICU, and find someone to cover for me.
There were many late nights and cold dinners. Not as close to my children as I could have been. Maybe I set standards that were hard to meet, like I set for myself in my profession. They were just kids.
My wife is a nurse. She was trapped in the web as much as I was. The vacation days were few. It has been more than twenty years since I left the office without calling every day, or checking e mails and lab tests every few hours. When electronic records became the norm I was hooked. I could make diagnoses and prescribe medicine from a chair in front of the beach. I saw nothing wrong or twisted in that behavior.
Some patients don’t do well. Your soul hardens. You fail to take credit for the good you do; you’re constantly concerned about what might go wrong. This attitude dominates the rest of your life. When the kids go swimming you worry that they may drown. Roller coasters may cause back pain. Because you have so much power over pain and suffering it becomes hard to understand and accept failures; your life is slanted.
When my dad got sick it was a chore to visit him. Another failure. When my mom followed in his steps I did much better, but I did allow my wife to do much of the heavy work.
My practice thrived. Most of my patients loved me. It’s hard to describe the sense of joy I feel when I’m the fifth specialist that a patient has seen, and it takes me ten minutes to make a diagnosis. The anticipation that comes over me knowing that in three months this tortured soul is going to be close to normal. The joy of hearing them sing my praises. It’s as addicting as a drug.
I must look like I’m aging fast, because over the last year dozens of patients have asked me when I intend to retire. My answer has always been that I like what I do.
As if there’s nothing else I could like.
But life does not listen to likes, or wishes, or longings. This is the only chance you get.
I have decided that I will explore other venues. I need to find out what else I like, hopefully long before age no longer allows me to enjoy it.
There are several minor medical problems that need to be better taken care of. I need to take a long trip without checking for lab results in my laptop. There’s that second and third books that I just can’t get around to edit. My sister wants me to walk a half marathon with her…
I cannot practice medicine with half the usual effort. I’d never forgive myself if something went wrong and I hadn’t been “all in” with the process.
Accordingly I’ve decided that I’ll retire from the full-time practice of medicine. February 26th will be my last day at the office. I’ll do a small amount of consulting. Will become more of an advocate for the homeless and the abused.
It will be a painful and difficult transition. Hard for me not to be as useful.
I thank all of my patients for the unspeakable joy that they have brought to my life. It has been a privilege to be worthy of their trust. May God bless and keep them always.
For those patients who read this blog: please do not call the office for further information. The schedule is crowded; patients need to be taken care of. You will receive a letter this coming week. I will host a party at the May Center on Friday March fourth at 5:30 PM. The employees will be there to say good-bye along with me. I will respond to facebook comments (time permitting); if you’d like to come to the party please RSVP to firstname.lastname@example.org