My favorite patients were the older physicians who came to me as patients. I was humbled, grateful, and awed by each of them. For some reason, I had quite a few physicians as patients, and caring for this group is interesting. It was not until I got old enough and had issues needing a doctor for myself that I learned how hard it is to walk both sides of that fence.
Dr. T. was in his early seventies when I first met him as my patient. I knew of him, and the word on the street was that he was good, kind, and respected. He was one of the old-school in that he had his office at his home, wore a three-piece suit, never cared what time it was, and treated most ailments with words rather than medications. Patients loved him. His family revered him, and it was his son who asked me to take care of him. He did not have a physician and treated himself as most did. Despite knowing how it is impossible to be objective about oneself, most physicians continue to be their own doctor to some extent. He was in the hospital when I met him – in the ICU.
The story is amazing. It was winter, and he was out making a house call one evening. He was walking through the snow and developed chest pain. He went into the patient’s garage and gave himself a shot of morphine. He then knocked on the door, completed his work with the patient, and asked that they call an ambulance. He was taken to the hospital and treated for an acute myocardial infarction – a diagnosis he had made himself, of course! He did well, and I could not help but marvel at this stately man.
A few years went by, and I put him on blood pressure medications. He stopped smoking after some battles. At that time, most physicians were smokers – it was considered safe and good for stress! Cholesterol was not yet a modifiable factor. His visits were wonderful, and he shared his view of those years of being a doctor before all the tests, medications, and diagnoses. He talked about being paid with a chicken before Medicare! I would not refer to it as the “good old days” because people died younger, suffered more, and a simple strep throat could kill you. His stories made me appreciate what I now had in my tool chest to help my patients.
One day he called and told me he was having a tear of an aneurysm in his belly. Doctors tend to give diagnoses rather than symptoms, and they tend to think they have the worst possible problem. I had him come to the ER by ambulance, and I would meet him there. He had diagnosed and treated himself correctly for a heart attack, so why would I doubt him now? With this diagnosis, every second counts! He came, and his CT scan showed exactly what he said, and we happened to have an excellent surgeon trained by Dr. Debakey in the hospital who came right down and took him to the operating room. He survived (most do not) and went home. I went to see him often there – more for his wealth of tales than for anything I could do for him.
During one visit to his home, his wife, a wonderful lady ten years younger, asked if I could come into another room for a minute. I feared she was ill, or Doc was hiding something from me. What she now told me made those options much more preferable. She asked me to give her the meaning of a certain gesture. She had driven to the grocery store, and upon arrival home, their handicap spot in front of her house was occupied. She could not carry the groceries far and had no one to help her. She double-parked and was carrying bags to the porch when a young man in a car drove up behind hers as it was blocking the one-way street. He began to beep at her. She went back to the car and took out another bag of groceries. She then told me that she had given him the finger (as she extended her middle finger up from a closed fist with amazing expertise) but had no idea what she had just told him! I stood there and quickly looked at my options in this uncomfortable moment. Medical school did not cover this topic. I decided it would be best to just be calm and matter-of-fact and explain what this gesture usually implies. She smiled, thanked me, and seemed quite pleased with herself.
I cared for both until their deaths. Decades have passed, and I find myself telling my current students what it was like when I began my medical career. They are amazed at the changes in this relatively short period of time as I was with Dr. T’s stories. One day they will do the same for those they teach. That is what life is – a journey that allows us to pass on the past and embrace the future. Thank you Dr. and Mrs. T.
John F. McGeehan is an internal medicine physician.
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