Some patients change our outlook

October 22, 2010

One physician's outlook on his patients' lives has fundamentally changed. He seeks to see life through their eyes.

Bessie was well into her 80s when I first met her. She was a vibrant, on-the-go senior citizen, always dressed to the nines and with a spark and love of life that left others decades younger than she was feeling old and tired in comparison. We hit it off well and began a special patient/physician relationship that is all too rare today. We celebrated her birthdays with cake-to-go and poems I wrote for the occasion.

When she was approaching her mid 90s and told me she had to fly south to take care of her daughter-in-law, who had fractured a hip-well, that was just typical Bessie. Several months later, Bessie was back, as beautiful and youthful as ever. She also had slowed a bit. She now used a walker to help her keep her balance, but a pocketbook slung over her shoulder held the latest novel that was all the rage of the New York Times bestseller list. She was using glasses now as well. But she was still Bessie.

A few years ago, after spending a 30-year career in a dual role as an endocrinologist and an internist, I decided to make a change and gave letters to all my patients explaining that, henceforth, I would be concentrating solely on my specialty. Therefore, I wrote, they would have to seek another physician for their primary care. Bessie read my letter without saying a word. Then with a twinkle-and determined look-in her eye, she ripped it to shreds, exclaiming, "If you think that, at 98, I am going to break in another young doctor, you are sorely mistaken!"

I was deeply saddened when, approaching 100, she told me she had to move permanently to be with her family down South. She just couldn't do it all on her own anymore and needed "a little help." We held a going away party for her, but Bessie didn't walk out of my life at all. I still was her doctor. She called me every month, just to check in and see how "the girls in the office" and I were doing. We talked politics and health issues over the 1,000 miles that separated us. For her 100th birthday party, my nurse flew down to surprise her. I always will regret that I could not go at the time.

Her calls continued well past her 101st birthday, but then that dreaded call came. Bessie was dying. Hospitalized for gastric outlet obstruction, she was found to have a duodenal mass. Not surprisingly, she was deemed strong enough to withstand the surgery that would save her life, but she would have none of it. Bessie had called to say goodbye. Her vision wasn't so great anymore, and her hearing had decreased. She required more and more dependence on others. It was time.

I tried to talk her out of it. "You have so much to live for still," I said, adding, "All life is so precious. You are still so vibrant." The usual. But my heart wasn't in it because I knew. I knew because she had trained me so thoroughly. One after another, we said goodbye. Me, my wife, my nurse, my staff. We cried that day. We were losing a friend.

Bessie died 3 weeks later, her son and extended family at her bedside. Her body came back home for burial, and we all said our final goodbyes then. If the immortality of a person can be judged by the influence he or she leaves behind, however, then Bessie is not gone. She left behind a legacy of love and admiration. I am a far different person for having known Bessie. She taught me that age-even extreme age-is as much a question of mind as of matter. My outlook on my patients' lives has fundamentally changed. I now seek to see life through their eyes. I try to make my expectations of care compatible with their expectations, all because of Bessie. I am blessed to have been her specialist. She trained me well.

The author practices in Reisterstown, Maryland. Send your feedback to medec@advanstar.com
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