I first met Kate when she was 32 years old and coming in for her yearly check up. I was new to practice and her previous gynecologist was retiring. Kate's real given name was Mary Katharyn. She could not give me any information about her medical history but I soon learned that she loved to go to the movies and that her favorite actor was Omar Sharif. She must have seen every movie that he made many times.
Kate was strikingly beautiful. Tall, slender, dark haired with a quick smile and dancing eyes. She had a dramatic way about her and she would even sing a few lines of a movie tune as she became caught up in telling me about a movie she had seen. Kate was on the dean's list her first semester of college. That was prior to the car accident which occurred just before her nineteenth birthday. Now she spent her days much as a four or five year old would under the almost constant supervision of one of her parents.
Kate's mother was a saint. The most patient person that I have ever met, she lovingly and tirelessly she cared for Kate year after year. She never complained even when I gave her permission to do so. Her constant concern was for Kate's well being.
I was thinking about Kate tonight when at dinner I used a trivet that she gave to me. A trivet is one of those little hot plate holders. This one is ceramic and covered with the image of a beautiful butterfly with multicolored wings. The day she brought it to me Kate went into great detail explaining how she choose the colors, painted the ceramic piece and then fired it in a kiln. Her eyes jumped as she described every detail of the creation.
I have not seen Kate or her mother in almost three years. When her father died, an older sister became the executor of his estate. Every thing changed. Their home was sold. I imagine that Kate is in some sort of care facility now. I do not even know if Mrs. E is still living.
Using the beautiful butterfly trivet is not the only time I am reminded of Kate. At the delivery of every healthy baby, when the parents breathe that sigh of relief that everything is alright, I think of Kate and her mother. I am reminded that there are no guarantees in life. As a parents most of us do the very best we know how hoping that the skills that we have will match the needs of our children.
*All names have been changed though those who worked with me may recognize the people as the stories are real.
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Musings of a physician in private practice for 24 years, now teaching in a residency program and working as an ob-gyn hospitalist in a large metropolitan hospital.
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The Local MD
Having now been a physician in private practice for twenty-one years, twenty-six days and about an hour and twenty minutes, it occurs to me that I have become what in medical school was often a derogatory term, the local MD.The presentation on rounds often went something like: "This 45 year old Caucasian male was seen last week by his LMD, and diagnosed with a viral upper respiratory infection..." At that point everyone knew that the LMD had missed the diagnosis. Otherwise the poor patient would not have ended up in a tertiary medical center with three consulting specialist, a fellow, a resident and four medical students at his bedside.What we, the medical students, the resident, the fellow and even the attending hospital physicians did not realize is that we would never know John Smith as well as the LMD. We would never speak to his wife using her first name. We would never be able to recall the names of all his children and know where they were in the world. We would never remember his favorite hobby let alone joke with him about it. Nor would we shed a heart felt tear when we gave him the diagnosis of the aggressive small cell carcinoma of the lung that had landed him in our midst and would kill him in less than three months despite our aggressive treatment that was the best medical science has to offer.At that point in my life I was very proud to be even the lowest ranking person on the team that was on the cutting edge of the diagnosis and the treatment of the gravest of conditions that plagued mankind. I felt so very lucky that I was being initiated in to this sacred fraternity. That I would soon be able to write "MD" after my name. I am still proud of my vocation yet I believe there is a wisdom that has only come with those twenty-years of practice.Today I realize what people want most of their physician is that he or she is someone who cares.Yes, we all want "everything medical science has to offer." Yet, what most of patients need is someone who will listen with their heart as well as with their head. Physician eyes are important, not only for seeing signs of disease in the body but for making contact with the patient's eyes where we are often allowed to see into their soul. All of the technology in the world will not replace a warm clasp of the hand or sitting at the bedside to share a few moments of the day along with the test results.So, I have created this blog. In large part it is a place for me to put my feelings. My hope is that at least some of these posts will resonate with others out there. Not just physicians, but others in caregiving vocations and even those for whom we care. If we are not here for each other then why are we here?
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