The local MD: Transitions

Saturday, January 25, 2020

Transitions

There have been many transitions in my life and in my career but none so definitive as leaving the practice of medicine. I reflect on this daily having begun to make the decision two years ago and now in the final weeks I am sure. I am glad that I am walking away and not being forced out. I am honored that there are people who are sad I am leaving rather than relieved to see me go.

Where am I going? Home mostly - a place that I made but never enjoyed as much as now. Ask my dog - I sketched his picture for you in pastels here

His name is “Jimmy” and he has become my muse as I purse drawing and painting. Another title I have given him is studio assistant. He is currently sound asleep by my side.

My goal is to have more to say about the past, the present and the future in the days to come as I remain “the local MD.”

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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?

The local MD

Saturday, January 25, 2020

Transitions

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Saturday, January 25, 2020

Transitions

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The Local MD