One doctor who himself suffered an illness complained -- as I wrote last week -- that "my experience with physicians has been tainted by sloppiness, mild negligence, professional fatigue and disaffection, greed and lack of wisdom."
The word tainted well might have been italicized. Valid as it may be, we can't let that view become our whole view of doctors, lest we become so sour that we ourselves spoil every contact with a doctor. There are many conscientious ones.
The Journal of the American Medical Association has a standing feature called "A Piece of My Mind" in which doctors may vent their feelings, light-hearted or sad, reflective or angry. Every now and then, I save one of these pieces.
A few years ago, Dr. William Tierney of Indianapolis told how he runs daily for exercise and also for therapy, for "in reality I run in a cloud of memories of failures, of lost lives . . . As I run, I remember Bradley, a young leukemic patient who had failed all standard and experimental chemotherapy, whose parents had lost their only other child to another malignancy, hating having her die in the sterile hospital, now only wanting their hopelessly ill son to die at home."
Bradley was sent home, then had to be returned to the hospital after all, dying. "Suddenly my heart feels heavy as I run, remembering the page to the admitting room, arriving there breathless, seeing in the eyes of his parents that that death, too, had been stolen from them. Their kindness and thankfulness gall me still."
Then "I remember Judy, the second-grade schoolteacher in her 20s, pretty and ill, cyanotic in the ravages of post-influenza staphylococcal pneumonia. Day after day, disaster after disaster, I fought for each organ as it failed." Judy died, and "I remember the accusations" of her angry parents, though "with less pain and bitterness than Bradley's parents' understanding and forgiveness."
Now, this doctor wrote, "I gather my dead about me as I run . . . I run hard, allowing the thoughts that all physicians cage deep within themselves to bubble to the surface and linger . . . Bradley, Judy, Bob and all the others live on in me, making their way into my consciousness when they may, either on the backroads of Indiana or in the critical care waiting room. They are there, always there. Their lesson has been sobering, disquieting and real. I listen when I can and run when I must." ::
Another such report, from Dr. Lorenzo Guzman of Sabana Grande, Puerto Rico:
"It was my birthday, and I was on the orthopedic surgery rotation of my general surgery residency . . . The day came and there was no cake, no gifts, not even a remembrance or greeting card."
The young doctor had to assist that day in two long, wearing operations. Then he spent 45 minutes looking for a misplaced key to his locker. Then "I had barely had time to cool off" when a nurse bellowed, "Your patient in Bed 1, Ward C, refused his meal and smashed the dishes on the floor. There are spaghetti and coffee all over the place. That's more than I can take today!"
"Immediately, I knew who she was talking about," Guzman wrote. "He was a 6-foot, 9-inch giant, 18, who played center for his high-school basketball team." He had broken his left arm in an accident, and an X-ray revealed a far-gone, wide-spread bone cancer.
His response to therapy was poor. "He was anemic, weak, bald and given to outbursts of ill temper." Yet "somehow he had become attached to me, and I made it a point to chat with him every night."
Now, however, "I shot out of my office. 'Listen, you punk,' I shouted. 'Let this be the last time you pull a stunt like this. If you do this again, I'll have your can out of this place so fast you won't even know what hit you! Now you help the orderly clean up this mess and report to my office.' "
Next, "I had barely settled into the chair when I heard a soft knock. I grunted and in walked the giant with a big, glossy red apple. 'I found out today was your birthday,' he said . . . 'I saved this nice apple from my lunch, and I thought I'd give it to you as a birthday present.'
" 'Sit down, you big lug,' I said. 'This apple is the most beautiful present one could ever hope to receive. I simply love it.'
"My patient died three weeks later, and I went to his funeral. On the way back I thought about my birthday present, and how from that moment on it was to be a beacon in my search for the real values in patients and in human beings." ::
In the Annals of Internal Medicine, a journal weighty with complicated medical science, Dr. David Mathias, a cardiology fellow at the Medical College of Wisconsin in Milwaukee,
wrote of a dying patient's difficulty in getting his doctor to talk to him. Mathias did so in a poem called "The Patient":
Doctor, look beyond this frail body,
This frozen smile.
Why do you hide your fear,
Fear troubles me.
You shall one day be what I am
And face what I face.
Why then can't you sit with me?
Are you not concerned with my thoughts?
Death is on the way -- I know that.
My family's smiles cannot conceal the truth;
They need their hope to go on,
But you and I know what lies ahead.
Sit and I will tell you
The wonders I have found.
For I was full of hate and fear,
Yet now I have found peace
And know the time has come to move on.
It is strange that we who face death
Have gone beyond our fears
While your spectators
Are paralyzed by yours
And avoid me because I trouble you.
Please, Doctor, talk to me.
You may find yourself,
And only then may I comfort you.
Next Week: Reports from readers.