Patients bearing gifts

Beware them? Not these. Their tokens come from the heart.

By Gail Garfinkel Weiss
Senior Editor

Accepting two chickens as payment for treating a patient may be a thing of the past, but that doesn't mean patients have stopped trying to feed you—or give you other tokens of appreciation.

Some tokens aren't token. When gastroenterologist Sarkis J. Chobanian was chief resident at the National Naval Medical Center in Bethesda, MD, he cared for the "favorite" wife of the emir of Yemen, and his colleagues treated the emir's daughter and other relatives. The emir, obviously impressed, presented the doctors with a jewel-encrusted chalice—an irresistible item that, sadly, clashed with an immovable federal rule prohibiting Navy doctors from accepting gifts of "significant value."

"I think the limit was $20 in those days," Chobanian laments. "Given our financial situation, it sure would have been nice to get my share of those jewels."

Equally valuable—for sentimental reasons—is the pair of sneakers a patient knitted for Sacramento internist Eugene Ogrod . "She remembered a simpler time when her mom bought her high-top sneakers for the new school year," he says. "I shared similar memories. The gift is especially poignant because she made it after we had diagnosed her lung cancer; her life expectancy was only a few months."

FP Stanley J. Sczecienski, an avid outdoorsman from Westland, MI, still delights in the carved fish plaque a patient made for him. "He's a master of the scroll saw," Sczecienski notes. "He actually took a walnut from a tree near my office and grew the tree before he created the art."

Another skilled patient showed his gratitude to Missouri ophthalmologist John C. Hagan III. His failing vision returned to normal after Hagan performed cataract surgery on him. He rewarded the doctor with three exquisitely carved canes (at left). "Someday, you may need them," the man told Hagan.

What am I supposed to do with this?

Have you heard the one about the Christmas card that wasn't? In December 1988, when internist Jeffrey Jackson of Silver Spring, MD, was halfway through his internship, he was having trouble adopting a holiday frame of mind. "The innumerable admissions, long nights on call, and crush of patient responsibilities were beginning to wear on me," he recalls. "So I was quite excited when one of my favorite patients handed me an envelope. 'My first Christmas card from a patient,' I thought. 'What a joy to be a doctor.'

"I decided to wait until I got home to open it—all the better to savor the moment. Finally, I slit the envelope—and found three completed stool guaiac cards. My first instinct was to cry, but I burst out laughing instead. At least, I thought, the patient had followed my suggestion for health screening."

If it's the thought that counts, otolaryngologist Wallace Rubin of Metairie, LA, doesn't want to know what the patient who gave him a lethal-looking knife was thinking. "The knife is beautiful, and handmade," he says, "but it's scary to receive such a gift."

Quincy, WA, internist Larry Smith received a more benign message. "For the first seven years after I finished residency, I worked in a rural area in northeastern Washington," he says. "One year, I received a fawn—yes, a baby deer—from a patient. I called my brother, and he took the animal to a wildlife manager, who in turn took it to someone who could care for it appropriately. Apparently, my patient had never been told to leave baby wildlife alone."

And now, fresh from your patient's oven . . .

"In New Orleans, we eat a good meal, then talk about the last one we ate and the next one we're going to have, so food gifts are very common," Wallace Rubin says.

As New Orleans goes, so goes the rest of the nation—although some edible goodies come in strange packages. Austin, TX, internist Theresa Pham, for instance, was surprised to receive a box of Texas armadillo droppings, until she realized they were pecan pralines marketed under an earthy moniker.

FP Randy Oliver of Evansville, IN, reports that holiday time in his office looks like "a church bake sale." His patients, he says, "like giving me gifts. It makes them feel good to take care of me for a change, and it puts us on a more even keel." FP Paul Ehrmann of Royal Oak, MI, who has received homemade apple pies and other delectables, agrees that such gifts are "a nice show of appreciation" that "creates a bond between me and my patients."

When a small gift means a great deal

In the life-and-death world of medicine, occasionally it's the patient who consoles the doctor. When New Jersey FP Warren Wolfe's 32-year-old daughter died several years ago, his patients came through with abundant food, flowers, cards, letters of condolence, and contributions to his daughter's favorite charity. He describes himself as "truly overwhelmed by the outpouring of kindness."

Some patients' gifts arrive postmortem, often in the form of a bequest. FP Jeffrey C. Hatcher of Paris, IL, treated an indomitable Chicago Cubs fan who remembered when the Cubs had last won a World Series, in 1908, and vowed not to die until the team won another baseball championship. It was a vow he couldn't keep, even though he lived to age 94. When he died, his 1945 World Series program—it's been that long since the Cubs won a pennant—passed to Hatcher, who hung the prized item in his office.

Emergency physician John C. Johnson of Valparaiso, IN, was scarcely out of residency when he admitted an 84-year-old heart patient to the ICU. "Back in 1975, ICU orders included 'no hot or cold foods.' Might irritate the heart, you know. Still, on her fourth day in the ICU, the patient asked for a small bowl of ice cream, and I agreed. Twenty minutes later, she went into cardiac arrest and wasn't successfully resuscitated. My first death in private practice.

"The family came by the following day to see me. I anticipated a malpractice suit, bankruptcy, and perhaps even loss of my license. Instead, they thanked me for caring for their mom and letting her have some ice cream before she died. She so loved her ice cream. They also had the mortician remove her pacemaker, and they gave it to me to use in the classes I taught at DePauw University. I breathed a sigh of relief. I still have the pacemaker."

 

Gail Weiss. Patients bearing gifts. Medical Economics 2002;1:58.