Restoring the magic

Office practice provided diagnostic and therapeutic challenges, favorable interactions with patients, respect from peers, and sufficient income. I read medical journals, attended medical meetings, and submitted articles for publication. I referred patients to subspecialists occasionally, but found I could handle most of their problems myself. Back then, patients had one doctor, not six or seven. I made house calls. They were enjoyable and worthwhile.

I was happy and enthusiastic about my work. "I'm going to continue doctoring until I keel over!" I once told my wife.

Subspecialists took over care of patients I had previously been comfortable treating. The number of my hospital admissions dwindled so that it was not worthwhile maintaining a hospital practice. I ended up taking care of the "worried well" (patients with insignificant problems), filling out referral forms, and fighting with insurance companies to justify necessary diagnostic tests. It seemed I wasn't doing anything worthwhile. My childhood dream of becoming a doctor had become a nightmare. And then came the malpractice suit. I lost it. No excuses; I failed to make an early diagnosis of cancer.

THE TURNING POINT

The worst experiences in my life were the deaths of my father, mother, brother, nephew-and that malpractice suit. You have to experience one to know how negatively it affects you.

My dissatisfaction led to frustration, then anger-anger directed at office staff, peers, and worst of all, patients. I was intolerant, impatient, and just plain nasty. I discharged patients from my practice for little things, such as non-compliance in taking medications or failure to undergo diagnostic tests I had ordered. Income became a priority where it never had been before.

I made adjustments: eliminated hospital duties, took more time off, enrolled in non-medical college courses, traveled, and started new hobbies. They helped a little, but they didn't make me a happy doctor.

Some enthusiasm returned when my son joined me in practice. We got along great, professionally and personally. I learned from him, and he learned from me. But after five years, even that bond was not enough to make things right. The enthusiasm, the passion, and compassion had vanished. I retired at age 62.

Three months later, my best friend and patient, Jeff, died in a hospice unit. He had metastatic brain cancer. I took care of him during his illness. He was my last patient, and at the time my only patient. The considerable medical and personal attention I devoted to Jeff-the countless house calls, the conversations with him and his family-made me feel like a real doctor again. I was at his bedside when he took his last breath in the hospice unit.