When I first started my ophthalmology practice over a decade ago, an impeccably dressed, highly successful businessman came in with headaches and eyestrain. Despite the fact that his lids were weighing down his eyes, he exuded confidence and optimism. I recommended that he get a blepharoplasty (surgery to trim the sagging eyelid skin) to help with his symptoms. I was wearing a freshly pressed, stark white lab coat. My history was too thorough. My exam was unusually long. Well….I was the living portrait of a newly minted residency grad. This would be my first surgery outside of residency. Yet, despite the glaring reality that I was a newcomer to the real world of medicine, my patient nodded and said, “Doc…if you recommend this surgery, let’s set it up and get it done. I have full confidence in you. In fact, I KNOW you will do a better job than anyone else.”
I did the surgery. His symptoms resolved, and since then he was a devoted patient. Every year for over a decade--without fail--he would come in for his annual exam and sometimes for the occasional eye emergency. But, I would be reminded of him every week as he sent nearly EVERY friend, every cousin, every in-law, his wife, his children, his contractors, his neighbors, his business partners, and even his other doctors to see me as patients.
How did he know so many people? How could he be trusted and admired by such a huge network of diverse people? The more I got to know him, the more I understood why he was so beloved. When I would call him from the waiting room, he would be laughing and joking with nearly all of the other patients in the waiting room. He would tell me stories about what he did when he retired—How he would bike across South America and Israel, go hiking in the rainforest, go camping in Europe, travel to five or six countries in one month, run marathons, and spend quality time with his wife, his in-laws, his children, and his grandkids. He was a self-made entrepreneur and had built a hugely successful company, retired young, and savored life. He traveled the world several times over and was in superb health despite having diabetes. He was always there for his family and friends. He didn’t miss a beat. He lived hard, loved hard, and inspired me so much with his exuberant and exotic adventures, that I would frequently use him as a role model when talking to patients who were newly retired and nervous about the transition.
About a year ago, I saw his name on my daily patient list. I had seen him 6 months earlier, so he was early for his check-up. I wondered if he had an eye infection or another emergency that brought him in so soon.
I called out his name--but I didn’t see him in the waiting room.
I called his name out again, and he wasn’t there.
I called it a third time and heard a barely perceptible voice saying, “It’s Me Doc.” I turned and saw a pale, gaunt man with no hair nod at me. Was that him? I brought him in and he immediately told me that he had been diagnosed with pancreatic cancer. Physically, I had not recognized him. But after chatting with him for a few seconds…I knew it was him. He was smiling. He was hopeful. He was optimistic. He confided in me that his biggest concern at this time was for his primary care doctor. He had never wanted his doctor to have to face the difficulty of giving him bad news. He did not want to become “a burden” for any doctor.
Just a few weeks later, his daughter came to see me and told me that he had passed away. A few days later, I started to develop an intermittent eye twitch in my right eye. It persisted for several weeks. I had never had one before.
His wife then came in to see me a few weeks after his daughter. She told me how she had to set up a family meeting to figure out who should tell me that he passed away. She told me how much I meant to him. I expressed to her how much he had meant to me. I shared with her how he contributed to growing my practice more than anyone else; How his retirement was an example I would share with all my friends, patients, and family members who were planning their future. His wife somehow already knew that I cared deeply about him. We both wept. Just a few days later, his son came to see me, then his brother-in law, his best friend, and finally his sister-in-law. We talked about what a great man he was, shared stories, and hugged each other. My eye twitch finally resolved completely.
My patient is no longer here physically. But I was able to feel some closure by demonstrating to his family and friends that his spirit will always continue to live and breathe inside my practice. Through the years, he sent me HUNDREDS of patients. For every patient he sent me, I am reminded about his uncanny ability to connect so deeply with people from all walks of life. I get the opportunity time and time again to recall his stories, his smile, his infectious enthusiasm, his hope, and his confidence. He had lived his life seizing and savoring every single day as though it might be his last. He was and always will be larger than life.
Losing my patient was one of the most difficult experiences in my life. But, I learned through this excruciatingly painful loss that there is infinitely more value to an ophthalmology practice than the rewards of treating eye disease and restoring sight. Practicing ophthalmology now for over a decade has given me the opportunity to build a relationship with someone who believed in me more than I believed in myself, inspired me to live life to its fullest, and single-handedly built an entire community of wonderful people around me whom have become some of the greatest supporters of my career.
In the early part of my career, I never fully understood how rewarding the doctor-patient relationship could become. I was laser-focused on building my practice, mastering surgical techniques, and achieving positive outcomes. I received intense satisfaction from achieving the goal of making people healthier. However, I hadn’t yet discovered that year after year, I had built relationships with patients that had become so deep and meaningful that their loss would be devastating. I hadn’t realized that these doctor-patient relationships are in fact the context that gives modern medicine meaning. They are the dynamic forces that propel me to go the extra mile time and time again. My relationships with patients have become so impactful for me that they have transformed the way I see myself and the world. They are my purpose and inspiration for practicing medicine and will be a part of me for the rest of my life.