I miss my patients, and in the two months since I left them behind for a new job in Ohio, I have thought of them every darn day. I have wondered how they were, and worried selfishly that no one would ever take care of them as well as I did; if mother hens practiced medicine they would know just how I feel.
Over the years, those patients included the medically afflicted, the opioid addicted and a few of the grand jury-indicted. There were babies I saw draw their first breaths and more than a few old folks I saw draw their last, both respiratory beginnings of great journeys to be taken that I can recall in vivid detail. I helped some patients in their struggles to become independent adults, others in their struggles becoming dependent elderly, and too many in their struggles to just be, period.
A large part of the range of human experience was expressed in my patients. There were homeless teens whose parents were glad to see them gone, and abandoned babies whose adoptive parents could not have loved them more. There were war veterans with whom I shared the unpleasant knowledge of what burned human flesh smelled like, and teachers with whom I shared the gift of having helped someone in our charge solve one of life’s difficult puzzles. Some of my patients walked the world as if life was a miracle, and for others it seemed to weigh on every step as though it was a terminal illness.
As a person, my favorite patients were the ones who treated me as a friend while I treated them, and who might just as well have stopped by the office for coffee as a cholesterol check. Our conversations would pick up just where they left off three months before without skipping a beat, the way conversations of good buddies do. Family news would be shared while pelvic exams were prepared, Obamacare would be debated while healing wounds were debrided, and if the balance between social and medical agendas got skewed one way in one visit, it got skewed back during the next.
As an intellectual, my favorite patients were the ones who made me think, and challenged my physician scientist brain. Their problems forced me to wrack that brain, search my medical books, wander the Internet, and probe their parts and or puzzle their problem repeatedly before planning and prescribing. Their care required me to update my knowledge of how to treat a familiar problem, or learn about a problem that was new to me. They allowed me to practice on them, helped make me a better practitioner of my art, and never made me feel bad about their having to help teach this old doc a new trick.
Relationships with patients are a bit like marriages, however, and not all of them work out. I fired a few of my patients over the years, more than a few fired me, and sometimes we happily or sadly fired each other. Usually we parted ways because they lost too many contests with my growing role running hospitals, and there was a better doctor than me out there for them. I also fired a few because they were so unpleasant to deal with my office staff wanted to Taser them instead of treat them, and truth be told, when they left I hoped the door would hit them on their way out.
Fired or favored, they all gave me more insight into how our health care system did and did not work than all the articles and studies I ever read. They kept me grounded in patient care reality even as my health system leadership role took me into the executive suite. As a result, my patients helped me succeed in the role that took me away from them, a bittersweet paradox they and I often recognized in the hundreds of goodbyes that were said in my exam room this past spring.
I have left my patients but they will never leave me, a thought that makes me feel like the Verizon guy; wherever I am, I stand there with my patients all standing behind me, and I am happy because I will always be able to hear them.
Erik Steele is the former chief medical officer of Eastern Maine Healthcare Systems. He recently accepted a new job at Summa Health System in Akron, Ohio.