Just now got home from work, for the last time.
I carried a cardboard box filled with things which belonged to Cathy, my secretary/office manager out to her car in the parking lot and she said, "I thought I was going to be sad. But, somehow, I'm not." She looked at me for a moment and said, "I won't miss that mob back there, not for a second."
The corporation we had worked for over the prior 11 years had gone bankrupt, and the new company which acquired us almost immediately alienated us, but most of all, that mob was clearly incompetent, and Cathy and I had looked at each other as one might look at an airplane pilot reeking of alcohol, who staggers toward the cockpit.
"Uh-oh," this cannot end well, we said.
When I resigned from our clinic 90 days ago, I did so only after I checked with her. I would not have resigned if she wanted to stay on. But she told me she was turning 70 in April and she planned to retire, so that gave me my free pass.
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| Medical School Class |
Today, she went to talk to the administrator, who had suggested that even after I left the clinic, they "might have something" for her, i.e., a job in another doctor's office but when she stepped in the office, the administrator handed her severance package all prepared for her. She was a little shocked, but not really. She can get unemployment and some other benefits, so she is not exactly bereft.
Cathy is the person you would dream up if you wanted the perfect health care worker: No patient's request was ever dismissed, delayed or ignored. She would hound me, advocating for even the most uncooperative, desultory patient, making sure prescriptions, lab request forms, letters to employers got done. Every day was filled with patients at the end of the day who Cathy felt needed "squeeze in" appointments. Patients always had grievances about the medical system, billing, prescriptions not filled correctly, but nobody ever had a complaint about Cathy. Every patient, doctor, co worker who ever dealt with her loved her and told me so.
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| Housestaff: Residents and Interns and Faculty |
When I arrived home, I thought, well maybe I should be sad. And I did feel that empty feeling I felt after exam week in college, when I had studied constantly, completed long to do lists for each course and then walked out of the door of the last exam and realized I now had absolutely nothing to do. The idea of free, unscheduled time was hard to fathom.
And now, tomorrow I will wake up and not have to leap out of bed and get my day going in order to get to work.
I have been told by my Merrill Lynch gurus that there is no reason, financially, for me to work. They claim I can live to be 100 and not hurt for money. They may even be correct.
When I resigned my job, I knew that there was not another endocrinologist from York, Maine to Portsmouth, New Hampshire all the way up to Hampton. I could open an office anywhere along the Seacoast and have a busy practice within a month.
But, after 27 years of signing leases, responding to the various crises of running a small business, Xerox machines breaking down, staffing problems, hikes in malpractice insurance, I was thrilled to leave all that behind and get a W-2 form and become an employee.
The problem with being an employee though, is you need a willing boss who wants to hire and maintain you--and the only bosses hiring doctors in Seacoast New Hampshire to the upper reaches of the Merrimack Valley are big corporations, and they are not hiring, at least not now. Recession is coming. Mass General/Partners is laying people off.
So, I am, somewhat unexpectedly, retired.
When I stepped into my house and put down my briefcase, I realized this journey had been 52 years. I started my career, with my freshly minted MD in 1973, age 26. And now it is over. Over that time, I had never been out of work. There had been a month off between jobs, or that slow period when I first hung up my shingle and started private solo practice in Washington, D.C., coming from a medical school in New York City and with no network of friends and colleagues acquired in medical school.
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| Who Was That Guy? After a Night on Call |
But I had never stopped being a doctor. I never started a company, never shifted over to hospital administration.
I did get one offer from the CEO of a hospital in Washington, who told me, "Nobody is going to be able to survive just seeing patients in the office for much longer. Come work with us at the hospital."
I hung up the phone and looked out the window of my office, and the faces of faculty members from years before, at Cornell, flashed before my eyes. Give up medicine! It was like leaving the priesthood. Worse than that. I developed acute angina, my left wrist tingling and spasming--what I took to be coronary artery spasm, which took a moment to resolve.
Over the years, we'd heard of some doctor or another who had "gone Hollywood," i.e., who had given up treating patients and gone to work for a drug company or who had left medicine altogether to start a software company, some spin off of medical practice, developing an electronic medical record or something like that, parlaying an MD into an MBS related career and we always smirked a little. Gave up medicine. Chased after the almighty dollar. How embarrassing.
But now, younger doctors who have enormous student loans, earn back that investment and build up a nest egg and get out of medicine as soon as they can. They shift jobs every two years, looking for salary increases. And they leave medicine. Women, especially, leave medicine, for motherhood, or for jobs which are less demanding in time and energy.
And, truth be told, in some ways, I've mentally checked out of medical practice over the past few years, in some ways. I've been practicing in an underserved area, where patients have little education, a load of financial and personal problems, are non compliant--they don't go for their tests, don't take their medications, don't keep their follow up appointments and don't go to the consultants I've recommended. And so, not having changed what they are doing, they do not achieve improved results for their diabetes or high cholesterol or thyroid disease.
And the things they say! I've learned from my patients that vaccines are a vast government conspiracy, that vitamins cure cancer and that lowering cholesterol causes more problems than its worth.
But, I've never, not even for a moment, been anything other than grateful to have had the chance to become a doctor, to have been trained at the New York Hospital, where we all believed we were in the best medical center in the world, and were very lucky to be a part of it. The Marines had nothing on us for group pride, and a sense of purpose.
One of the professors at Cornell was named Aaron Feder. He made rounds in the early morning at the hospital and again after seeing patients all day in his office, he'd come back to do his evening rounds. I heard he was found dead in a hospital stairwell at age 63. He never took an elevator. Everyone smiled when they heard how he had died. "That's Aaron Feder," they said. "Died with his boots on. Died as he lived. That's how a real doctor dies."
