Doctors: The Good, the Bad and the Ugly

In the world of my childhood, doctors were heroes who could do no wrong.  I still remember my pediatrician, Dr. McC., a small, mild-mannered man with a high pitched voice.  That was back in the day when doctors made house calls.  If my sister or I were sick, Dr. McC would arrive, wearing a neat black suit and carrying his medical bag.  In our world, his opinion was law, a gentle law but law nevertheless.

It was only after I was grown that I realized doctors might have feet of clay, that they weren't infallible, had differing opinions and could be downright nasty.  I learned this in spades when my husband fell ill with leukemia.
Our entrance into the cancer system was choreographed by a doctor I characterize as the ugliest of all.  

"You have acute myelogenous leukemia," he barked.  "The variant you have is very hard to cure.  You said you were willing to participate in a clinical trial.  The research nurse will talk to you.  Check into the hospital today."  He stood up and headed for the door.

Yes, we want doctors to tell us the truth, but we'd like the blow softened, at least with a gentle tone.  We'd like the doctor to spend a few minutes answering questions.  Not this guy.  He was half way to the door when my daughter stopped him in his tracks.  "After we hear from the nurse, if he decides on standard treatment instead of the trial, what do we do?"

He glared at her.  "Leave," he snapped.  "Standard treatment is not what this hospital is about."  Then he proceeded to lecture us on the importance of medical research.  That was The Beginning.

Along the way, we met encountered doctors who were more sympathetic. Yes, we asked for a change of physicians, but it didn't matter much.  In a teaching hospital, regardless of your physician of record, you get a different one each week, depending on who is on call.  So we met dozens of physicians--some kind, some callous.  There was the doctor who informed me my husband's kidneys "had gotten angry," eliciting a growl from me to "talk to me like a grown-up;"  Another doctor informed Ralph he wasn't behaving well and could not receive services on the rehab floor--a week earlier he had called Ralph one of the best patients they'd ever had.  We'd apparently seen him on both good days and bad days.  One doctor wrote in his chart that he "was not pleasant."  Perhaps that was because he was dying?

But at the end we were so lucky.  In every end-of-life book I've read, doctors are criticized for not taking time with patients, for holding out false unrealistic hope, for recommending useless treatments that prolong life but make it torturous.  Ralph's last physician, Dr. DeLima, was the doctor everyone should have in their final weeks of life.  He explained our options, taking all the time we needed, was honest about what each option would give Ralph, never seemed in a hurry when he came by.  He made the final journey an easier one and I will never forget his kindness.