OPINION
DOCTORS ' Lounge
I MAY BE Getting Old, But …
Ronald L. Levine, MD
I
was recently sitting in a crowded waiting room, waiting for my appointment with a doctor. Only 30 minutes late, I thought. Not too bad. I was also supplied with a clipboard with multiple questions that I had previously filled out several times in the same office. At least it took up some of my time.
As I was sitting there, I ruminated about a recent afternoon when I was reminiscing with a good friend, also a retired octogenarian doctor. We talked about many of the changes that have taken place in medicine since our retirement and how things were in“ the good old days.”
As we recalled, doctors were trained to treat others in the profession as family, maybe even better. We both remembered Arch Cole, the Professor of Anatomy at UofL Medical School telling us that our patients were more important than our families and their care came first. My wife always resented that quote. I have told her today’ s doctors rightly do not follow that dictum. The days of the solo practitioner are long gone, so that family time is importantly available to physicians of today.
Doctors and their families were not charged a fee for treatment years ago. Other medical professionals, nurses and medical technicians from the hospital were always given discounts; clergy of any religion received no charge. The doctors and their families were always hustled back to see their friend, the doctor.
Things were different then, we both concurred. We remembered when computers were first discussed as coming into use in hospitals and offices, and we thought how that was going to eliminate all the paper work and save the forests. Well, we know how that went. We also never envisioned the day when doctors would frequently spend more time facing a computer than their patients. We had many different memories of those“ good old days.” The Physician’ s Desk Reference( PDR), which was about ½ inch thick, was on all of our desks and in examining rooms. Smoking was commonplace. You could cut the smoke in the hospital doctor’ s lounge with a knife. I remember a well-known surgical professor who would take a break during surgery, step outside the room with OR gloves still on, have a nurse light up a cigarette for him, take a few drags, change his gloves only and go back to the operative field.
We both remembered Louisville General Hospital( LGH) with the 30 bed wards, racially segregated, with no air conditioning. The only other hospitals in Louisville that admitted African American patients were the old St. Joseph and Jewish Hospital and the Red Cross Hospital that was strictly for African American patients. There was only one real emergency room in the city and that was at LGH. Other hospitals had ERs but were limited in what they could handle, as few had a full-time doctor on the premises. There was no emergency ambulance service as such. Emergencies were often transported via a police car, the“ throw and go.” Doctors in training as interns then could never forget their rotation through the ER.
My friend and I continued to think about the pros and cons of those old days. It was amazing what we could diagnose and treat with a pretty successful cure rate without CT Scan, MRI or Ultrasound. What a marvelous instrument the stethoscope was, as well as the use of a good history and palpation with our hands. We both remembered that when practicing medicine in Louisville before 911 calls, patients could dial their doctor directly! We think is almost unheard of in today’ s world, for patients are extremely fortunate if they get a phone call returned the same day by a physician, rather than secretarial staff.
When we physicians or our families had some illness and received a prescription, we often got samples from our friend’ s offices or contacted a local pharmaceutical rep for samples. It was and is a shock to see the cost of drugs in today’ s world.
I may be getting old, but I do remember a great deal about how it was then and now. I remember learning a great deal about the importance of the doctor-patient relationship as a senior medical student. I worked, as did many other medical students, as an extern at Jewish Hospital covering the Emergency Room, which was a small two room area on the second floor of the hospital. Our job was to see the occasional patient and to triage by calling the family doctor to come in, or to send them on to LGH. An elderly patient was brought in with a severe stroke and was obviously moribund. I called his family doctor, also an elderly practitioner, to come in. When he arrived, the family was almost instantly relieved. He literally just touched the patient with his stethoscope, and turned and reassured them“ We’ ll do our best, Martha.” The relief in that family was almost palpable. I learned a lot that day.
Today’ s doctors are so much smarter than we were, and they have a greater amount of knowledge to absorb than us. I’ m sure that in many ways they are better physicians than us, with certainly a greater number of diagnostic tools and therapies. But with all that, too frequently there is an absence of doctor-patient warm relationships, which are sorely missed.
I may be old, and perhaps some of my memories are a bit warped. I may be old, but I recognize many of the pluses and minuses that are present in today’ s world and the difficulties facing the doctors in practice today. Having said that, I guess I’ m so thankful for today’ s doctors who have made it possible for me to still be around, so that I can say –
“ I may be getting old, but …” Dr. Levine is a retired gynecologist.
JUNE 2018 33