I can not easily summarize 30 years of clinical practice.  There are great things I did that made peoples lives better.  There were unintentional mistakes I made that inconvenienced some or slowed the recovery of others and one case I remember where the person was hurt.  Everyone finally did O.K.  Unfortunately  no one bats 1000. 

During these years I have sat at the bedside of dying patients while they took their last breath.  I have comforted family members and waited on the mortician to come. 

I have investigated murders and suicides as a fledgling medical examiner in Baltimore county.  A few times I have had to tell friends they had cancer and once or twice I was there to feed them the last meal they would eat.

Other times I have felt like a waiter taking an order ” That will be the antibiotic entree, with sides of antidepressant and hemorrhoid cream.”  I want to sing at those times, “Have it your way, have it your way.”  People are people and there is one rule never to forget - they are basically more interested in themselves than they are in you.  People can surprise you with deep gratitude, heart-felt thanks, kindness and generosity.

I have been paid on a hot day with dripping fat-back put into a paper bag.  I have eaten plates of goodies I didn’t need and returned the plate on my next house-call.  Other doctors patients have knocked on my door to request I come out to the car to see someone that was sick so they wouldn’t have to wait in the ER on Christmas day.  Once with my wife in labor for child number 4, the president of the bank in a little town came to my house.  He had fallen and hit his lip with a stick of wood.  While I examined him in the kitchen, his wife visited with mine.

With 20/20 hind-site I can say I should have done some things differently.  But that is part of the journey, learning and passing that learning to those coming behind.  I love to learn and derive much satisfaction when I do the right thing for the problem.

Medicine has changed so much and so much more is expected.  In the basic ways it is still the art and science, with emphasis on art, of learning by watching others.  The object is to gain the skills and knowledge necessary to help people understand and do what is necessary for their life.  In this process I have learned to help no matter what my opinion about the recipient needing my help.

I have learned to do what it takes, giving my attention no matter what just went on.  I have learned to be patient, firm, and to guide.  I need to learn the language of each patient and to speak it so they can understand and make decisions as an informed patient.  I am not talking about Spanish or Chinese.  I am talking about farmer, banker, mechanic, housewife, teenager and so on.

This has been my journey, nothing special except it is mine.  I can share it or hide it.  Thank you for taking the time to read this.  I wrote it to make the words on this blog more effective.

My future is in prevention.  Treating problems after they are started and have progressed will always be needed.  I don’t want to be good at making the diagnosis, I want to be good at preventing the diagnosis.  I have done patient coaching for many years but without the benefit of formal training.  I am in the process of honing my skills and learning more about behavior modification.  I recently finished a Cooper Institute couse in coaching healthy behaviors.  I want to help more people do more of what they need to do and help them make it a want to do.  I hope my retirement will be filled with coaching opportunities.