Bucks Montgomery Physician Spring 2021 - 15

at night. But that does not make us any different to
Mothers and Fathers, Grandmas, and Grandpas.

enough, he will be present for the passing of most of
his long-standing and beloved patients. This is both a
blessing and a curse. It is a curse because it forces the
physician to accept failure over and over again. It also
brings us closer to the realization of our own aging and
the long-term consequences of our own mortality.

You see but this job you can say goodbye to. You
can eventually retire...but wow is it hard. When is
my brain too lazy, when are my service less than
quality, when are the hours or emotions too much?
It does happen. There is a point when you are not
serving the patient as much as you are serving your
own ego...but when and who will tell you?

It is a blessing because most of those you have cared
for through the years appreciate your presence as we
approach our last stage in live. Of course, there are
always those who do not accept their fate that will
blame you or look elsewhere for advice that is different,
searching for hope wherever they can find it. That
is understandable but unfortunately ends with both
patient and physician feeling abandoned and alone.

Your practice needs another body to work, to take call,
to help pay the bills. The community is kind to old
doctors. Your patients have aged with you and need
you as a friend as much as a physician. The standards
between doctor and patient change because the needs
of doctor and patient change. Some of these standards
have evolved nicely and others are a compromise of the
standards of medicine we hold dear as professionals.
But also some things a physician just does not understand
until he or she ages a bit. Boy, did being a father change my
perspective on the challenge of parenting. And aging has
changed my perspective on end of life issues. Seventy years
old is not near as old as I thought it was when I was 30.
I've learned that living with pain is ok, in fact for many it is
the norm. I've learned that solving all problems is neither
necessary nor possible. I've learned that sometimes we
all need a dose of reality to explain the problem before
us. I've learned that recognizing limits in ourselves and
our patients makes most relationships smoother and
for those that it does not that is ok. You can't please
everyone, but you can be honest with everyone. I've
learned that no matter how hard I try over time every
one of my patients will die and I will feel I have failed
them in some way where I could have been a better
servant. Mostly I have learned that being a servant not
a leader providing guidance, advise and occasionally
medications based on medical guidelines is one way I
can reconcile the strong desire to heal with the reality
that you can't far too often. As the old wise physician
from the TV series MASH Hawkeye Pierce said:

I solemnly pray that I will serve as long as I am able
knowing when I must step down. I pray my mind remains
sharp and my heart remains ever present until that time.
I also pray that when my time has come that it will be
obvious enough for me to step down in peace knowing
I leave a job well done. Finally, I pray that as I see my
patients age with such courage, some with a selfless
acceptance and peace, that I too can have even half their
courage knowing there are yet
many ways to serve in the
last stages of life.

" The first rule in medicine is patients die....the
second rule is doctors don't change the first rule. "
This is beginning to sound quite morbid and sad and
I most certainly do not feel that way, but one reality
of the aging physician is that if he hangs around long

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Bucks Montgomery Physician Spring 2021

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