In Praise Of Older Doctors: A Grateful Patient

By

Leonard Zwelling

Don’t let anyone kid you. No matter what you are able to do at 70, you are officially an older American. You’ve been on Medicare for five years. You’ve been getting cheaper movie tickets for eight to ten. You’re not sixteen any more and in case you have forgotten this fact something usually reminds you right about the time you step out of bed in the morning. Or stumble.

That being said, at 70, you probably depend on doctors a bit more than you did half a lifetime ago. It may not be true for you. It is true for me.

Today was one of those days. Hey, the golf course is closed on Monday. May as well visit the doctor.

One visit didn’t count. That was to MD Anderson to pick up my retuned and refurbished hearing aids. No doctor seen, just parking paid. The new parking system at TMC uses scanning technology that is highly variable in its functionality. Of course, it still takes ten minutes to park at Anderson because you are always behind a pick-up truck from Louisiana driven by someone who hasn’t been to Houston before and thinks by going up the ramps in the parking garage at 5 miles per hour a parking space capable of containing the oversized vehicle will magically appear. It does. On the eighth floor.

Visit one was to my neurosurgeon at Methodist. Yes, I have managed to acquire a neurosurgeon who has operated successfully on my back three times. I had limped off a golf course in San Diego a few weeks ago with a pain in my right back and leg similar to the one I had ten years before in my left back and leg that initially led me to my meeting with my neurosurgeon in operating rooms at Methodist in 2009, 2010, and 2011.

Since I had made the appointment, my pain had abated somewhat but appointments with this doctor are hard to get so I kept mine with the notion that he would provide me with his brutally honest assessment of where I stood back wise.

We talked and he did the unthinkable. He thoroughly examined me, assessed my gait and muscle strength and reflexes. I asked if I needed a new MRI.

He said, “I don’t treat MRIs, I treat patients and how they feel.”

I said, “ I was feeling better.”

He said, “you might wake up with the worst sciatica ever tomorrow morning, but for now, keep doing what you’re doing.”

In other words, this older doctor said that he was not even going to look for trouble. My kind of doctor.

Later that day, I took a strange toothache to my dentist. He looked at the x-rays he had taken two weeks before when I first presented with the pain and he had adjusted my bite occlusion. That had produced transient relief.

“You know that tooth had a root canal and crown already. I’d rather not fool with it. Let me check your bite again.”

Indeed the bite needed further adjustment.

In both cases experienced caregivers did less. They used their clinical judgment of the situation and of the patient (me) and knew that these were not emergencies and that the patient would tell me if things get worse.

This is my praise for these doctors. They know what they know and are comfortable with not knowing exactly what was going on because the price of finding out right now was too high and the payoff for doing so too low.

They don’t teach you that in medical school or dental school. A life in practice teaches you that.

In both cases I am the grateful patient, experienced with both men and trusting their judgment. I know that they are there for me if things get worse, but I am also confident in going forward knowing that time is the most valuable drug in both instances. What is crucial is that they know that, too.

That’s why I like older doctors. They have seen a lot. They have seen a lot go wrong. And they know when to allow nature to help them do the healing. These are great skills acquired over a lifetime of practice.

I have nothing against the younger crowd and some of my docs are under 40, but I am always reminded of what my teacher Dr. Eugene Stead taught me so long ago.

“When a doctor recommends surgery, I ask for an older doctor.” Dr. Stead was the consummate internist and there is an important role for surgery as I have recently noted in this space, but my experience this Monday was a lesson in restraint. And in great medical judgment.

Much thanks to my doctors. All of them. Grateful!

Leonard Zwelling