Nov 1, 2010

My Favorite Patient Died Today

I just got a call from one of his relatives who found my number in his wallet:

“The Dude” was one of Doctor D’s first patients. He was assigned me when I was a new doc starting out in residency.

The Dude was one of those people that we all go into medicine to “help.” He was poor, and on disability, and had never gone any further than high school. The Dude also weighed about 400 pounds and smoked 4 packs a day, and he hated taking medicine ...and it was new Doctor D’s job to “take care of him.”

Medically speaking, I never was much good for The Dude. He kept doing all the things that eventually lead to his demise. In the end though, it was he that did me immeasurable good.

He actually preferred residents to our better-trained teachers, “I love these new Baby Docs when they come each year!” he exclaimed when he met Doctor D. From then on Dr. D and the Dude were always together. The Dude had a lot of office visits and hospitalizations. He was the epitome of the “difficult patient” and D spent his first year as a doctor stressing about how to save The Dude from impending death.

But it was The Dude who won out. His infectious kindness and joy in the face of pain and illness inoculated Doctor D against the harsh medical world around us.
One day D visited The Dude in the ICU and muttered, “How am I going to save you, Dude?”

The Dude let out a gravelly, smokey chuckle, “You don’t need to save me Doctor D! You’re just nice to me and I appreciate that.”
The Dude is laid to rest

Our doctor-patient relationship evolved over our years together. I did less telling him what to do and more sitting at the feet of one of the wisest human beings I have ever known. The Dude lacked any book smarts, but I know he was brilliant. He understood how a joyful attitude can keep you alive when every textbook says you should have died years ago.

The Dude had about the most unhealthy body and physical habits you can imagine, but he had the healthiest soul of any person I have ever met. He taught Doctor D that there is so much more to life than diagnoses and treatments.

The Dude promised he would try to stay alive long enough to see me graduate from my residency. He ended up outliving his promise by years. I moved to another state after graduation, but we stayed in touch. I was no longer his doctor, but we remained friends.

I took my son Little D on a road trip when he was just a baby to meet my sage friend. It was well worth exposing the kid to a little second-hand smoke. It was like taking your child to be blessed by a living saint.

The Dude and I would write or talk on the phone every couple of months. I started this blog with The Dude in mind. I wanted to answer questions for real folks like him that didn’t give a damn about medical stuff, but found themselves stuck in doctors offices and hospitals anyway. He's the only patient I ever cared for in real life who knew about my secret identity as Doctor D. He read regularly.

We last spoke about 6 months ago. I had “Call The Dude” on my long list of things to do last month, but I never got around to it. I sure wish I’d called my jolly, smokey old friend!

It came as a shock that he's dead—which is strange considering I expected him to die at any moment for the first few years I knew him, but once you really love someone you kind of expect them to live on forever.
Now The Dude is in a place where he has no need for doctors or medicines.

Enjoy heaven, my friend! I wish I'd told you that you were the best teacher Doctor D ever had!


Wren said...

It's absolutely lovely that you were able to have such a joyful friendship with The Dude, even as you struggled to save him from himself. I get the feeling, Dr. D, that you did him more good as a kind, understanding and compassionate friend than you'd ever have been able to do him as his doctor. Thank you for telling this story; you've made me smile even as I join you in grieving your dear friend. Be well.

C said...

This is such a touching story- one of the reasons I wanted to go to medical
School in the first place. I hope I'm lucky enough to one day have a patient or 2 i develop a relationship with. I'm sorry for your loss.

DrSnit said...

I am so sorry to hear about the death of your friend. All life is precious and beautiful. I'm so glad you could see your smoky jolly friend and share his life with us.

Sending Snit style love Doctor D!

Anonymous said...

Lovely post. Sorry to hear about the death of one of your first patients. What a great, candid post into one of the many unique doctor/patient relationships you have. I appreciated your insight.

Anonymous said...

A nice post....just nice....I loved it.

Drew said...

Touching, down-to-earth, and very frank story. I'm sorry for your loss, not that saying that makes it any easier....

Anonymous said...

May The Dude rest in medical peace, and may his soul live on in your heart.

Anonymous said...

You really “saw” Mr. Smoker Dude, really appreciated him, and I think he appreciated you at a deep level too, Doctor D. That is the most wonderful sort of doctor-patient relationship, when each person finds a way to take in and truly enjoy the endlessly complex nature of the other. So many factors inhibit this from happening in the typical medical encounter, but you show how beautiful it can be.

Kyla said...

Sounds like you two were a gift to each other. Connections like that aren't easy to come by. I'm sorry for your loss.

Maha said...

I'm so sorry Dr D :(

Albinoblackbear said...

It's patients like that who make working in health care worth it.

You both recognized something in each other that was special, and that is the most amazing connection one can have with a patient.

I'm sorry for your loss.

Old MD Girl said...

What a touching post! I'm sorry for your loss, Dr. D.

tracy said...

Just a lovely post, Dr. D. You are exactly the kind of doctor i would like to have. i admire your compassion so very much.

i am so sorry for your loss.

101Md said...

I think I've learned more about the doctor-patient relationship by reading through some of your archived posts than I have in the past year and a half of med school! Thanks for sharing, and I'm sorry for you loss.

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