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