When things between Pat and me got serious and she felt that I was about to pop the question, she warned me: “My patients are my first concern.” She elaborated: “It is not just that they take up most of my waking time, but they leave little unused emotional bandwidth.” I bravely responded that my life also kept me quite busy, that I liked to spend evenings and weekends writing, and that it was just dandy that we both had full lives and were not going to lean on each other excessively. In my heart of hearts, I believed that I would find a way to gain a bit more of Pat, and reminded myself that we both would retire before too long (we met late in life, after we both lost our partners), at a point in which we would have all the time together I craved and then some.
It took a bit longer than I expected, some twenty-five years to put a number on it. During those years, Pat lived up to her commitments. She chose to continue to practice medicine in Rockville, MD, where there are, in her words, “real people,” rather than in Foggy Bottom, the ritzy neighborhood we live, a choice that added a long commute to her long workday. A typical evening started with a report on travails of today’s drive home and then a discussion, which I found fascinating, of what Pat did that for various patients. It turned out that Pat’s idea of internal medicine was to take care of her patients — whatever their needs. She was just as likely to call the children of a patient, to tell them that their parent no longer was able to live on their own, or find a social worker to help a patient short of funds — as to call a specialist or arrange an MRI. Part of the evening was also dedicated to reading The New England Journal of Medicine, and to reviewing some recent medical texts. Then there were calls to colleagues when Pat wanted to hear what they thought might be the cause of a puzzling medical condition one of her patients faced. One night each week she fielded phones calls as she covered for her partners, as they did for her the rest of the week. Sometimes these calls led to a rush to the hospital to take care of a patient.
One the anecdotes Pat loves to regale our friends with, is that, as we got close, I asked her, “Where should we spend the summer?” As a professor, for me the period from the end May to September was a time to go to Aspen (first choice), Martha’s Vineyard (quite acceptable), or London (I am a theater addict). Pat responded, “We shall the spend summers in Rockville, MD,” where her practice is; she add “that, of course, we could take a week, maybe two here and there, to travel — but my patients do not take the summer off and neither do I”.
I tried to tell myself that the fact that I felt like I was her last priority was completely uncalled for. It was part of the deal I agreed to — and what she was doing was the Lord’s work. And we did find time to see a play, go out for dinner, hang out with our children and grandchildren, and visit with each other. However, all these times were always bracketed by the knowledge that duty might call at any moment. And my sense was that I should not lay what troubled me on a dedicated healer, who already had an overflowing cup of human travails. So I counted the years, then the months, and then the days until Pat would retire.
It took much longer than expected. Pat did not retire when she turned 65, 68, or 70. She was going full blast at 75. When Pat finally announced that she would retire, shortly before her 78 birthday, I was delighted — and worried sick. I was concerned about how she would deal with the many free hours and the sudden absence of scores of people who adored her (Pat was on a list of the most popular doctors in DC) and who thanked her profusely for saving their lives or at least keeping them from a horrible disease.
Pat signed up for classes on opera and music history at Georgetown, and on architecture at American University. These two-hour classes turned into full mornings, because Pat got her fellow auditors to have lunch together after the lessons. On Wednesdays, she rose before me, like in the old days, to join the weekly coffee klatch with a group of her friends. On Fridays, it was a trainer, whose “homework” she carried out faithfully at least three times each week at the gym. Sundays she went on five-mile hikes to the National Cathedral and back. (I could have tagged along — maybe for one mile, with my ten-years-older legs and a fraction of her willpower.) When Pat volunteered to participate in a medical experiment at a nearby hospital, I called her “my favorite guinea pig,” a term which may have revealed some displeasure. One day, Pat said she’d had an interview, and next I learned that she joined the board of the Village. (The Village seeks to help people “age in place”, by organizing volunteers who help the elderly and those otherwise challenged to visit doctors, go shopping, and find companionship.)
Pat agreed to make house calls once a week for a 102-year-old lady who no longer was able to leave her apartment in our high-rise. This was going to be a short-term commitment, Pat explained. The lady, God bless her, just turned 106! Once in a while we get a call that a neighbor has collapsed, and Pat rushes over to find that the neighbor was merely dehydrated and there is no need to call an ambulance. Another neighbor who feared she was having a heart attack, which Pat cured it by giving her some Maalox, for reflux. Following another recent call, Pat did accompany someone to the hospital because, as she put it, “I can better deal with ER docs”.
All this was eclipsed by Sheila and Bill (names modified). The scuttlebutt had it that Bill was back from the hospital, where he was treated for stage IV cancer, and that his wife Sheila, 92 years old, was having trouble coping. Pat decided to bring the couple some food and get other neighbors to take turns visiting and bringing meals. She took Sheila, who does not drive, shopping. In the process, Pat discovered that neither Sheila nor Bill had a will. Pat succeeded in convincing them of the merits of wills — and found a lawyer in the building who volunteered to draft them. Pat next was on the phone dealing with Social Security and arranging hospice services for Bill. When Sheila broke her hip, Pat was with her in the ER and visited her daily in the hospital, and went to check out the rehab unit Sheila was to move into next. Pat found home health workers, who took care of bedridden Bill, and she briefed family members who lived far away. When Bill died, Pat sat with the body, as others washed it. She took a picture of Bill to Sheila, who could not leave the hospital, and consoled her. At the same time, messages were flying among Pat, others who helped, and various professionals, as if our home was an AT&T switchboard.
We still go out for dinner, see a play or movie, and we travel more than we used to. I’d be lying if I said that I am fully okay with the seemingly endless flow of texts and calls, which cut into our conversations. However, how can one object to treating patients who are friends and neighbors? And I no longer need to worry about what Pat will do once she retires — or expect that I will have more of her for my selfish self.