A toast to my patients

His wife thinks he looks like Tom Cruise.  There is a resemblance, I can see him riding a motorcycle off the side of a burning building, jaw fixed, eyes on fire, ready to save the damsel … only he is not so short.  Funny, brilliant and genuine, we have known each other for exactly two decades, sharing the growth of our families, the anxieties of middle age, and the vicissitudes of life.  He is direct, aggressive, articulate, but considerate, honest and giving; the classic gentleman.  He is my teacher. He is my friend. He is my patient.

Today, honoring those 20 years, we drank a toast.  A single shot of Jim Beam, from plastic cups.  We raised our glasses, not just to his survival against the dread disease, but we remembered, pondered and relished the time we have had together.

A 52-year-old patient of mine died.  Her life ended, among family and friends, after a brutal struggle against an unrelenting cancer. She was an incredible person, which could not be diminished by the disease which punished her body.  There was purity to her, a gentle maturity and understanding that transcended daily events and rose above her struggle.  Joyous, giving, funny and creative she taught how wonderful life can be and how precious the time we have together.  She gave me hope, courage, friendship and added a special spark to life.  Though I am glad she is no longer in pain, I miss her deeply.

It is hard to cross that line, patient versus doctor.  The therapeutic relationship demands distance.  However, some of the most important moments happen, when the line blurs.  Recently, my wife and I shared the hospitality, warmth and teaching of a patient of mine, celebrating Passover Seder.  She, and her family, took us into their home for a perfect night of prayer, song, wine, food and laughter.  They trusted us with some of the most important moments in the year.   A powerful, passionate, loving and stubborn woman, whose focus in fighting cancer has inspired my staff and I for years, she welcomed us into the intimacy of her family, and touched our hearts.

Every high school, college and medical school student, every intern, resident and fellow, every junior or senior attending, hears these days, “Why in the world do you want to be a doctor?’  The cost, years, and sacrifice. The loss of youth. The fading prestige. The nights worked while children grow up.  Penny-pinching insurance companies, pitiless lawyers, ponderous administrators, pesky vendors, pestering drug reps, angry patients and mounds of paperwork.   Grueling, lonely, exhausting and unforgiving, the money you make pays for massive loans.  It is not worth it.

You know what I say to every high school, college, medical student, intern, resident, and fellow? There is no better career, no more remarkable experience, nothing better that you can do with your life, than to be a doctor.

If you give yourself to this remarkable vocation, risk not just your body, time and mind, but your soul, then you will find a glimpse of the kaleidoscope of life, a deeper understanding of man and small insights into the incredible people who trust their care to you.  For moments, you will touch the divine.

I raise a glass.   I raise a glass to every patient that has honored me with their health, life and dreams.  Those who teach hope, strength, beauty, healing, and the battle of life.   May you live long, live well, laugh, learn, love and find peace at journey’s end.  I thank you, because no matter how much I try, no matter how much I give, I can never repay all you have given me.

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

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