A Father's Day Tribute

Of all the people who knew my father though, I was the only one who experienced all the elements: doctor, teacher/colleague, father and dear friend.  Once I entered medical school, I was able to join him to see patients in his office across the street from Children’s Hospital—this private sanctum opened up for me as I entered his world.  With a patient’s permission, I stood quietly in the back of his exam room and was struck by how Dad would often start by rubbing a patient’s shoulders for a minute.  I thought this was a clue to some vital information.  “Why do you do that?” I asked.  “What do you learn from rubbing someone’s shoulders?”  “You help them relax” he answered.  Classic Dad.  Put someone at ease and they will trust you to care for their health and their lives.  He started his Boston medical career as an endocrinology fellow at the Brigham, and was still practicing there until he died.  

When I was an intern at the old Boston City Hospital in 1987, Dad would come over from his office, dressed in an elegant suit, smelling of after-shave and looking impeccable, his stethoscope in his pocket.  I was a wreck, wearing scrubs, exhausted and demoralized by caring for a service of drug-abusing AIDS patients.  But together we would round.  Dad was courteous and warm, shaking hands, asking questions and then demonstrating to me a fine point on the exam.  Who taught me about a palpable gall bladder—Whipple’s sign?  Dad.  Who demonstrated what happens to spinal reflexes with hyperthyroidism?  Dad.  Who taught me about splinter hemorrhages in endocarditis?  Dad, of course.  He was an absolute master of classical clinical medicine—not a finding escaped him.  But moreover, he listened so carefully to each of these demoralized people, many of whom would eventually die from the horrors of full-blown AIDS. Through him, I learned to listen, and to see each as a human being in pain.  And to be kind.  “There but for the grace of God” he would say. 

We would talk about patients and friends who had died but there was always a space around us—after all, we were physicians and we didn’t get sick.  So when his somewhat dormant lung cancer begun to act up seven years ago and then kicked into high gear, I was—amazingly—stunned to find that not even Dad could defy death.  Certainly, if you were looking for a fighter, you didn’t need to look any further than my father.  Four weeks short of his 80th birthday, still seeing patients and doing it with all his extraordinary skill and love, Dad fell on the tennis court and we found that the cancer had spread to the lining of his brain.  A valiant course of brain radiation powered by every ounce of stoicism and grit a human can possess weren’t enough; he died a month later.  When Dad was done, he was done and he died peacefully, surrounded by those who loved him.  No lingering odyssey filled with more pain.

But wait a minute.  I was left trying to figure out how this happened.  We don’t succumb to illness—that’s for our patients.  We take care of them, we treat them lovingly and carefully, but we somehow remain healthy.  Dad’s transformation from white-coat-wearing, stethoscope-wielding physician, sitting in his office, dispensing patient advice over the phone, making house calls and knowing the answer to every endocrine-related question I could ask into a frail patient was excruciating.  I remember the day I convinced him to let me push him in a wheelchair as we traveled a long path between two hospitals—I had to promise I wouldn’t tell anyone. Once he sat in that wheelchair, there was no going back. People began to talk to me instead of him, assuming that because he was so clearly a “patient”, he could no longer answer their questions.  He became fainter somehow, like the color and the life were being sucked out of him. But he was still Dad, impatient with poor service, annoyed at the waiting room televisions that showed George Bush talking about the surge, giving directions as I drove and voicing concern about the rest of the world.

When he died, it was like the world grew darker.  We had never become one of those “families dealing with cancer” even though that was precisely what we had been. There was no living with the kind of cancer Dad had; it was all about buying time and when the disease really got going, it wasn’t waiting for anyone or anything.  Dad, of course, knew this and I knew it too.  But the feelings, the hopes, the wishes: maybe he’ll be the one to beat the statistics, maybe the radiation will knock off each malignant cell, maybe a miracle will happen.  How many times had Dad—and I—heard those statements from patients?  How many times had we tried our best to be compassionate and honest and straight-forward, caring for people as they died and grieving with their families? Physicians are healers. We hold our patients through whatever they endure and we do our absolute best to give them the best of care. Truly though, I am finding that it is all about a sentiment that I think comes from Native American lore: You don’t really know a man’s life until you walk two moons in his moccasins.  For every patient I have cared for in death,  for every friend I have commiserated with over a loss, for every family member with whom I have mourned, I didn’t know what death really was until my own father died.  And the loss is more profound and painful than I ever imagined.

So here it is, nearly seven years later.  I think about Dad every day. I see some of the patients he had referred to me, and we talk about him at the start of their appointments.  I still pick up the phone to call him with an endocrinology question before I remember that I can’t.  His number is programmed into my cell phone; I can’t bear to delete it. I listen to the music he loved. Each day, I listen to patient’s hearts through his stethoscope.