by carlocmd

An elderly aunt came to the clinic today. She had wanted an opinion on her stomach troubles, but could not ask in front of other family members during our get-togethers. Therefore, on Monday morning, as the clinic opened, she was there.

After the short pleasantries, we got down to the clinical evaluation. It turned out that her symptoms were minor, and worrying about their occurrences kept her up at night. We spoke at length about how each of her symptoms came about. When we finished our conversation and completed the jigsaw puzzle of her medical condition, understanding dawned on her face. She was at peace.

“Thank you,” she said. “Knowing what ails me made me feel better.”

I got ready to see the next patient.

I heard a commotion outside. My aunt came back in the room.

“Your secretary would not charge me for the visit,” she said. “This is no way to run a business. It is the first day of the week, the first day of the month, and I am your first customer. In business, the first money to come in is lucky money. You should not turn away good luck!” she explained.

Tita,” I fondly told her, “what I do is not a business.”

I know what you’re about to say — that we should be running our clinics like businesses. There are business books that teach you the principles of business and their application to health care. There are several of these books on my shelf right now, and I gaze at them, seeing through the eyes of a clinician, trying to separate the grain from the chaff, applying what is consistent with my personal beliefs and ethics, and disregarding the rest (Lucky money? Superstition. Um, not here, not me.)

It is tiring work, this reading and sorting. It seems we doctors must never stop learning.

Sometimes, though, I long for the purity of the profession of medicine. Her coming here, the dialogue, and the beginning of her healing… isn’t that reward itself?