Mystic, Connecticut, USA
Earlier in the week the last patients were seen, their records given to them or sent to their new physicians, and the final farewells were said. The movers have left, and the office is now empty except for an old cast-iron medicine cabinet, a pencil sharpener attached to the wall, two empty filing cabinets, some pills on a shelf left by a pharmaceutical representative, a stethoscope and a white coat dangling from a hook behind the door, and a calendar showing the month of June 1993.
I glance around the almost vacant office and in my mind’s eye see Rose, my able secretary and receptionist, talking to a patient. Is that Joan Murphy with a thin plastic tube running from her nose to the portable oxygen unit at her side? Or Sara Edmunds describing her chest pains in her pronounced English accent, or ninety-two-year-old Angela Zepponi, with a bulge beneath her collar bone where the battery for her pacemaker is implanted? Or is it Mark, a heart transplant recipient, or Jim, a survivor of a Blalock-Taussig shunt operation for tetralogy of Fallot done many years earlier? Or Phil Wesley whose prosthetic aortic heart valve could occasionally be heard clicking as he entered the room? I had come to know them all well, them and many others, their hearts and their lives. The images blur; perhaps there is something in my eyes.
I have so many memories from my patients lives: sharing the sadness of families when attending wakes and funeral services in places of worship or at the gravesides of patients who had died, or on happier occasions being a guest at weddings or celebrations of patients and their families. I always enjoyed cups of tea, coffee, or a glass of homemade wine with patients before leaving a house call and appreciated gifts of strawberries, blueberries, cauliflowers, squash, or tomatoes grown and picked by patients who brought them to my office or home. I corresponded regularly for many years with a patient whom I had once resuscitated from a cardiac arrest and who had since moved to another state. I remember bringing a very sick patient in an ambulance one wintry evening to a hospital a hundred miles away for an emergency operation on a ruptured heart, and recall sleeping in the coronary care unit several nights in a row in order to be readily available for a patient (and friend) during the early stages of his heart attack. In all these years much was seen and learned from these experiences that no textbook or medical school could have taught me. It was from such experiences that I discovered how to truly care for patients and to become the kind of doctor I had hoped to be when I entered medical school.
It is time to go. I retrieve my stethoscope and white coat and leave the office, locking the door behind me for the last time and taking with me memories and stories of my patients. These were their gifts to me, memories and stories, still as precious and as unforgettable now as they were then, many years ago. I am indeed a fortunate man.
MARTIN DUKE, MD, FACP, was a 1954 graduate of the New York University School of Medicine. Following a tour of duty in the army, residencies in medicine and pathology, and a fellowship in cardiology, he was in private practice in cardiology in Manchester, Connecticut from 1963-1993. During this time, he served as director of Medical Education and chief of Cardiology at the Manchester Memorial Hospital and held a teaching position at the University of Connecticut School of Medicine. He is the author of two books and over 100 articles on medical topics. Since retiring from medical practice, he continues to write for and be on the editorial board of Connecticut Medicine, the state medical journal.