Hektoen International

A Journal of Medical Humanities

Lonely physician

Dean Gianakos
Lynchburg, Virginia, United States

Photo by John Sorenson on Pexels

Jack wakes up early Sunday morning to walk along the Carolina shore. The sand feels cool under his bare feet. He passes a fisherman preparing flies for his pole. He stops to watch the brilliant orange sun rise over the horizon. The blue green ocean is still. Gently kicking the soft sand, Jack wonders what his staff and colleagues are doing right now.

This is the first day of his vacation. Except for a few long weekends here and there, Jack cannot remember the last time he took a true vacation. He works as a hospitalist at County Hospital in South Carolina. He loves his work. He loves his work so much that he frequently works extra shifts for his colleagues during his off weeks. He also likes the extra money. He left outpatient medicine twenty-two years ago to re-experience the rush of taking care of acutely ill patients and the intellectual challenge of diagnosing unusual problems.

Six months ago, Jack went through a painful divorce. Through the ordeal, he lost ten pounds and significant income. He still suffers from insomnia.

After receiving several patient complaints about Jack, the CEO of his group approached him about taking time off.

“I’m fine. I’m really fine, Sid.”

His words and tone of voice were not convincing. The dark circles under his eyes and flat affect told a different story.

“Seriously think about it, Jack. Your health and well-being are important and impact our patients and staff. I don’t want to make this mandatory, but I will if I have to. I am mandating that you make an appointment with our employee assistance program.”

Farther down the beach, a flock of seagulls congregates on the sand near the shoreline. There must be more than fifty gulls, preening their gray and white feathers. Jack pauses to watch them. Although he is only a few steps away, they ignore him and continue grooming.

Before he moves on, he spots a lone gull thirty yards away from the flock. His thoughts drift to the doctor’s lounge where he eats lunch alone at a table distant from his colleagues.

“I wonder whether that gull is as lonely as I am,” he muses.

Another hundred yards down the beach, he observes a man sitting in a beach chair surrounded by many gulls.

“Feeding breadcrumbs to all his feathered friends,” Jack laughs to himself.

The truth is, Jack has no friends, not even feathered ones. He lost connection with his best buddy, Phil, years ago. They were friends during residency. He cannot recall the point when work became the primary focus of his life. Practicing medicine can be addictive. The daily praise and gratitude from patients feed the fragile egos of physicians like Jack. Like other addictions, workaholism fractures relationships and isolates doctors. Jack’s ex-wife, Maureen, and his children can attest to this.

Jack strolls back to his condo. He wonders what he is going to do the rest of the day. He is glad he brought medical journals to read. On his balcony, he looks out to the blue pool below. He sits down to drink his coffee and read the morning paper on his phone. Fidgeting in his chair, he gets up to check out the pool.

On the way down the stairs, his phone rings.

“Jack? This is Mike K. from residency. Remember me? The hospital operator gave me your number when I told her I was a doctor.”

“Yes, sure I do, Mike. What a pleasant surprise to hear from you.”

“I’ve got some sad news, Jack. Phil T. has had a severe stroke. Maybe you already know this, he and I are partners in Boston. His wife, Sarah, asked me to call you. I know you and Phil were close during residency.”

“Yes, yes, we were. I’m really sorry to hear this, Mike. Thank you for calling. How is he doing now?”

“He’s had a hemorrhagic stroke and is not expected to survive.”

Jack hangs up the phone. He leaves the pool and heads back to the beach. He stares at the vast ocean and watches the seagulls fly overhead. Time has flown by.

At the funeral, he listens to the pastor recount the strength of Phil’s faith, family, and friends. After the service, he warmly greets Sarah in the reception line.

“I’m so sorry, Sarah,” he says with his arms around her and tears in his eyes. “An amazing man, an amazing doctor. I wish—”

“Say no more, Jack. I can tell you, Phil never forgot you and I know you never forgot Phil. Love and friendship transcend time.”

Jack squeezes her hand and moves down the receiving line. He connects with other physicians from his residency class. They share doctor stories and reminisce about the good old days. Jack learns that one of them practices in a nearby town in South Carolina.

“I had no idea you were in South Carolina, Thomas. We’re practically neighbors!”

“Yes, we really are, Jack. We should get together, have lunch sometime. Maybe play some golf.”

They exchange contact information before going their separate ways. In the parking lot, Jack watches a long line of cars leaving the funeral, headlights beaming.


DEAN GIANAKOS, MD, is Chief Academic Officer at Centra. As a general internist and former faculty member at Lynchburg Family Medicine Residency, he has taught residents and medical students for over 30 years. Dr. Gianakos frequently writes and lectures on the patient-physician relationship, emotional intelligence, and the medical humanities. He serves on the editorial board of The Pharos.

Spring 2024

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