“The Heart of a Doctor”

Friday, March 19, 2010

As I was going through my morning routine, there were several revelations that occurred to me. First, I realized that I hadn’t blogged in a long time and the year was getting away from me. It isn’t that life has been uneventful; on the contrary, life has been rich. There hasn’t been any real change since the last time I wrote to you. However, this morning was different.

I finally realized the answer to a question that has been bothering me since I graduated and started my practice. Why are all the patients going to the guys that went to school before I was born? I am at the top of my class, don’t they know that!

When you graduate with a doctorate in your field, at the top of your class, from one of the best schools, you are more than well prepared to practice at the highest level. I was 25 but I looked 19. I think I started to shave at the age of 22 so that gives you an idea how young I looked. I was close to 250,000 dollars in debt with school loans and equipment cost. My first office was 800 sq ft with one chair and a fish tank that I maintained. I think I had 4 patients my first week of business and two of those were my parents. There was no way I could buy a practice full of patients so I just did it the old fashion way and hung out a shingle.

Way in debt with an overhead and a baby girl there was no time to not be making money. I did side jobs to pay the rent and answered my own phone. There was urgency with every call and walk-in patient. These things were not taught to me in school. Some patients would walkout saying, “You are too young to be a doctor.” I couldn’t believe that all the patients out there were going to these doctors that hadn’t opened a text book in thirty years and I was starving.

This morning I realized that really only one thing has changed in thirty years of practice. Sure, there are new materials and techniques but the application is still the same. People and their problems haven’t changed. Really the only thing that’s different is me. I have evolved into the very guy that was the enigma and subject of that age old question. I know now why people gravitate to the doctor that has been treating patients in the same place for a long time. It is not necessarily because they are so much better at what they do. It is because they feel the heart of the doctor.

I am so grateful everyday that I get to wake up early and get ready to see my first patient. Not because I am starving, but because of the opportunity to help someone with their problems in a way that only I can help. I am starting to work on the fourth generation in some families. As a doctor you share the joys and the burdens of life with your patients. You take ownership in the children’s children. You share the tears of disappointment as well as those in celebration. The heart of a doctor matures with each year that you make it because your patients love and support you. This level of maturity generates a level of responsibility for each person you treat that is beyond description.

You figure out how to fix the problem in hard times so that when things get better you can do it right. You genuinely look forward to seeing your ‘friends’ on a daily basis and spend time catching up from their last visit. I find myself excited about my continuing education classes because it will make me better at what I do. That sense of urgency of the 25 year old doctor is still there but different. Now, that feeling is the joy of being able to work for my patients. There is an urgent desire to always do the right thing. The work must be perfect or you just do it over and make it right. Not because someone is watching but because this is your patient, your friend. You love them and you love what you do. That just takes time.

I thank God for this morning’s understanding of the doctors’ heart. I am a lucky man for many reasons. One of which is the fact that I have had the privilege and opportunity to make a living doing what I love. I don’t know many people that can say that. Thank you for giving me these years. I promise to keep getting better and appreciate every year that I am able to serve you. I finally genuinely have a doctor’s heart.

Perfect Eyes …

October 20, 2009

This afternoon I was buzzed to the hygiene room only to find my dear patients of 28 years Rosalie and John. They have always made their cleanings on the same day. As a matter of fact, in 28 years I have never seen them apart. They are very special patients as they are a part of the population of patients that have been married over sixty years…and they are still mad about each other. Their story is one for the movies. John is a good looking Italian that fought in WWII and Korea. I can tell that Rosalie was a real looker at the age of 19 because she is still a beautiful women. On Monday, Rosalie will be 90. I love this generation. Over the years this group of patients have raised me without even knowing.

I am a very happily married man and I attribute a part of my successful marriage to the privilege of knowing patients like Rosalie and John. Over the years we have gone through serious illnesses, hip replacements, the loss of a child, and now facing a 40 year old niece with a terminal diagnosis, just to mention a few. We have shared recipes, grown basil together, competed in sauce production and debated the difference between species of mushrooms. They have held me up when I was down and celebrated the birth of my child. Rosalie never leaves the office without asking me about my family in detail. I remember John always kidding about turning Rosalie in for two younger girls and Rosalie would lovingly slap his arm and tell him to get in the car. They are inseparable… there is no John or Rosalie …only Rosalie and John. That is just the way it is…no option. Some have the privilege of seeing this in their own family. I would guess that the percentage of people my age or younger that are exposed to this unique relationship is very low. Way below ten percent.

I have my profession to thank for this observation because I see this all the time. A large percentage of my practice is made up of this population. What a rich blessing and opportunity for me. It is a bitter sweet however. At the age of 90 I have to expect that I will lose either Rosalie or John. The loss is very hard, but the pain of watching the survivor trying to cope with half a life goes on for several years. I know that it is just a matter of time before I get that phone call that breaks my heart and leaves me with nothing to say. When one dies, something dies inside the other. This might sound weird but I pray for that much love in my marriage. To be so connected, so “in love”, that their absence tears your heart. Marriage is hard. It certainly is a process and an institution that takes many years to perfect.

I see the perfection in the eyes of the survivor every time they come in for a checkup or care. The eyes that cry out for their other half. The eyes associated with loneliness and the rapid degeneration of the soul. I wonder if Rosalie and John realize how good they have it while they are both here? As I watched Rosalie carefully get out of the chair and navigate across the room I thought of the many years that she would bounce out of the room giving John instruction for the next visit. I love them. Not just for their friendship, but for the many lessons of life they have shared with me over the years.

These are the days that I go home and hug my wife wondering if it is possible for us to understand ‘perfect eyes’ at 22 years of marriage. To appreciate each other for what we will become instead of what we are. I think ‘perfect eyes’ can be realized at any stage of marriage if you are privileged enough to be exposed to it somehow. This is why you get married and fight for longevity. I am a lucky man to have been even a small part of John and Rosalie’s life. We all need to look around for other Rosalie and John’s and glean from their achievement.

Are You Kidding Me !!!

October 19, 2009
Today we got the results from this weekend’s college football pool. Stacy (who is known as Clueless in the pool due to the lack of football knowledge of any kind) SLAUTERED Tami and I for the 6th week in a row. Now she is in the top ten out of almost three hundred real football fans! Of course I am still way ahead of Tami, which is all that really matters :) But this is absolutely insane.
We put Stacey in the pool as kind of a joke. I thought that it would give us something to talk about while we were working. Last week I wanted to see how she was making her picks because it just didn’t make any sense that she was doing so well. So when it was time to pick her teams for this week, I went up front and asked if I could do it with her. She shyly looked at Tami and whispered in Tami’s ear. I asked what was up…I just want to see how you pick your teams. Tami started to laugh and said that Stacey didn’t want to pick with me helping because she didn’t want me to copy her picks!!! ARE YOU KIDDING ME !!! What an insult !!!
I take great pride in reading all the stats and really deliberate over my picks. Stacey only watches a football game if it is playing in the sports bar while she is out and about. Even then, she will always ask what color the team is wearing so she can at least root for her pick. But she is killing all of us in the pool. So I pressed the issue. Tami handed me the list of games and I started giving the teams with the point spreads.
Stacey looked at me really funny and Tami stopped me and said, “You don’t understand. Stacey doesn’t care who is playing whom or even understand what a point spread is…she just wants you to name all the teams randomly!!! ARE YOU KIDDING ME !!! So I started randomly calling out names and Stacey would stop me every so often and say, “Minnesota and Navy”. I asked why and she said, “I don’t know…the winners just come to me as she points to the air.” ARE YOU KIDDING ME !!! I was sure that I was going to beat her this week. Especially considering her method. So …I have decided to throw all stats in the trash and pick teams out of a hat filled with all the teams names and see if this week I can come close…LOL UNBELIEVABLE !!!

Changed Life!

October 6, 2009

Wednesday, February 20, 2008. It was a busy day and had just ended my day with an implant consultation. I sat at my desk and pulled up the patients chart and x-rays. I usually glance at the scan prior to looking over the health history to get an idea of the patients general health. There were five teeth in the front of the upper and four teeth on the lower with three molars randomly dispersed. Most of the teeth that remained were badly broken down with marginal dentistry that was not completed. I was shocked to find that this were the x-rays of a 28 year old young man. I immediately thought about all that this young adult must have gone through for his mouth to be in this condition. That is a sad realization for a father of three. The health history was unremarkable. My curiosity got the better of me so I grabbed up my loops and proceeded to the operatory where the staff had seated this young man.

As I walked into the room there was a nice looking young man that was well dressed and sitting in the chair with both hands folded on his lap. He was gazing down at his hands which were white from squeezing them so tight. I positioned myself in front of him and introduced myself and at that point he slowly turned his head and with a quiet stutter mumbled something that sounded like he was horrified and embarrased. I immediately backed off and sat down in the chair in front of him and quietly said, "I'm looking forward to helping you...my name is Gary." He looked at me for the first time and with the same quiet broken stutter. He stated that he would like to know how much it would cost for implants. He didn’t smile at all. Most of the time we talked about his mouth he looked at the ground. He Was very introverted and possibly abused by another doctor. My heart immediately broke for this young man. His dental condition had converted a wonderful young life into a broken old man that was ashamed to interact with people.

I spent two hours explaining all that could be done and how long it would take to finish the work properly. By the end of the consultation he still had his stutter but seemed excited about the potential. Then we had to talk finances. I knew that all the major reconstruction necessary would be a financial burden for anyone, much less a 28 year old that was 'on his own' since the age of 15. We decided that we could start on the upper teeth and go from there.

Now it is Tuesday October 6, 2009. I haven't seen this young man since his last cleaning six months ago. That's right, we finished all his dentistry one year later in February of 09. This young man is an intelligent, hard working and responsible man that we all accepted as family after working with him for several months. I have no idea how he was able to finance such expensive dentistry but it was perfect. Every aspect of this case was to utter perfection. When he walks into our office now he is smiling from ear to ear. His speech is definite and commanding without the hint of a stutter. I told him today kiddingly that he is just too happy. As I performed a minor procedure on one of his teeth that we had been watching, I asked him what he was up to. He simply said, while laughing, “My life is great! I didn’t realize that I never smiled before. All my pictures before I had my teeth done, showed that I was forcing my mouth closed to avoid embarrassment.” He went on to say, “Now all the pictures of me show me as a happy guy that can’t stop smiling. I go out a lot. I love my new life!”

I finished the procedure and told him that he looked great and stepped into my office. I couldn’t help but think how lucky I am to be in a profession that I love so much.

A profession that does more than fix teeth or reconstruct smiles. This case is just one example of many that I have had the privilege to see through to the end over the last thirty years. There are no words to describe the feelings that are running through me as I reflect on the other side of this case. What a rich and rewarding profession. I am a lucky man. This is why I love what I do.

College Football Pool Joke!!

October 1, 2009

Today is College Football Pool Day and Tami, Stacey and I have to get our picks done before five. This year is too funny! Tami is a sports nut and really fun to talk to about the games and the season. This year we decided that it would be fun to get Stacey involved so I would have someone to talk to chair-side about the games. There is one problem; Stacey knows absolutely nothing about football!! As a matter of fact Stacey’s name in the pool is Clueless.

We are into week four and the office joke is that Stacey is winning the pool. Not just beating us but killing us. This is a very big deal because Tami and I are so competitive. So we decided to ask Stacey for advice regarding the USC vs Cal game this weekend.

When I asked her who she thought would win the USC/Cal game this Saturday she very smugly said, “Sure no problem. Who are they playing?” Tami and I laughed so hard we just sat there and cried… Too Funny!!

Not your typical dental appointment…but so very much better!

September 30, 2009
As I locked the drug cabinet and set the alarm, I had to stop and reflect on this day in particular. One of my dear patients, of over twenty years was diagnosed with pancreatic cancer in July and today she was in for a cleaning. Her loving husband had asked me at his last appointment if a cleaning appointment would be possible for his wife considering all the medications that she was now taking. I told him that I would love to see her and that it would be good for her spirits.
The office was buzzing with anticipation and a bit of anxiety as we waited to confront this beast that had inflicted our friend. I must admit, that in all the years that I have known this patient, she is the last person that I would think would be inflicted with this monster. She was extremely healthy with very little medical history. Love to exercise eat well and extremely active in her successful business all while maintaining a beautiful marriage and family of over thirty years.
The news that she was diagnosed with cancer was more than a shock to my whole being. I remember just sitting at my desk with tears in my eyes thinking about the dream house she and her husband had been talking about building in Santa Barbara when they retired this next year. I couldn’t suppress the thoughts of what my friend would have to face as she began the
treatment associated with fighting this monster.
Earlier that morning I was called into the hygiene bay to check one of the hygienists recalls. It was one of the kids that had grown up in the practice and was now an MD working at Cedars. He looked in excellent shape with good color and eyes that were alive and bright. I say this because it was only four years ago that this young physician was diagnosed with terminal brain cancer and given six months to a year to live. Today, he is in total remission.
This gave me an opportunity to encourage my patient facing pancreatic cancer. I told her that I just checked the teeth of a young physician that was diagnosed four years ago with a brain tumor and given six months to a year to live. This was at the beginning of his life and career. I told her
that he was now working and received a diagnosis of complete remission. I watched as new strength was infused in her eyes. She sat up in the chair with a proud demeanor and explained to me that we just don’t know do we. We talked about the new sense of joy she has at every ncounter with her loved ones regardless of how small. The reality of what it means to live in the moment. How silly it is to worry about things that haven’t happened or that we have no control over.
As she described these new found realities, I couldn’t help but access my own life and person. It taught me the value of taking the time to visit and listen to everything that is being said. I
felt this overwhelming peace come over me that relaxed my soul. At that moment we both began to cry with smiles on our face. I gave her a hug and held it for a while. As we parted I smiled and while wiping tears from my face I said that I would see her at her next cleaning and that she didn’t have any decay. She hesitated, smiled and said she will see me in six months.
Not your typical dental appointment…but so very much better.
by Dr. Gary O’Brien