Dr. Peter Temple

       

        It was a sad weekend in that it marked the passing of my med school friend, professor, and mentor, Dr. Peter Temple. Still, there was hope. His receiving of friends, as one might expect, was a big party that showed how many people he influenced. Not only does he leave behind a wonderful nuclear family, but many folks like me whose lives were enriched by him. Dr. Temple showed me how to be a doc but still enjoy life; he perfected the art.

       The celebration of his life was friends and food and drink and music. Kids ran through the yard, splashed in a puddle, played with some new puppies, and climbed the cedar trees around the house. In addition to ham sandwiches and fruit and cheese there was sushi and edamame and chocolate cake and of course bluegrass on the front porch. Folks there included guys like George on the banjo, who played with Peter and Junior and Greek in the Tar River Boys back when I was in med school. We played standards out of Temple’s set list; numbers like “I Wonder How the old Folks are at Home, and “I’m Using my Bible For a Road Map.” My daughter had to pull up the lyrics for it on her cell phone, but we honored his request that we do “You Go To Your Church and I’ll Go To Mine,” one that I had promised him years ago I would play for him whenever the time came.    

         I was sad to see him pass, but glad he has no more suffering. One thing is certain; there will never be another one like him.

Dr. B

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The Smithsonian Exhibit/The Don Gibson Theater/A Gig With Darin Aldridge

        Harvey County is small, the kind of place where City Hall is in the back of the Dairy Queen, and our only fancy restaurant is the Magnolia for Sunday lunch after church. In all my days, I have never seen the likes of what’s cooking over in Cleveland County, the home of Don Gibson and Earl Scruggs. Two famous people and both from the same county. Here in Harvey County we’ve never had anyone famous I know of, except one time back in the black and white T.V days my aunt was on “The Price is Right.” She won some nice patio furniture and almost got the new car.

        Cleveland County is a different matter. They’ve got it going on. It’s big enough that they have a Smithsonian educational exhibit on traditional music there. It came to the attention of music scholar and U.N.C. Chapel Hill Professor William R. Ferris who came and gave a speech at the ribbon cutting. He said to mark his words; in just a few short years the world was gonna beat a path to Cleveland County, Shelby, N.C. just as sure as pilgrims to Mecca ’cause it is one of the birthplaces of traditional music as we know it.

         That sounded like something I wanted to be a part of, so when Darin Aldridge called and asked if I wanted to sit in with him on my day off for a gig, I said “yes” right away. Darin and Brooke Aldridge are at #5 on the “Bluegrass Unlimited” hit parade this month and have made #1 on some of the gospel charts this year. Check out their website: wwwdarinandbrookealdridge.com.

        I had to ask. “Hey Darin, I heard the Gibson stage was for professionals only.”

        “You’ve sold some books haven’t you?”

        “Sure.”

        “Then you’re a professional artist. Don’t worry, I’ll get you in.”

        “Cool.”

         I showed up at the back door, and was greeted by a dapper man in a tweed coat. His name was Stan.

        “You Dr. Bibey?” he asked.

        “Yes sir.”

        “Where’s your hat?”

        “The wind kept blowing it off. I left it at home.”

         He looked in my eyes. “Hm. One blue, one green; it is you.”

        “Yep.”

        We shook hands.

        “Mr. Aldridge is waiting on you. Artist lounge.”

        Can y’all imagine that? Some old country doctor jamming with the pros at the Don Gibson theater. Lord, where is my mandolin gonna take me next?

        I found Darin warming up on the Bill Monroe number “Jerusalem Ridge.” I was as excited as a large child. “Let me get my mandolin out. Whadda you think we ought to play for ’em?”

       Darin smiled. He reached in the refrigerator and got me a Co-Cola. “They’re just little people. They’ll like the same songs we do.” 

       First we played an IBMA film clip of Sierra Hull and Ryan Holliday. Darin thought they would identify with them because they were so young. He was right. Sierra and Ryan played some tunes and explained about the roots of the music and how it came from across the pond. We put the video on pause and played some old Carter Family tunes to demonstrate.

       The second segment of the film was on bluegrass, and had some old footage of Bill Monroe and Earl Scruggs. We played “Reuben,” which was the first three finger banjo tune Earl figured out years ago, and then “Foggy Mountain Breakdown,” the theme song for Bonnie and Clyde. Back when T.V. came to Harvey County we used to watch Earl on the Beverly Hillbillies show, and we played a line from that one too.

        I wanted to be certain they understood the significance of their heritage. “Y’all are from Shelby, the home of Don Gibson and Earl Scruggs. Be proud of that and never forget it.”‘

        We had time for questions. I played mandolin for most of the gig, but guitar on FMB. One asked, “Why did you learn the guitar?”

        “To meet girls,” I said. The child scratched his head. I could tell he was confused. “That was a long time ago,” I explained. “After I met my wife I took up the mandolin. Didn’t need to meet any more girls after that.” 

        Darin laughed. “Way back then his folks were afraid he was gonna run off and turn into one of ‘dem Beatles.” (Lots of young people learned the Beatles repertoire from my old LP collection; they were long since disbanded when Darin came along.)

        At one time or another, we had played guitar, mandolin, banjo and fiddle. The kids looked at all the instruments on the stage. “Which one is the hardest to play? one asked.

        Darin allowed as to he thought it was the fiddle. He picked it back up and broke into Sally Goodin. One of them wondered if I’d play the fiddle. I declined. I wanted to be asked back someday, so I didn’t push my luck. Sometimes I play it when no one else is home, and the family dog always howls and runs for cover. In bluegrass they call it rough style.

        It was a fun gig, and Darin said he’d come help me do my talk at the Rotary Club. Tomorrow I’ll be back at my day job; prostate exams, PSAs, and prayers I don’t ever overlook a cancer. That’s what I do, and I’m pretty good at it I guess, as I’ve stayed out of trouble for many decades. More important I try hard to the point of being driven to migraines at times. If I miss a diagnosis, it won’t be because I don’t care.

       But that’s tomorrow. For today old Doc gigged with the pros, and how many country doctors can say that?

        Friday I’m gonna go back to the Don Gibson theater. Now that I’m a performing artist there, I feel more at home than ever. Earl Scruggs will be at The Don Gibson Theater with his boys Gary and Randy. It’s already sold out, but I’ll tell you all about it soon.   

        Back to the salt mines.

Dr. B

Better Than I Deserve

        A friend of mine died a few months back. He was such a cool guy. Whenever anyone asked “How are you?” he always said, “Better than I deserve,” and smiled.

       I feel the same way. I started a blog in 2007 to learn to try to learn how to write. I had no idea where the journey would lead. The best thing to come out of it was new friends. Ted and Irene Lehmann were the first ones, and I soon found out they were true bluegrass. Ted writes one of the biggest independent bluegrass blogs around. They have become fast friends and we see them at most of the festivals we go to.

        Ted wrote up a post on “The Mandolin Case” and the “Journey of The People’s Mandolin.” I was touched by his kindness. Y’all go over and check him out at www.tedlehmann.blogspot.com. As my old friend would say, “it’s better than what I deserve.”

         Y’all remember Julius? He graduates today, and old Doc here is “”Professor for a Day” and will hood him in the ceremony. I’ll bet it ain’t every day a mandolin picking country doctor gets the honor. I was his community med mentor, and he said my rotation was his favorite. Hm. Maybe it was those jam session at the Bomb Shelter, or perhaps it was “Temple’s Law,” but whatever the reason I am honored.

        I wish I could tell you I’m the next Twain, but I am obligated to write the truth, so just me will have to do. But look at it like this. How many books do you have on your shelf by a physician bluegrass fiction writer who is also a Professor of Medicine for a day? It’s like a chance to get in on batting practice with the Cubs. Too much, but all fun. 

       Talk to ya Monday.

Dr. B

I’ll Just Say So Long

        Julius finished his rotation Friday.  My song of the day after he left was Tim O’Brien’s ‘Look Down That Lonesome Road.’  The tag line at the end is quite apropos.  It goes, ‘I hate to say good bye, so I’ll just say so long.’  Julius was the best med student we’ve had come through Harvey County in a long time.  I couldn’t say good bye, so I just said so long. 

        Besides, he’ll be back.  Believe it or not, Harvey County has gone plum modern.  We used to do all the I.C.U. work ourselves but now we have a couple of intensivists.  I knew Julius wanted to get into that kind of work, so I sent him over to see them to see if he could do a rotation with them late this fall.

        Our intensivists are two sharp guys we somehow lured here from the Mayo Clinic.  When they first showed up in town I realized my days as the local king of the bubble tests had come and gone.  (For those that don’t know the term, my son coined it.  In grade school when they had a standardized test I asked him if he was scared, and he said, “No sweat Daddy.  All you gotta do is fill in the right bubbles.”) 

        When I ran into this duo, I remembered my father’s counsel.  “Son, in this business, you’re gonna run into people smarter than you.  When you do, don’t be jealous;  go make friends with them.” I did just that.

        They are an odd duo with odd names.  Zellington and Grinzler.  Sounds like a World Wide Wrestling team, huh?  They are like an Abbott and Costello comedy routine except they got their punch lines out of ‘Harrison’s Text of Medicine.’  One, Zell,  is short and uh… stocky.  The other, Grinz, is tall and does his best to be austere in spite of Zell’s antics.

        When I sent Julius to ask them about doing a rotation with them he was concerned.  “I don’t know, Doc.  They’re from the Mayo Clinic.  Sounds pretty high powered to me.  Will they take me on?”

         “No problem, son.  When they ask you what your objective is for this rotation, just say, “I hear there is a lot of debate in Harvey County as to which one of you guys is smarter.  Dr. Bibey asked me to find out and report back to him.”

        Julius did as I said. Grinz took one look at him then said, “Smart ass,” and signed.  Zell grabbed the paper out of his hands and signed it above the line where Grinz did.   

         I also had Julius negotiate for Friday at lunch off so he could eat with me on the ‘Starving Medical Student Foundation.’  The boy did good.  We have an appointment at Chang’s Chinese the first Friday in November.  Like Tim O’Brien sang, “I hate to say good bye, so I’ll just say so long.”

       See you soon, Julius.

Dr. B

Here’s the link to Tim O’Brien’s tune:

www.youtube.com/watch?v=vMbNkyTCTG8

Doc Rule Number Seven- Speak the Language

        Even before I finished med school, folks began to tell me I was a good diagnostician.  It would be wrong for me to take too much credit.  I learned the secret early on, and it was easy- listen to the patient.

        I was a good student but I realized when I got to medical school we had a couple who were brilliant, and I was not that gifted.  When we started to take care of patients I found my gift, though.  That gift was I liked the patients.  It was the secret to life as a Doc for me and I am forever grateful for it.

        I recall one fellow with malignant hypertension. (High blood pressure to a dangerous level)  I remember sitting by his bedside and saying, “Well we only have one more medicine to try, but it has a side effect you might not like.”

        “What’s that, Doc?”

         “It can make you hairy.”

        “Well, I hope it grows in the right places.”  (This was a burly man who had hair everywhere except on his head)  He got a big laugh.  I always had a way with people.  By the way, the medicine was Minoxidil, which later was reformulated as a lotion and marketed as Rogaine.

        In med school, we used to make rounds with an entourage; attendings, residents, students, etc.  Some of the students tried to make every diagnosis from a text book.  I read the books too, but I’d often make my diagnosis after the entourage left.  Sometimes the attending would talk ‘at’ the patient.  You could see the patient all but beg to get in a word.  After the team left, I’d go back in the room and sit down with the patient and the family.  If it was a slow night sometimes I’d watch part of a movie and eat some popcorn with them.  There they’d tell me everything that was on their mind.  I never had any trouble figuring out what was wrong.

        It bothered one fellow student.  “How’d you get so smart all of a sudden?” they asked.

        “I dunno.”  I tried to explain  a couple times.  I never could understand how such a smart person couldn’t get such a simple concept.

         By the end of med school I was pleased about my progress.  They had an award for most promising Family Doctor.  As has often happened to me in life I was the runner-up.  The kid who won stayed with it a year and then changed to Radiology.  Oh well.  I’ve been happy enough with my lot in life even if I didn’t win the award or get rich and famous either.  My patients tell me I am a good Doc for them, and that is the only award that matters to me.

        This is an old med school story.  Like many it might be only a legend, but it is still a good one.

       Seems there was an old preacher who had prostate cancer.

      The attending made rounds and said, “Reverend,  tomorrow we will proceed with an orchiectomy.”

        “Whatever you say, sir.  You Doctors at Sandhills are the best in the country.  I trust whatever you say.”

        The resident was skeptical.  After the attending left he said, “Pastor, we have you on the OR schedule tomorrow to have your testicles removed.”

        “Whatever you say, sir.  You Doctors at Sandhills are the best in the country.  I trust whatever you say.”

        The med student watched all that and was not at all certain the man got it.  He decided he’d better explain one more time.  The boy was from the country, and he wasn’t all that sophisticated, but he thought he knew how to communicate with this man.

      “Preacher, I just want you to be sure you understand, but in the morning they’re gonna cut your balls off.”

        The hell they are!!

       The point of the story:  It is imperative to speak the patient’s language.

        And by the way, that is as close to off color as you’re gonna get from Doc, but I thought it made the point.

Dr. B

Rule Number Six- The Patient is the Center of the Universe (Not the Opposite)

        This post was inspired by a blog pal of mine, Ms. Cindy, who works at a Vet office.  She is new to the Vet business, but already understands it in a way some veterans never do.  She wrote “I want to help make things better.”  That’s it.  I am certain she is the kind of human being who be an employee of the month at our place, ’cause she gets it without being told.

        In the Doc world, this rule is so simple that I can not understand why anyone would have difficulty with it.  Yet, there are some that do.  Some folks are in it for money or power or prestige or I don’t know why, but they are the ones I never get along with.  I have two trusted nurses who have been with me for decades, and they are there because they want to help make things better.  They never base their decisions on anything other than what is best for the patient.

        Many years ago I had an employee who wanted us to get a ‘Corporate’ Country Club membership.  She felt we needed a marketing type person, and that her face at the club would ‘upgrade’ our public image.  As you can imagine, she didn’t last long.  I have nothing against anyone at the club, but I don’t want an image.  I want to be a Doctor, and hope folks will trust me enough to give me the honor to serve.  She was in the gig to look important, not to help make things better. 

        She sells lingerie now, and there’s nothing worn with that either, but her concept of the Doc gig just didn’t jive with mine.  As Larry Cordle would say, “I’m a little rough around the edges,” and the young lady just didn’t get what I wanted our little Doc office to be about.

        So, sorry to preach but what it is about is the patient.  One time we had an open house.  The band was scheduled to play and we were gonna have some chickens on the grill.  One of my patients asked, “Doc, is it O.K if I come?”

        “O.K.?  Lordy, George it’s your party, not mine.  If we have an open house and it ain’t for the patients we might as well all go home,  ’cause we’ve forgotten what we’re here for.”

          The image of George munching on a chicken leg and tapping his toes to bluegrass is a permanent one on my brain.  We can’t forget what we came to the party for, and must forever remember to dance with who brung us.

Dr. B

Man Cave Hyperlipedemia- Country Doc Rule Number Five

        Just to let you know, Doc can learn from the student too.  Julius has gotten in the habit of giving folks a package insert on new start drugs.  He goes over the basics then asks them to read up it and get back with us if they have questions.  It covers a lot of ground in a hurry.

        His recent contribution was the spark for this post.  Today I’d like to post a Julius rule.  I’ll tell more of mine later.  Rule number five is to make learning fun.  I have always believed that, but Julius is young and has taken the concept to a new level.

       The other day we were at lunch and Julius said, “You know Doc, I wish I had my dart board here for lunch.”

        “Dart Board?”

        “Yeah.  At home I have one in the apartment.  Some of my buddies come over at night and we toss darts after we cook on the grill.”

       “Is that like one of those man caves they talk about?”

       “Yeah, exactly.  Could we have one here?”

        “Darts at lunch?  I don’t know man.”

        “Hold on a minute.”  He went out to the car.  In a minute he was back.   “Look here.  This is how I memorized the hyperlipemia guidelines.  I call it the Simvistatin Dart Board.”  The bull’s eye had the number 70.  “See, if your patient is diabetic you want to hit the 70.  (An LDL of 70 is the goal for a diabetic.)

        “Son, that is the coolest teaching aid I have seen in some time.”

        Before you know it we had the hyperlipidema dart board up and running.  At lunch Julius and I invent clinical scenarios, decide on the correct LDL goal indicated, and take turns at darts.

        I held a dart and poised to throw.  “O.K. Julius, my patient is a 67 diabetic, and status post coronary artery by-pass.  What’s my target?”

         “Trick question, Boss.  By the time the next guidelines come out 70 ain’t gonna cut the gig.  Like blood pressure and golf, go low.”

         “You are a good kid.”  I winged my dart past the coffee maker.  “Bull’s eye!”

        Julius laughed.  “Never bet against old Docs at golf, darts, or bubble tests.”

        Our lunch break is usually 20- 30 minutes and we’ve taken to darts for half of it.  We went all out.  We’ll order a bacon swiss cheese burger basket take-out from Lou at Harvey Billiard and Bowl.  We put some of those frosty beer mugs in the refrigerator to pour up our Co-Colas in.  We even got a dish of dish of cocktail peanuts and took to betting nickels.  We left off the swinging doors though.  I think Corporate has a rule against alteration of the physical structure.  After a week we’d memorized every algorithm known to the Heart Association, and had gotten dang good at dart tossing too.  Hm.  Makes me wonder if we’ve got room for a pool table.

         Last night when I got home Marfar asked how my day was.

         “It was great hon.  Me and Julius are having all kinda fun.”

          “So, what did you do?

          “Oh, today we went to a bar and threw darts.”

         She gave me a sideways look and smiled.  “Whatever winds your clock, dear.”  She knew there was no point in asking.

Dr. B

Breaking News: Julius is an Ace

        You may have noticed I haven’t mentioned Julius in a few days.  He was off to take Part II of his Boards, which by the way is the gateway to Doctor City.

        I gotta tell you this is my proudest day ever as a Doc mentor and teacher.  Julius came back to home base with the biggest grin I’ve ever seen.

        “How’d you do kid?” I asked.

        “Great Dr. B,  just great.”  He laughed out loud.  “Man, I was just whistling through the whole thing.  I’ve done my best with books, but at every turn I remembered all these old cases you’ve told me about over lunch or breakfast, and all these patients we’ve seen in the office who you’d rattle off ten years of history without a chart.  Man, it was a breeze.  All I had to do was fill in the right bubbles.  It was all your stories that carried the day.”

        I all but cried.  “Julius, that makes me prouder than anything I’ve heard as a teacher.  I am humbled.”

        “Yeah Doc, honest to God half the time I’d recall some bluegrass tune you imprinted on me to remember all the right answers by.  You remember the lady we diagnosed with temporal arteritis?  You said, ‘Ain’t no way she’s gonna go blind for lack of Prednisone while I’m off playing ‘Dim Lights, Thick Smoke.’  Get a sed rate, too.’  It was easy.”

        “Good Lord have mercy, boy.  A+!”

        “Yeah man, I applied Temple’s Law a couple times, and I never x-rayed a pregnant woman.  I diagnosed a heart attack when it looked like indigestion.  I rocked the house.”

        By now I was in tears.

        “Hey, we had a fill in the blank section at the end,” he said.

        “We didn’t have those in my day.  Back then it was a straight bubble test.”

         “Yeah, they asked about the value of a screening chest x-ray for lung cancer. ”

        “What didja tell ’em?”

        “I knew I’d already aced the thing,  so I penciled in a chest x-ray to screen for lung cancer ain’t worth a fart in a whirlwind.”

        “That’s My Boy!  How to go Julius!  I’m as proud as punch of ya.”  Lord y’all, I hope the world can take another one, but I might have created another me.  I didn’t know what to say.

        “I ‘preciate ya Doc.”

        “Son, you are a good kid.  You’re nice to people.  Don’t you ever change.” 

        “Yes sir, I won’t.”

        “You stay like you are.  The Doc gig ain’t about money or status or nothing else but people.  There are too many people in this business who chase the wrong things.”

        “Doc, that’s the best advice you’ve given me yet.  ‘Don’t chase the wrong things.’  I won’t forget.”

        I sent Julius to interview the next patient and closed my door.  I said a prayer and thanked the Good Lord for blessing me so profoundly.  After I’m gone there’ll still be some people Doctors left as long as Julius is around.  To have been any part of that just broke me up, and I had to recompose myself to get ready to go back to the salt mines.

Dr. B

OBAD (The Dark Side of Doctoring) -Rule Number Four

        OBAD stands for Official Begging Armistice Day.  I’m sure that will require some explanation.

        If ‘The Mandolin Case’ sells more than four books, I have a sequel planned.  It is called ‘Acquisition Syndrome; the Doctoring Business.’  As far as what it’s about, legal advises me all I can tell you at this time is this:  A wise patient of mine, a farmer, told my nurse Lynn O’Carroll, “Dr. B knows something and he ain’t talking.”  But the gist of the saga is that along the way Dr. B learned a few tricks of the trade and figured out ways to get people taken care of even if some fool does their best to stonewall the process.  It happens more often than you might think.  To their dismay, over time I am gonna tell what I know. 

        Fifteen years ago if I wanted to get a CT head scan Lynn  O’Carroll would call and say, “Dr B. needs a CT today.”

        And they’d say, “Sure sweetie, what time?”

        It is no longer that way.  Now mind you I’ve never been one to order a CT on every headache patient.  A history will usually do it.  But if there is even one ‘red flag’ warning sign I’m on the warpath and will not be denied.

       When you have a lady who has fallen in the last month and has a new headache like she’s never had, and you run into some insurance guru who finds a scan unnecessary, I always ask what he would want done if it was his mama.  If he doesn’t want to rule out a subdural hematoma then there are only a few logical conclusions.  Either he is poorly trained, doesn’t care, is more interested in money than truth, or hates his mama.  None of them are good.

        The idea of ‘managed care’ is if you make the Doc jump through enough hoops he’ll stop hopping and take a few chances.  Sorry, I made an A+ in Hoop Jumping 101.  Nowadays a Doc not only has to care, read like a wild man to ace his Boards (O.K. I’m gonna brag on my 94th percentile) and work hard, but he also has have an iron will to force the system to do right when it has created more inertia than a barge that lost it’s tugboat.

          I call it OBAD.  Official Begging Armistice Day.  I never beg anyone for help.  If they aren’t willing, I proceed to plan B, go to door number two and lumber on in anyway.  It is the power of the lessons of Acquisition Syndrome; the 80/20 rule.  (Rule number four)  80% of the time people will do right because they want to.  The other 20% have to be positioned where they have no choice but to do right.

        I can’t tell you the details of this week’s case.  It is too fresh.  Even if I fictionalized it, it would be recognizable and a breach of patient privacy.  So instead I have to make it into a parable.  But as I told Julius; “if they won’t do right make ’em.” 

        On our flight this week, I was the pilot and Julius was my co-pilot.  On Tuesday we hit some awful turbulence.   

        “Hey pal, my rudder is balky and she don’t wanna trim out.  We’re losing oil pressure on the right engine.  We’re gonna have to feather the starboard side and put her down in a cow pasture.  I know one we can get to from here.”

        “If anyone knows Harvey County, it’s you, Doc.”

        “Go back there and get approval.  Tell that arm chair QB it’s an emergency.”

        Julius was back in a minute.  “He’s say his computer simulation says it’s doesn’t meet the criteria.  Procedure denied.”

        “Tell him to look out the window.  The dadburn engine is on fire.”

        “I did.  He said they have to go by protocol.”

        I tossed Julius a chute.  “Take this to him.  Tell him he can jump if he wants to, but I gotta get this dude on the ground.”

        “O.K., boss.”  Julius turned to head for the back of the plane.

        “Hey, kid.  Tell him one more thing.”

        “What’s that Doc?”

        “He might as well take his computer too.  It’s no good to us here.  He might want to play some video games at least if he survives the fall.”

        “Yes sir.”

         “By the way, tell him I’ll go ahead and call in my dictation.  If this thing doesn’t make it I’m gonna document the fact he got in the way here.  Legal will tell him not to worry too much.  It’s only one passenger.  She’s just some country lady and I know he doesn’t think she’s that important.  I know the husband.  He thinks right much of her, but he’s reasonable.  My guess is five mill will cut the gig.” 

        Julius smiled.  “I expect that man in a suit and tie in a Harvey County courtroom would have a hard go.”

        “Yeah, remind him a dead Dr. B is gonna be a difficult opponent.  You don’t diss dead people.  Tell him it’s against the law.”

        Julius did just that.  The man froze.  He was scared to go against us. When it’s your own life on the line, people see it in a different light, and besides the guy was tighter than Jack Benny.

         We got her down, got the lady off the plane, and put out the fire.  I told the little regulator man I believe I’d get some new software for his simulator.  One of these days he was gonna convince someone more naive than me to go along with him when he’d never laid eyes on the patient.  When he does he’ll have to hope I remain as obscure a writer as I am now.  By the way, he admitted he’d never flown a plane.  I wasn’t surprised.

        The patient did fine, and I wasn’t scared until it was over.  Then I cried.  Medicine made me tough as a pine knot, but it ain’t gonna make me mean.  I’m gonna go play some music.

        I’m glad I did not spend my life as some insurance chart jockey.  As hard as it was, I’d rather be Doc, even if the pay wasn’t as good as those executive guys.  l’ll close with a favorite quote.  It is from Sir William Osler, the father of modern medicine. 

        “Seeing patients without reading books is like going to sea without a compass, but reading books without seeing patients is like not going to sea at all.”

        I love books, but I love patients more.  Some things and people are forever.  Osler was, but I assure you all those little regulatory guys will be lost to history. (as they should be)  They are nothing but a nuisance to be thwarted, but I have learned to do it well.  I’ll probably be lost to history too, but at least I tried to do right.

Dr. B

Country Doc Rule Number Three- Apologies are Necessary

        Years ago there was a movie (was it ‘Love Story’?) where there was a line that said, “Love means never having to say you’re sorry.”

        I’m not so sure that is true in love.  If I forget to take out the garbage I tell my wife I’m sorry.  I can be a dumb man testosterone poisoned lug at times, but with all she does for me I figure it is the least I can do.

        I am certain a ‘no apology’ policy is not good practice as a Doc.  When things go wrong, at least we can say we are sorry.  And I think we owe to to folks to try to figure out why and how it wrong if we can.  I will tell you that is not always easy and often requires some study, but I at least promise folks I’ll work on it.

          Some people say Docs shouldn’t apologize, and that it might make them more at risk for litigation.  Well if that’s true, so be it.  The truth is the truth, even if hard to find at times, and and we should always search for it.

         And if you want to get practical about it, most of the big shots believe it lowers the risk anyway.  It’s a good thing, ’cause I can’t be any other way.

        Like all Docs I’ve had to do a few depositions along the way.  Each time the truth proved to be a powerful ally.  It never let me down, and things worked out fine each time.

        So, at least as far as this Doc goes love means it is best to say you’re sorry if things go wrong.  I don’t give  d@^# as to the assignment of individual blame.  That makes no difference to me.  The main thing is to try to figure out how to tweak the  system and lower the odds a bad event might happen again.  I don’t view apology as a sign of weakness,  although I know some folks do. 

        Julius and I are going to make this our lesson plan for a few days.  While he has been here things have gone well.  But I am in a lower profile job now that I am older.  When I was working day and night it is a wonder more didn’t go wrong than what did.  He is considering a career as a hospitalist, so he might as well start to ponder the issue now rather than later.

         What do you guys think?  I hope you’ll let me know.  As my agent said in the beginning, “Son you are going to learn a lot from your readers.”

Dr. B