My First Day Off

I’ve rarely been a real risk taker when it comes to physical activity.   I’ve never jumped out of an airplane, rappelled down a mountainside, or skied in fresh powder after being dropped from a helicopter.  When I swim, I like my pool water warm, and when I ride, I like my horses elderly and as they say, “bombproof.”  I like my skin and bones, well-padded as they are, intact.   Do I dare to eat a peach?  Yes, but you won’t find me scuttling across the “the floor of silent seas.”  I keep to the surface.  And the older I get, the more my apprehensions and hesitations apply to those around me as well, including but not limited to my dogs.

Today was my first day of retirement, and incidentally, the first day in four that it hasn’t rained here in Southern California.  Ellen DeGeneres joked at the Oscars last night that we’ve had a tough few days–“it’s been raining, but we’re okay.” Although the Scottish deerhound’s ancestral home is in the highlands where it never stops raining, or snowing, the SoCal brand of deerhound does not like to get its feet wet, and so the dogs have had very little exercise these last few days.  Today the sun broke through and all hell broke loose.  In my younger days, when my deerhounds would run full tilt and chase each other through the tall grasses of Sherborn Massachusetts, the ground would rattle and I would experience a thrill quite unlike any other—the thrill of the chase, the hunt.  I could almost see that red stag bounding up a hill, ever elusive, the dogs nipping at his heels.  Now, I see dollar signs.  Anterior cruciate tear?  Five thousand dollars.  Fractured radius?  Five thousand dollars.  Collision with a tree?  We won’t go there.

I had been outside with them for maybe ten minutes when the wild rumpus began.  Queen, the smallest of the three, and the fastest, is always the instigator.  She took off through hedges and around corners with her sister, Quicksilver in hot pursuit.  Magic, the old man at 9 and a half, has slowed down quite a bit.  He was never the brightest, yet over the years he has learned to use his bulk to “head them off at the pass.”  As I was hauling slightly mildewed dog beds out onto the patio, he intercepted one of Queen’s speedy zoom arounds and the next thing I knew, she was yelping in pain.  Rushing to her side, I saw the damage, a four inch tear in her skin, just at the groin fold.  Suddenly, my “to do” list for the day was narrowed to only one task.  I took her to the vet.

As always, I should have known better than to let close to three hundred pounds of aggregate dog loose simultaneously after being in the house for three consecutive days.  And I have a sneaking suspicion that the accident wouldn’t have happened if I’d been, say, at work, the way I normally am on Monday mornings, with Queen and Quicksilver ensconced in their separate yard, and Magic and the little dog Yoda in the house.  After a brief anesthetic and fifteen or sixteen sutures, Queen is home and will be fine.  My “to do” list will wait until tomorrow to be done—I guess that’s the nice thing about being retired.  No bones were shattered, no ligaments torn– we’re all still standing.  And my veterinarian’s children will be able to attend college.

As I’ve said before, when you run with the big dogs, it’s always something!

I Do Not Need A Concierge

My veterinarian answers my phone calls.  The other day I called her office to ask for a renewal of the pain medication for my little dog Jack.  He has been blind and deaf for over a year, but now his rear end is going and he is falling a lot and having a hard time getting up. When I asked for the medication, I did so with a certain queasiness that perhaps refilling the prescription was my way of putting off the inevitable.  Suddenly I wanted to talk to the vet.  I told the receptionist that it was not an emergency, but could she please call me back by the end of the day.  She called me back within the hour.

Today I sat with a patient who has recently been through a battery of tests to determine whether his cancer has spread.  He told me how frustrating it has been for him to call his doctors’ offices for the test results, and not receive any calls in return.  This man belongs to an HMO where he can go on line and look at his results himself.  I asked him why he did not do that and he said, “Because I am scared to read the results when I don’t know if I will understand them and there will be no one to talk to.”

Six months ago I received a letter in the mail, from the University that employs me.  The letter said that because I am faculty, I am eligible to have a “concierge doctor” at a sharply discounted price.  For a mere $5,000 a year more than the exorbitant rate I already pay for my Blue Cross PPO, I (and my spouse) will be entitled to a doctor who will see me within 48 hours if I get sick, who will help me “navigate” the system if I get cancer, who will return my phone calls within 24 hours, and who will make sure that if he is on vacation, a covering physician will see me.  My Jewish grandmother rolled over in her grave, sat up and said, “This, I should pay EXTRA for?”

Growing up in a medical family is both a blessing and a curse.  My husband and I are third generation practitioners, if you count my grandfather who was a dentist, and his grandfather who was a veterinarian.  As a consequence, we remember the days when physicians were expected to return patients’ phone calls themselves in a timely manner, guide their patients through difficult decisions and life crises, and see their patients urgently when necessary.  Merriam-Webster defines “concierge” as a person in an apartment building, usually in France, who serves as doorkeeper, landlord’s representative and janitor.  Is this what I want from my doctor?  Is this what I want to be?

My husband and I had the same reaction when we read our proffered “concierge letter.”  We want a doctor who will see us if we are sick, advise us when we have a crisis, and return our phone calls without being paid extra, because IT IS THE RIGHT THING TO DO.  This is what we expect.  This is what I provide for my own patients.  This is what all patients deserve.  If my veterinarians can behave like doctors, so can we.