Friday, December 26, 2014

A son's tribute to his MD father

MK Sheikh wrote a lovely essay a few months ago about his father.  I have been saving it for the right time and now present some excerpts here (along with some added graphics.)  The story is emblematic of the journey taken by many, but stick till the end for a 20-year old special message that remains key today:

My father, along with my brother and countless other extended family members, was a physician. Public health has been a part of my life as long as I can remember. Last fall I started graduate school at The George Washington University; first as an MPH student studying health policy before transferring to the MHA program in the spring. My cohorts, professors, friend and experiences have all at times contributed to the feeling I am exactly where I belong. My father, however, has been an omnipresent lens through which I view my studies, health care, and the world.

My father was the oldest of eight children born to a high school teacher in rural Pakistan. By all accounts he was as smart as they come with a work ethic to match. The top national score on standardized tests soon landed him spots in highly regarded secondary and then medical schools in the burgeoning metropolis of Lahore.

After finishing med school and opening a small practice outside the city, he made the decision to come to the United States and pursue a residency. In the interim, he found a position in the small coal-mining town of Man, WV.

Following a residency in Detroit, my father settled down to practice internal medicine in a small town called Michigan City, Indiana. It was 1981 and he made the decision to open his own practice, despite having no formal business education. However, he always understood and could relate to people. Maybe its because his own was impeccable, but he always seemed to be a good judge of character. He made one very smart managerial decision: he surrounded himself with great people. He hired two nurses.

One was a young woman by the name of Pam who had very little training and experience. My father was not bothered with that and saw promise in her. He spent the time to train and educate her, and today she remains one of the longest tenured and most trusted nurses in the community. The other was a woman named Mary Griggs. Mary was a seasoned, quick witted, sharp-tongued woman you did not want to cross. She handled nursing duties, medical records, finances and front office duties. If Lean Six Sigma had been around at the time, Mary would have been a master black belt without breaking a sweat. As someone fascinated with operations and management, my favorite statistic involving Mary was she collected on 95% of bills.

Over the years, the three of them stayed together through the different organizational structures my father was in. For a long time I never really understood the dynamic; the three of them were vastly different people. It wasn’t until I met other successful leaders and studied management concepts that I understood. My father had that uncanny ability to be present with whomever he was with. He never saw himself as the boss, but as a team member.

My favorite story involves his rounding. As a child I would sometimes what on earth could make my dad set his alarm so unbelievably early every day. He was always the first one to the hospital in the morning. He liked being able to spend time with his patients, talking to them about more than just their medical care. My father had a fondness for coffee, and his colleague said as soon as he got on the floor he would pour himself a cup in a small white styrofoam cup. He would sit down with each patient and sip from the cup while he talked to them, never finishing it and leaving it on a table somewhere in the room before getting to the next patient with a new cup.

His fellow physicians admired his work ethic but also become competitive, so it became a game to try and beat Dr. Hasan to the hospital floor. Dr. Raheem, a long time friend and colleague of my father, said one time he thought he beat him. He didn’t see his car in the lot, hadn’t seen him yet in the hallway, but after walking into his third or fourth patient’s room he noticed a half empty cup of coffee in a white styrofoam cup and knew that he had once again been beat. My father never saw it as competition though. To him it was about providing his patients the care he saw as part of his duty as their physician.

As retirement approached, everyone who knew him was excited my father might finally take some time to relax and not work so hard. I knew better, because for him medicine had become his love. Not because of the practice itself, but for the way it allowed him to serve others. It came as no surprise to me then that he decided to apply for the a license to practice medicine in the state of Texas, his intended place of retirement. The application process was not simple. It required passed exams and endless forms with very arbitrary deadlines. My father became rather obsessed with obtaining the license. Helping him one night in an attempt to beat a deadline requiring a complete reset of the entire process, I asked why he was doing it. He didn’t plan on finding a job, didn’t really need the money and had earned the time to rest and relax. I knew the answer before I even finished asking; he wanted to find a free clinic to volunteer his time and service. It was never work for him. 

Last year he was diagnosed with Stage IV pancreatic cancer. When the oncologist came in to give us the news, he presented the level of metastasis and asked if my dad wanted to hear the options. I looked at him and will never forget the stoicism with ever so slight shades of both a smirk and sadness on his face as he calmly said no thank you, he would just go home and let come what may. Over the next month he resigned himself to being on the other side of the physician patient relationship. We consulted palliative care, nephrology, radiology, cardiology and oncology to maximize end of life comfort. Through it all, I marveled at what a great patient he was. He never complained, always treated nursing staff, PA’s, housekeeping, hospital services and hospice staff with the utmost respect, and often a joke or two. Everything I had ever learned about health care from his time as a physician was magnified watching him as a patient. Sometimes it takes something very personal to provide humanity to terms like patient satisfaction and quality of care.

Some months after his passing, the community hospital he spent his life serving in Indiana held a memorial service for my dad. I expected to see some old family friends, colleagues and hospital staff. What I was not prepared for was a roomful of former patients. One by one, when the podium was opened up for any to speak, they stood at the microphone often in tears talking less about specific procedures, ailments or care stories, and more about how much they trusted him as a physician and a person. How nice it was to have a primary care provider they considered a friend. How comforting he was in their toughest times. How my father was really a part of the community, had been their doctor for decades and was now their children’s doctor.

Shortly after though, I came across an interview with my father in the hospital newsletter. The article is dated March 1991, and my father had just been elected president of the hospital’s medical staff. The quote is over 20 years old but just as relevant today as then:

My father taught me a lot about medicine and health care. That education paled in comparison to how much he taught me about humanity, and new lessons come every day from his memory and example.


Marilyn said...

This is so beautiful, it brings me to tears. Not enough is said about the humanity, passion and sacrifice most physicians and other health care providers bring to the job of caring for others.

When my own physician-husband was dying of the same dreaded disease, he woke me up one night to tell me about certain patients he felt he had really connected with and made a difference in their lives, during his career. He told me that his greatest professional satisfaction was not the degrees, not the publications, but the ordinary patients he had helped.

It was the reason why he had become a doctor. said...

Thank you so much for sending this blog to us. The story and the quote capture what we, as medical educators, are trying to communicate to the next generation of physicians.

This physician was a true leader: of the heart, the soul and the body. Let's hope that others in the position of helping to heal others read this inspirational writing.

Joan Lowery, Lowery Communications

Anonymous said...

An outstanding post to a truly outstanding human being.