The Healer

After more than thirty years in medicine, I have finally learned what it really means to be a doctor.

Leon Friedman (name changed) became my patient several years ago. He was a Holocaust survivor who wrestled with his memories. Yes, he suffered depression, and what some would call "survivor's guilt." He had lost his whole family and endured an amazing odyssey of hiding places, brutal work prisons and finally, concentration camps. As he aged, several medical conditions plagued him. I saw him frequently for one problem or another; sometimes I thought he just wanted to talk.

His visits often challenged my diagnostic skills. Some of his complaints were clearly psychosomatic, and at times, it was difficult to sort out the pathologic from the emotional. He was cordial to me and my staff and he seemed to take comfort in my reassurance. I respected him, too. Not only did he survive unspeakable horrors; he was able to build a life in America, establishing a sheet metal business, sustaining a happy marriage which produced three loving and intelligent children.

I enjoyed speaking with Leon about his interests in politics and religion. He could find a religious reference for almost any situation. When my own parents died, I frequently attended the evening services at the synagogue where he was a member. He would greet me and call me his "rofeh," the Hebrew term for physician. He explained that Jews all over the world pray everyday for a "refuah shlemah," a complete healing of the sick.

And then when Leon had a persistent cough, I ordered a chest x-ray. Although there was no evidence of pneumonia, the film showed new shadows. A follow-up CAT scan confirmed my suspicions of possible lymphoma. Because of his advanced age, and because the condition was causing no symptoms, Leon and I agreed to a course of observation. An oncologist concurred.

But after about a year, Leon complained of increasing fatigue and malaise. We were able to get a biopsy of a cervical lymph node which, as I expected, confirmed the diagnosis of lymphoma. We talked about the options. At first, he was very despondent and wanted nothing done. But after consultation with the oncologist and his family, he agreed to try chemotherapy.

The treatments were rough. He got weaker. Was it the lymphoma, I thought, or was it depression? Soon enough, I got my answer. Leon developed a sudden, raging fever and was admitted to the hospital for suspected sepsis.

To my dismay, my primary hospital had no available beds, an all too frequent occurrence, so Leon was transported across town to another facility. I knew he would receive excellent care; I knew the hospital and I knew the other physicians on his case. But I was still out of the treatment loop.

Then, I received a distressing call from Leon's son. He seemed to be angry with me for not assuring the continuity of care. I tried to explain that I was not a member of the other hospital's staff, that I had received some reports, but that I could not be involved in the day-to-day care of his father. Furthermore, I explained to him, I felt confident in his doctors and that they could call me at anytime.

He really did not seem satisfied. Then he said, "At least you could have called." My mind was numb. I can't visit every sick patient who ends up in another hospital. What was he saying? I should call all of my patients in the hospital? Leon was a loyal patient, a nice man, but he wasn't my good friend. He wasn't a relative.

I was torn, upset, but I held my tongue. I thought to myself that the son was just emotionally distraught because his father was so ill, and probably dying. The experience continued to nag the inner recesses of my mind. I had conflicting emotions: anger, anxiety and even guilt.

That night I decided to call the oncologist. I learned that Leon was deteriorating and hope was fading. I called Leon's wife and went over the whole situation with her on the phone. She seemed satisfied with my explanations. She thanked me for the call.

Next week was a hectic one, busy with office and nursing home patients, hospital emergencies and the usual annoyances that physicians face every day, such as paperwork, irritating calls from insurance companies and the like. Somehow, I found the time to dash across town to visit Leon in his room. The visit was brief, but he seemed very pleased. I left feeling comfortable that I had helped to lift his sagging spirits.

Then a few days later, the oncologist called to tell me that a bone marrow biopsy showed that the chemotherapy failed miserably. The fever was caused by the malignancy. I called his wife again, but reached one his daughters. I answered questions truthfully and clearly. I felt that I was involved in Leon's care at this time to the best of my ability, even though I was relegated to the sidelines by his being in another hospital.

That night, on the Jewish Sabbath, Leon died.

I went to the funeral. It was a frigid wintry day, snowing, and the attendance was small. Other than the children and grandchildren, there were no other living relatives. Most of the friends were members of his synagogue. I listened to Leon's son deliver a stirring eulogy, and I learned more anecdotes about his life. Then the Rabbi spoke. He compared Leon to the burning bush in Exodus, the bush that was consumed, yet would not die. He spoke about the bush not being just a sign of G‑d, a revelation for Moses, but also a symbol of the durability and strength of the Jewish people. And Leon was the perfect example of a man who was wrought with adversities, but somehow was able to survive, and establish a new and fruitful life.

Then the Rabbi said something that hit me like a dart. He said that Leon had the uncanny and admirable ability to see the good in others. That comment stayed with me: the ability to see the good in others.

I wrestled with the Rabbi's observation. For weeks this thought and the telephone experience with Leon's son gnawed my consciousness.

Gradually, my thoughts became more lucid. I began to understand that maybe Leon's son knew that his father had great respect for me and that he depended on me, and may have even revered me as his physician. To Leon, I was not just his physician in the sense of a person he went to see when he didn't feel well. I was his friend, advisor and confidant. I was a "healer", a "rofeh." This man, who was so good at seeing the goodness in others, felt so comforted by my interventions and by my very presence. How ironic that he saw the goodness in me that I was unable to see in myself.

Physicians get so "caught up" in the trivialities of medical practice, worry incessantly about lawsuits, fret about antagonistic patients and families. We forget so often that our patients respect us, hang on to every word we say, and depend on our advice and expertise. And many patients even revere us.

I am now determined to approach each patient in a different way. Since my patients look to me as one who heals, teaches, advises and gives comfort, I owe it to my patients to respond to them as one who appreciates the goodness that they see in me.

Thank you, Leon for teaching me this lesson.

Your Rofeh wishes you everlasting peace.