The Break-up Letter

I have never received a “Dear John” (or even a “Dear Benjamin”) letter before.  Sure, I have had my share of breakups on the bumpy road of dating that eventually lead me down a seemingly mile-long aisle to an exchange of vows.  And though many of my ex-girlfriends may be critical (still) of many things that I did or failed to do, I know none of them can complain that I ended our love affair with a stroke of a pen or – in today’s parlance – the stroke of a computer keyboard. 

While it is easy to focus on the way that this relationship ended – with no hug, no opportunity to respond, no chance to express meaningful gratitude, and no possibility to beg for another chance – the real problem is that getting dumped means I need to fill an important void, worry about my well-being until I do, and still mourn the loss of an empathetic, caring, compassionate and smart woman from my life.  Some, as they say, “don’t know what they’ve got until it’s gone.”  I knew how fortunate I was, and that makes the loss more difficult.

After re-reading the words on the letter – both the standard typed words and the personal handwritten note in the margin, all I could say was:  “Grand Rapids.  Really?  Grand Rapids.”  With the words settling into my stunned mind, I realized that this was a fait accompli, and I would have to accept the change.  Before moving on, though, I reflected on our experience together.  Whenever I needed her, she was there.  She was patient.  She listened and never judged.  She eased my pain.  When things were going wrong, she cheered for me.  She cared for me, and I trusted her because I could see in her eyes and hear in her voice that she was genuine.  Truly, the real deal.

Maybe the lesson that I should take from having had the opportunity to learn from her, to have been fortunate to have met her for what amounts to a few minutes in our lives, is that our relationship… this type of relationship is so important.  It has the possibility of being something great when built on honesty and respect.

I know that she has her reasons for departing, and I’m relieved that this breakup had nothing to do with me.  But, I still will miss having Karen Garibaldi as my doctor.  And while I am searching for someone to replace her, I will continue to compile the lessons that I learned from her:  Never look at your watch or a clock when with a patient; listen intently; move the little, physician’s rolling chair closer to your patient; recognize that a hug can sometimes be acceptable between a doctor and a patient; empathize with real stories when appropriate; follow-up; answer e-mails; return telephone calls personally; reassure; remember (or at least peak at you’re the chart to remember) things about your patient so they do not feel like one of 4,000 charts; if you bump into a patient at a public restaurant, genuinely introduce the patient to your dinner partner as “my friend, Benjamin;” and above all, lose the white coat and just be a human being who cares and has a special skill set that may ease pain and suffering.

The lessons that made Dr. Garibaldi so successful are applicable to all of the jobs that we do and to the lives that we live.  Don’t you think?

In medical school, students are bombarded by lectures that contain minutiae that most practicing physicians – if honest – would classify as irrelevant, long-forgotten and – if really honest – only part of an unnecessary, pledging process.   Students are asked to memorize neurological tracks that will not impact care, cells in a microscope that will never be seen again, and muscles that are dismissed by practitioners “as things that only the anatomists know.”  While looking for a new physician (and hoping that I do not need one in the meantime), I cannot help but note that I do not care if my doctor can “guess” where a stroke might be in my brain (because they cannot treat it without scanning my brain); I don’t care if they can pick a pronormoblast out of a line-up (because they will never see one again); and I don’t care that if they can’t remember “genioglossus” faster than I can stick out my tongue (because  it matters far more if I can make my tongue protrude midline, after all).  I do care, however, that my new physician learned the lessons that made Dr. Garibaldi a great doctor.  Though, I do worry that maybe nothing in medical school made her the person that makes me wish that she was still my doctor.  Then again, maybe she will tire of the pretty rapids that run through downtown and recognize that the Gerald Ford Presidential Museum is not a great draw for friends to visit, and come back and take care of me….

Among other things, I plan to write about various medical experiences, and I thought that highlighting how important the doctor-patient relationship is, how fortunate some of us are to find a true caregiver, and how we should all work to ensure that patients get the kind of care that Dr. Garibaldi gave me, was a good place to start.  I’d love to know what you think.