When Patients Become Parents: A Blast from My Past

Monday morning my office was filled with “new” patients. Seeing patients and families whom I have never met has a very different rhythm from a follow-up visit, so I alternate my days—mornings or afternoons for “new.”

After 26 years of practice in Buffalo I have met somewhere between 800 and 1000 new patients. By now I have been involved with close to 25,000 different families. 10 years ago I saw my first next generation patient: a former patient of mine brought in her child. A few months ago I saw my first next next generation patient: a former patient of mine (I saw her when she was a teenager) brought in her grandchild. It is always rewarding when a former patient becomes a parent (or now grandparent) of a patient. Admittedly I don’t always recognize these now matured faces and changed bodies, and most get a kick at seeing if I remember them.

As soon as I walked into the exam room this week, I knew that I had taken care of this mother when she was a child. On her lap was a cute little guy who I assumed was my patient-to-be. My eyes were drawn to her voice and then to the scar on her neck. And then she reminded me of her name (and that we had become Facebook friends). But only when I asked her former name, did it all come back.

I was just beaming. It doesn’t get better than this, I thought. Here is someone who almost had a tracheotomy for life, and now is married with an infant and has a good airway and a good voice.

I asked her about her life and she told me she worked at Sister’s Hospital. She was in medical billing. And then she told me why.

“I remember when I had my tracheotomy and the insurance company was giving you such a hard time about doing the procedure. You really fought for me. I was able to have my surgery.”

Truly, I didn’t remember the details, but I wasn’t going to argue.

“You inspired me to go into medical billing so I could help others get the care they deserve.”

No doubt the healthcare reform debate has brought to everyone a heightened sense of awareness of the many hoops physicians must jump through in order to get care for their patients.

Pre-authorizations for medications, surgeries, x-rays, and more, take up an enormous amount of time and energy. Tired of fighting it is human nature, even for the most earnest, to take the path of least resistance and succumb to the cookie-cutter algorithms that don’t quite fit many patients.

I have never been good at taking the path of least resistance. I am a sucker for a good fight when I know it is right. It might be a genetic defect for all I know, since I come from a long line of people who resist the status quo. (My father was the first one to challenge the Sunday blue laws in New York, which then abandoned its ban on Sunday retail shopping more than 40 years ago.) If I think that a patient really needs something, letters and phone calls and whatever it takes, I will try my best. And I usually prevail.

While I don’t remember the details of this particular patient’s needs, this patient-turned-parent obviously did. To her it made all the difference in the world. I thank her for sharing with me. It doesn’t get much better than this.