My two new partners and the practice suddenly became the center of my life. Over the years I would imagine that the best way to describe the relationship was very much like a marriage. By that I mean that it was a relationship that developed slowly over many years and, although most of the time it was pleasant, there were times that demanded some give and take by everyone. Also the relationship involved a significant amount of money which added further stresses on us all. The other thing we would struggle with was the addition of women into the practice. This would prove to be a major event in our group and medicine in general. As I mentioned before when I first joined the group, I was on a fixed salary for the first three years. The thought was that after that period of time we would find out if we wanted to continue the relationship. At that point I would have the option of buying into the practice and the real estate that was owned by the partners. All of that involved lawyers, contracts and considerable understanding to successfully accomplish. Depending on which side of the fence you were on determined how you looked at the situation. If you were buying in, the natural tendency was to think that everything was being inflated in value and, if you were on the owner’s side, you would naturally want to get the most for what you were offering. This involved a very delicate balance in order to still remain friends. Some people never get past this part of the relationship and I saw many doctors come and go with different groups as a result. So like all relationships, there has to be a lot of understanding and looking at the bigger picture rather than each little item. Overall, I must say that I always felt that I was treated fairly during that phase of our relationship. We also were quite busy with the practice at the time and I think the fact that we held frequent business meetings helped out quite a bit for us all to understand what was going on. There were no secrets and everything was very transparent. Unfortunately our medical education did not involve any business training, so we all had to learn that part as we went along. Some of us were better at the business side and had more interest in it than others. On the one side were the spenders and on the other, the savers, and it was always necessary to fairly balance the two. In hindsight I think the groups that hired professional advisers or practice managers probably made the best decisions in the long run but that obviously was much more expensive.
I really liked the other two members of the group. Patrick Dwyer was a classic Irishman with all that entails and Ed McCartin was a rather reserved Scottish gentleman. I got along with both from our first meeting and that is the most important reason I chose to join them. Those relationships grew over the years to the point where I would say that we became brothers in a sense. I do not intend to go deeply into our relationships because I consider that to be a private issue. Each one of them brought one of our children into this world so that in itself made them special to Kathy and I. It is necessary however to talk a little bit about them to understand just how doctors interact. All three of us were quite young when we started out together but, right from the start, we had a chemistry that seemed to click. First of all, our training was very similar, mostly in New York City hospitals and medical schools. So from the beginning, at least for me and I think for them, we had backgrounds that seemed to mesh well together. Since our training was so similar it meant that we had the same thoughts on how to treat different medical conditions. That was really the main reason I chose to come to the Jersey Shore rather than Florida. I never really felt comfortable with the doctors in Florida and I think culturally our training seemed to be quite different. I understand this so much better now that I have retired and am experiencing Florida medicine more closely. It is very hard to find compatible people to practice medicine together because of the many variables. Over the years I saw more failures than successes because of either personality problems or their philosophies of how to practice medicine were just too different to work together well. But right from the start that was not the case with our group. The original group that preceded us had been started by a doctor who was the first fully-trained Obstetrician/Gynecologist in the area. Dr. Robert Sexton and his two partners, Dr. Richard Brooks and Dr. Robert Evans, had developed a rather large following over the years and were considered the premier group in the area prior to my arrival. My partners, Pat and Ed, had joined their group several years before I came along. Shortly thereafter the three older doctors decided to give up Obstetrics and Pat and Ed took over the entire Obstetrical practice. There were other groups in the area, but they were not as big and some were even in solo practice. I could never see how anyone could be in this specialty alone because of the time commitment but, occasionally, I saw some that could do it very well, at least for a period of time. But for me I was always more comfortable within a group. I placed a high value on my time off that the group afforded so I could spend as much time with my family as possible. But there were some who made the sacrifice of going solo and being constantly available 24/7 and I respect them very much for being able to do that, but it was not for me. On the patients’ side, there are pros and cons as well. While it is nice to only have one doctor caring for you when that doctor does finally take a vacation now you are stuck being delivered by a total stranger who is filling in. Being cared for by a group does not allow a patient to get to know all the doctors in the group well but at least there are no surprises at the most important time of delivery. Seeing different doctors in the group may seem a little impersonal but at the special time of delivery you get to know that one pretty well. We also worked very hard to make sure we spoke with a unified voice on as many things as possible, which I think helped out quite a bit. So I think you can now understand a little better the picture of group versus solo practice in Obstetrics.
At the point when I joined the group it had just moved into a brand new office. It was in a medical complex of professional buildings in Brick Township, New Jersey. Barbara Rose, the office manager, showed me around and the last stop was a totally empty room, my new office. It consisted of beautiful wood paneling and carpeting but that was it. “Here it is doctor and now you will need to pick out the furniture and decorate it to your liking.” As I gazed around at it, I thought of the long road I had traveled to get to that point. What a nice start, having a brand new office to work in, and it was all mine! That night I brought my wife over to see it and we discussed various ways of decorating it. That was a lot of fun and I enjoyed it very much. I also spent time getting to know the various women who were employed by the group. Prior to my first day on call, I had to be credentialed by the hospital, which involved providing my curriculum vitae, medical license, medical school diploma, internship and residency certificates to a committee of physicians to verify my training. There have been instances where imposters have been allowed on the staff of hospitals so that process, albeit time consuming, was taken very seriously. So after supplying all the necessary information and documents I was called before the committee for an interview. I remember that as being a pleasant experience, but I could see that all the “i’s” were being dotted and the “t’s” crossed. I was informed that I was joining a very respected group which was extremely nice to hear. I did not know my partners very well as of yet and it was nice to hear someone else thought I had made a good decision. At the end of the meeting, I was told that they would recommend that I be admitted on to the staff of the hospital but first that recommendation would have to be passed along to the Executive Committee and then ultimately on to the Board of Trustees for final approval. That is quite a process and, unfortunately, a timely one and I was biting at the bit to get to work. On the same day I also met with the members of the Ob/Gyn Department at one of their monthly meetings. Before the meeting, however, I was given a written exam of my basic knowledge in the specialty and, after my introduction, I was given an oral examination by the members of the department. As I expected I passed both examinations. I remember thinking to myself at the time what an insult that was. I had just completed years of training at very respected institutions and yet I was being questioned by a group of physicians at a small, private, community hospital. But they were extremely polite and nice about it so my slightly ruffled feathers were quickly smoothed over. Now after all the formalities had been completed, I would have to wait for the result of the formal process before I could start working at the hospital. In the meantime I had started to see patients in the office and one by one got to know the patients who would be delivering soon. I was welcomed by the ladies in the office and by the patients very warmly. As I sat in my new office having a cup of coffee I thought to myself that I had finally arrived at my goal. I was very excited, proud and thankful. A few days later a letter arrived saying I was accepted onto the medical staff but, as with all new doctors, it was only on a probationary basis until my skills could be further evaluated and deemed satisfactory. There were times when I thought I had applied to the Mayo Clinic rather than little Point Pleasant Hospital but, several years down the road, when I became chairman of the department I began to understand why the process, though somewhat demeaning, was necessary.
In the meantime my wife, son and I were settling into our new home in Sea Girt. We had rented a beautiful ranch home in a lovely little community less than a mile from the beach. I had gone down there many times when I was growing up with my parents for vacations but little did I know then that I would eventually come to live there. We lived across the street from Dr. Gabriel Rizzi who was one of the prominent surgeons in the area and his family welcomed us with flowers and an invitation to dinner to get to know us. The office had started to book appointments for my first patients and, pretty soon, it was finally time to get started. But before I would get started, I had one more important thing to do in New York. I had to bring the new sailboat that I had purchased from a dealer on Long Island down to the Shore. That was my present to myself for all the years of sacrifice and I was very proud of it. Besides sailing being in my blood from my father, I had spent several summers in nearby Toms River at Admiral Farragut Academy learning how to sail as a teenager. Despite the fact that I thought I was competent, I hired an experienced sailor to accompany me in bringing my new boat down to the Jersey Shore. It was a miserable day that I had chosen with a lot of rain and fog, and it took much longer than I had planned to arrive. It also involved more risk than I had planned and I was very happy that I did not do this journey alone. Thank God for radar as we navigated through the shipping lanes which led to New York harbor. Those were the days before cell phones and my wife was quite nervous until we finally arrived several hours later than planned. In hindsight I should have bought a boat at the Shore to begin with and saved all that hassle. On the trip I had quite a few hours to reflect about how happy I was, but I also reflected on how hard I had worked to get to that point in my life. I was about to set sail on another new adventure and I could not wait to get started.
My first day in the office was quite interesting and I was so excited to finally get to work. I remember that day very well. It was quite a memorable day for me, but there was little time to enjoy it as I was immediately very busy seeing MY first patients. My schedule was arranged by my partners to slowly break me into the practice by just seeing the Obstetrical patients who were due soon and I didn’t have to be on call yet. That was good for me as I was getting used to everything and it also was very good for the patients who would get to meet me before the new doctor might help deliver their child. I also made several trips to the hospital to tour the labor and delivery suite and get to meet the nurses I would be spending a lot of time with in the upcoming days, weeks and years. I was warmly welcomed, but I could sense that I was being seized up as well as I was sizing them up. I also began to assist my partners with surgery to get used to the routine in the operating room. Pretty soon my little introductory period was over and my first day on call rapidly approached. The excitement grew as each day brought me closer to that day. That was really going to be what I considered the start of my private practice. I finally was going to be the only one in charge of my patients and although I must say I was a bit nervous, I was very happy to be at that point in my career.
As the morning of my first day on call dawned, I reported to the labor and delivery suite at 8 o’clock. One of my partners had just finished delivering the only patient we had in labor, so I was given a nice clean slate to begin with. The next patient to come in was going to be all mine to care for. After the customary transfer of information on the patients we had in the hospital from my partner, I headed to the postpartum area to make rounds on our patients who had recently delivered. My next duty was to circumcise the babies who were going to go home the next day. The nursery nurses were very helpful in getting me the instruments that I was used to using. All surgeons have their own likes and dislikes when it comes to the different instruments available for each procedure. So after getting a little work done, I finally calmed down and awaited what my first day on call was to bring me. I delivered two babies that first day uneventfully and I started to feel pretty good about myself. I am now a little embarrassed that I don’t remember the name of the first patient that I delivered. It would have been nice to remember that special person. I knew the nurses were really checking the new doc out, so I tried to be as pleasant as I could and act as confident as I could without being arrogant. That can be a very fine line to follow, but the next morning I woke up after a quiet night and was very happy that day one on call had gone well. At least compared to my first night on call as a resident, everybody under my care was still alive and well, thank God. I must say I did have some anxiety about my first night on call as I remembered how awful it had been as a resident doctor.
The next hurdle was my first surgical case. It was only a D&C but, the day before, I remember getting the operating room schedule and seeing under the surgeons’ names Dr. P. Ketelaar for the first time. I was so proud I saved it and gave it to my parents, who were as excited as I was to see it. Well the next morning, I had mistimed how long it would take me to get to the hospital from home and I was quite upset that I was going to be late for my first case. It was only a few minutes, but that was a cardinal no-no, especially for the new doc in town. The operating room supervisor was a middle-aged woman by the name of Tillie Underhill who was right out of central casting. She was tough but fair and she was going to set the new doc straight right away. To her credit, she did not say a word or try to upset me until I was finished with my case. When I was in the recovery room with my patient, she called and asked to see me when I was done. Oh, I knew immediately that I was in big trouble. There I was on day one in the OR having been given the coveted first case of the day and the supervisor wants to talk to me. Great, that was not going to go well at all. So when I was finished writing post-op orders and talking to my patient and her husband, I headed back to the OR with my tail between my legs. She said “it’s nice to meet you, doctor.” However, “in MY operating room, we begin our cases on time”. If you would like to continue to have the first not the last case of the day, I expect you will either be here early or on time in the future. I politely said “yes ma’me, it won’t happen again” and walked away to lick my wounds. And it never did, at least under her watch. I saw her a few years ago after she had retired and we both had a good laugh about our first encounter in “HER OR”. I recently heard that she had passed away and I said a prayer for that very dedicated woman to rest in peace. My first major surgical case was also memorable. It was a hysterectomy on a rather obese woman and, although the case went well, the patient’s wound opened up two days later and I had to bring her back to the OR to repair it. Fortunately, there had been a few normal deliveries and Cesarean sections in between those two to maintain my ego. One day one of my partners decided to have some fun with the next OR schedule that I had another hysterectomy for. He penciled in repair of the wound for two days later. Haha, welcome to the real world of surgery, doctor. It’s amazing in how many different tones the word “doctor” can be delivered! I was upset and felt totally embarrassed. So after my inauspicious start in the OR, I began to realize that humility is a necessary trait to have in this profession and, as soon as you might begin to think you’re good, bam, something comes along to humble you and teach you a good lesson that you are not. So much for thinking I was the latest and greatest hot shot surgeon in town .
The first few years of private practice were quite hectic and rarely did I ever spend an entire night on call at home. Also our second son, William, was born and we began to look for a bigger home of our own. Juggling work and trying to be a father and a husband was, at first, a difficult task for me. It was particularly tough on my wife who pretty much raised our children by herself the first few years. I remember coming home one night after a tough day and my wife saying to me as I entered the door, “they’re all yours, they are still alive so I’ve done my job”. Many of the nurses at the hospital used to kid me that they thought I would only go home if the coast was clear and the kids were all in bed. I really did not plan it that way nor will I deny that it never crossed my mind. After a rather exhausting search of the area and the birth of our third son, Patrick, we found a lovely Tudor-style home in Wall Township. It was located on the property where an old apple orchard had been and the surrounding homes were quite large and prestigious. Many of the trees were still there and the setting was just beautiful. Each home in the area was located on at least one acre of land so there was lots of room for the kids to play as they grew up. Across from our new home was a beautiful pond with a small brook, which wound past our house aptly named Hidden Brook. It was a lovely setting which we immediately fell in love with. We had found our dream house and it was time to go to the bank to get a mortgage. The price was quite reasonable by today’s standards but, back then, it seemed like a fortune and I wondered if the bank would actually loan us that amount of money. Once they said yes and told us what the monthly costs would be, I remember literally falling down on the living room floor and wondering how we would pay for it. But it all worked out and we moved into our new home on “Pill Hill.” The name was coined from the fact that many of the home owners in the area were other doctors. A newspaper article about the area used the title “Pill Hill” and it quickly replaced its real name of Hidden Brook Estates.
The first three years had gone by very quickly and it was time for me to become a full partner. That was nice, but I had no money to do that so off I went to the bank to get another loan. However, this time I had no collateral to secure the loan but once again the answer was in the affirmative. The process of becoming a full partner proved to be a bigger deal than I had realized again with lawyers and meetings to work out all the possible scenarios for resolution of problems should they occur in the future. That was one of the most uncomfortable times for the group but, after a lot of give and take, we finally came to an agreement on the buy-in price. We also had to come up with a new contract for the partners, which again involved a lot of negotiations. We eventually were able to construct a contract that seemed fair to everyone at the time. It would, however, be the center of a conflict in the future that unfortunately would lead to the eventual breakup of the group. I missed so much of home life those first few years because we were so busy. There really was no way, at least that I knew of, to make things easier. We were very successful and the practice began to grow tremendously. That was nice, but with it came a lot of problems that had to be resolved. At the rate it was growing, the only solution would be for us to take a new partner into the practice. So for several years we just had to deal with the bad days and hope every once in a while we had an easy day on call or were not called away from a birthday party, night out or dinner with a friend. Finally, after several years of banging our heads against the wall, we decided it was time to bring in a new partner. That proved to be a very difficult decision because we were worried that maybe we were growing into too large and impersonal a group that women would not be happy with. But if we were to have any private lives with our families, we knew we had to get help. Women were now entering our specialty in ever-increasing numbers, so we decided that we would be the first group in the area to hire a female physician. Well that proved to be quite a task as old chauvinistic male values don’t die easily! So the integration of a woman into this previous male-based specialty proved to be quite an adventure. Some of us were completely against the idea while others were convinced that it would be a good business decision. Now it was really becoming more like a marriage what with women, men and money all needing to be balanced. As we interviewed more and more candidates, we all gradually became convinced that it would be a good thing for the practice. The mind game of accepting a woman fully would take a little longer. The woman we decided on was young, pretty, smart and was married to an orthopedic surgeon from the area. She was quite bright, a Phi Beta Kappa, and a lovely person. Her training was at a prestigious residency program in North Jersey, so her background certainly fit the profile of the candidate we were looking for. So again, we turned to the lawyers to hammer out another employment agreement. That proved to be a wonderful selection on our part and she and I remained partners until I retired. There were many stereotypes that a female surgeon was going to have to overcome. Was she going to be strong enough physically to meet the demands of the specialty? Yes she was. What about the conflicts that would be created when she had to take time off to have a baby? She literally went from caring for a patient in one room to lying down in the next room to have her own child. She asked for no quarter and she proved our concerns were unfounded. Would the demands of being a mother, wife and doctor be too much? Well, she handled all those obstacles with style and grace and, from day one, she blended in perfectly. So we welcomed our new associate, Dr. Theresa Rene Benecki, into the group and she proved to be a very valuable addition. Just as society was becoming accustomed to women in the workplace, so too were they being incorporated into the medical profession. I applaud them for their pioneering resolve to show that they were equally capable of doing the job. As a matter of fact, they have done so well that it is now males who are becoming the minority in our specialty. My how times change! It was such a good experience that, when it came time for the next person to join the group, we all eagerly elected to bring in another woman.
To offset the stresses of work sailing was beginning to play a larger part in my life. I joined the Manasquan River Yacht Club for several reasons. They had a great sailing program which included offshore racing which really interested me. They also had a beautiful pool and a small marina right on the river. This proved to be great for Kathy and the boys. As I became more involved the sailboats got bigger and faster and before long I was christening the fourth edition of Dutch Treat. I bought all the subsequent boats from a local dealer and a salesman by the name of Ray Schrader. We became best friends and when he opened a business himself we became partners in Schrader Yacht Sales. Those were the good old days of offshore racing, boat shows, and visits to Block Island Race Week.
Unfortunately tragedies are a part of medicine also. The hardest part of this specialty is dealing with the loss of a baby or mother. Soon I was to face both of those challenges and I would forever have to live with its effects on me. Fetal monitoring, as I’ve said earlier, was a major advance in the specialty. As we learned over the years, it is not the precise predictor of fetal well-bearing or distress that we all hoped it would be. There are still too many false negatives and false positives. I am not as concerned about a false positive as I am about a false negative. Too many times with a false negative tracing we are lulled into thinking all is well when it really isn’t. One day, while on call, I was taking care of a patient who was about to have her first child. All seemed to be going well as she progressed through the first stage of labor and began to push. The baby was moving down the birth canal quickly and the fetal monitor tracing showed no ominous signs of distress, I thought. As we moved the patient from the labor room 10 yards down the hall to the delivery room, something had obviously gone wrong. After we positioned the mother on the delivery room table, the nurse as usual, checked for the fetal heart beat of the baby and said she was having trouble hearing it. The baby’s head was crowning and with some pressure on the patient’s abdomen the baby was delivered. Unfortunately, the baby was born limp and without a heart beat. I quickly began to try to resuscitate it and inserted a tube into the baby’s throat and past the vocal cords. The cords were blocked by thick meconium, which is a sign that the baby had a bowel movement prior to birth and it had subsequently aspirated the material down into its lungs. I spent more time trying to resuscitate that baby than any other in my career because I couldn’t believe what was happening. How could things have gone so wrong so quickly? All of that took place in front of a couple who, in one minute, were ready to welcome their new child into the world to watching me desperately trying to save their child’s life. It is over 30 years ago that it took place and it still haunts me to this day. When it became obvious that the baby was not responding to anything we tried, it was time to stop. I turned to the parents and had to tell them that their beautiful baby boy had died. As they held each other and cried, I almost became physically sick. What had happened so suddenly to lead to that tragic result? I went back later and looked at the monitor tracing to see if there were any clues I had missed that the baby was in trouble. There were none. I spent the next several hours with the couple trying to console them and answer what went wrong, but I had no answers for them. I must say that the mother and her husband, through an obvious great amount of faith, were able to deal with the tragedy in a way that amazed me. Sure, they were shocked, sad and then angry but, in the end, they were the ones who helped me get through the tragedy also. I felt like I had somehow let them down, but they assured me they had seen it all and knew that there was nothing I had done wrong. It was God’s will, but it left everyone heartbroken. I was so upset I was unable to work for several days. Over the years I delivered two other children to that lovely couple, by elective Cesarean Section to avoid any risks of labor, and I felt honored to bring joy into their lives more than the usual way I felt after any other delivery. I still take care of that patient and it has helped me over the years see that she still has confidence in my ability to care for her despite the tragedy we all went through. I even cared for her sister for many years. To make things worse, the patient’s father died suddenly the day after the event from a heart attack. How horrible a turn of events for that young woman! Within hours she had to deal with the loss of two close members of her family. There is no way to train a physician to deal with that type of tragedy, but I can tell you I have seen several other sad events like that take place with other doctors and their patients. All I can say is thank God I never had to deal with that situation again. No one is immune to it and, unfortunately, it is one of the saddest parts of our specialty.
A few years later I had to deal with another Obstetrical tragedy, the death of a mother. One day while I was on call I was requested to do a consultation on a pregnant woman in the intensive care unit or ICU. The patient was 26 years old, 7 months pregnant and was admitted to the hospital via the ER in a coma. She had been seeing an Obstetrician in North Jersey and was vacationing at the Shore for the summer. We got a lot of those patients because of the nice vacation area we live in and, whether it be a patient who goes into labor prematurely, a woman having a miscarriage or someone with some other medical emergency, these cases are the disasters that can occur when on call. They are disasters because they are the true emergencies that we are called on to care for. Those are patients that we don’t know nor do they know us and they are situations fraught with danger for both patient and doctor. Well, anyway, I was called to see the patient and after having obtained a history from the family, I examined her and despite the fact that she was in a coma it appeared that her baby had survived this terrible event. Then came the tough decision, what to do from here? The neurosurgeon who was caring for the patient had carefully documented that she had suffered a cerebral hemorrhage and despite being stable it was uncertain whether she would ever regain consciousness. Why me God? Why couldn’t someone else have been on call that day? Well, the long and short of the story was that the plan was to keep the mother alive until the baby was mature enough to be delivered by Cesarean Section. The medical staff was able to do just that and, when she was approximately 36 weeks pregnant, I did a test called an amniocentesis, which involves inserting a needle through the mother’s abdomen and into the uterus to collect some of the amniotic fluid around the baby. This fluid would then be analyzed and the resultant L/S ratio would tell us whether the baby was mature enough to be delivered. The initial test showed that it was not, so I had to repeat the test in a week and that time it showed the baby was capable of living outside the womb . I scheduled the patient for a Cesarean Section the next day and delivered a healthy baby boy. I remember the joy the father of the baby had as he looked and held his son for the first time and also the sadness in his eyes that his young wife would never know their child. What mixed emotions everyone involved had at this point. I had cared for the patient that I had never spoken to for so many weeks and, now that my job was over, I wondered what her fate would be. The doctors, her husband and the family now had the difficult task of deciding whether to remove her from life support. The medical team assured them that the situation was irreversible and that, without the machines keeping her alive, she would die. They finally decided to remove her from the life supporting machines and she expired several hours later.
What a tragedy for the family and for this young baby who would never know his mother. I felt so close to them even though I had never really communicated with the patient. I had cared for her and spoke with her husband almost daily for 2 months praying and hoping that one day she would just wake up and the nightmare would be over. But unfortunately that was not to be the case. The day after she died, I was called with the results of her autopsy. She had a brain tumor that had ruptured a blood vessel in her brain and that was the cause of her coma and subsequent death. I felt relieved that everyone had made the right decisions and that there was really no hope to save this woman. However, that was not what I had signed up for when I decided to become an Obstetrician. I wanted only the joy of delivering a healthy child to a healthy mother. But now I was again placed in a terrible situation which, for me at least, the effects have remained for a lifetime. I’m sure it would have been harder if I had known the patient before that tragic event, but at least I was spared that. So now for the second time I had witnessed a woman die having a baby and I can assure you I really did not know if I could ever go through it again. I subsequently saw one of my female partners go through a similar tragedy. She was on call one day and caring for a patient of ours in labor when, all of a sudden, the patient stopped breathing and suffered a cardiac arrest. A Code Blue was called over the PA system of the hospital which brought doctors, nurses and technicians running from all over the hospital to assist. This was even more urgent because the page was coming from the Labor Room. While the patient was being resuscitated a Cesarean Section was performed to try and save the baby. Unfortunately the baby did not survive either. Again, one minute everything is fine and the joy of anticipating the birth of a newborn is destroyed in a heartbeat by a disastrous event. I spoke to my partner shortly after and she was in shock. She thought the patient had suffered an amniotic fluid embolus in which fluid and debris enter blood vessels in the uterus and subsequently went to her heart and lungs resulting in death. The autopsy the following day would prove her to be correct. These events, though rare, are almost always fatal as it was in this case. I knew the pain she was going through, but she handled it as best as possible. It still brings a tear to her eyes to discuss it many years later. I happened to be on call the very next day and I really thought that I was not sure I could survive another disaster like that. Again those are the situations that a doctor could be called on to face any day of our career. So the joy of helping our fellow man must always be tempered by the thought that we could suddenly lose the person we are caring for despite our best efforts. That is a tremendously sobering thought that we live with and, believe me, there is nothing that can take away the pain of those tragedies. It lives with you forever! The next time you think your doctor makes too much money or that they are in the profession for the money, please think again. We must endure the sad parts of our profession as well as the good and sometimes, I get very angry when I hear someone accuse a doctor of being in it for the money. It only shows the ignorance on their part of what a physician goes through on a daily basis while trying to provide the best care for our patients. The next chapter will bring us to the subject of malpractice, which is very emotional for most physicians. To think that we do not care for our patients or would negligently harm them is a stab at our very hearts. It is not just a business, as a lawyer once told me. It is so much more than that. The day that medicine becomes just a business is a day that all of us will deeply regret. Unfortunately, I think we are being forced to look at it as a business more and more nowadays.
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