Chapter 49


Fam Pract Manag. 2003 Oct;10(9):70.

Office makeover

After 15 years of working in the same space, it was time for an office makeover. Although I had repainted my office several times over the years, it was always in the same shade of white. Now, I wanted a different look, something my patients would appreciate and I would enjoy.

My wife and sister-in-law had fun choosing the floor coverings, but when it came to picking the paint, we decided to use a real pro, our friend Nancy. Nancy has an eye for color and selected lemon yellow for the walls and white for the trim and doors. I was a bit skeptical, being somewhat resistant to major changes, but after Gabriel, my painter and patient, had done several rooms, I was impressed. “I love it,” my wife said. I had to agree; it was awesome.

Nancy had plenty of other suggestions besides, since she had no personal attachment to any of my things. “Lose the ficus,” she said. “It’s much too big for your waiting room. Replace those chairs, get rid of that table and have a slipcover made for the couch.” When it came to my pictures and art, Nancy was a minimalist. “Your walls are too busy,” she said. “Let’s rearrange things.” She grouped some of my photographs together on one wall, careful to match the frames, and rehung most of my pictures in different places according to their theme, color and size. I helped her hang them. “Move that one a little to the left,” she said. “No, up a bit. Maybe a bit lower. That’s perfect.”

Gloria, my temporary office manager who was observing all of this, started hee-hawing. “You gringos really crack me up,” she said.

“Why?” I asked. “How do you hang your pictures?”

“It’s easy,” Gloria said. “Each of my kids has a wall. I put all my pictures of Isabel on one wall, Junior on another and Cali on another. Melissa, Mary and Pepe have their walls too. I just start in the middle and work my way out. It’s so funny watching the two of you fussing to get it just right.” Then she started laughing again while I was grunting and trying to hold up a particularly large frame.

“You know, Gloria,” I said, “I’m really glad this is your last day working for me.”

The shock of recognition

It was time to take my 92-year-old mother to the city so she could fly home to Florida after a three-month stay. Before she left, she wanted to visit an old friend, Marsha, who lived in a nursing home close to the airport. Marsha and my mother had been best friends in school but hadn’t seen each other for over 20 years. At their last visit, Marsha had driven Mom all around the Bay Area and was still working full time as a bookkeeper. Now, she couldn’t even take care of herself. Congestive heart failure had rendered her oxygen-reliant, and she was bed bound and wheelchair dependent. She was nearly blind from macular degeneration and was hard of hearing besides. We didn’t know what to expect.

When we arrived at the nursing home, a nurse told us Marsha had gone to dinner, but no one in the dining room looked familiar. All the residents had white hair and blank stares. “Which one is Marsha?” I asked an attendant. The woman she pointed out didn’t look like the Marsha I remembered, but I went up to her anyway. “Marsha, it’s Sandy and Gert,” I said. No response. “Sandy and Gert Brown are here to visit you,” I said, directly into her ear.

“Who?” she asked, quizzically.

“Your old friend Gert and her son Sandy,” I said. Suddenly, her demeanor changed. Her face lit up, and she came alive. She looked like Marsha!

The two old friends had a joyous reunion, while I visited with Marsha’s daughter. I asked when her mother’s health had declined. “She was doing great at 85, but when she had to give up driving and working, it was all downhill from there.” I was reminded of Pearl, my gardener, who was still doing a full day’s work at age 90. “So that’s the secret,” I thought. “Never retire.” It’s a good thing I love my job. I wonder what my Social Security payments will be if I don’t start collecting them until I’m 90?

The over-the-hill gang

Every Saturday morning I arise at 6:15, feed the dogs and get ready to go down to the health club for some pick-up racquetball games. What I particularly like about these games are my cronies, all in their fifties, with assorted medical maladies. We’re not talking sports injuries here. Danny recently underwent a cardiac ablation for intractable atrial fibrillation. His dual chamber pacemaker is keeping him alive. Doran experienced sudden death last year on the court, was resuscitated by an EMT he had the good fortune to be playing against and survived. Six months after his CABG, he was back in the game. Don wasn’t referred to a urologist soon enough for rising PSAs, had carcinoma on biopsy and underwent a radical prostatectomy followed by radiation therapy. And Russ has a prosthetic hip.

I find this group inspirational, especially when confronting patients who tell me they don’t have the time to exercise. I tell them about my racquetball buddies and say, “If a guy with a battery-operated heart and another with coronary disease and another with cancer and another with a plastic, weight-bearing joint can find the time, then you can too.”

After playing with the over-the-hill gang, I will not suffer whiners.

Dr. Brown, a solo family physician living in Mendocino, Calif., is a contributing editor to Family Practice Management. These excerpts from his journal illustrate the many characters, stories and lessons family practice has to offer. No real patient names have been used.

Conflicts of interest: none reported.

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