When The Lights Cannot Be Turned Out

     Ever since man discovered that fire would push away the darkness, light has played a considerable role in our lives. One good thing about the electric light is that, for the most part, we can still control it. The ability to turn the light on and off whenever we desire is great, but there are times when the light cannot and should not be turned out. This is especially true in medicine. My father and mentor, who will celebrate his 86th birthday this month, taught me this and many other valuable lessons. Taking a bit of editorial license, I want to share some of these lessons with you.      My father is the only child of a Southern Baptist minister and his devoted wife. Growing up as a preacher’s child had its share of challenges, but Dad used the opportunity to excel in several areas. He graduated from high school at age 16 and Rice University in Houston at age 19, and thanks to World War II, medical school by age 22. Yes, my father was a licensed physician at age 22. He chose to specialize in general surgery and entered his residency program. Service in the Korean “conflict” interrupted his formal training, but at age 26 he found himself in charge of the surgical service of an Army hospital in Japan. Following his military service he moved us to a small, West Texas town to practice “real medicine.” He treated everyone and every problem that came along. A few years ago he finally retired for the third time after 54 years of practice. He always tells me that he has forgotten more medicine than I have yet learned. He is probably right!      As my medical education progressed, my father was right there letting me work with him, teaching me many things that came from experience and not just from a book. He taught me the importance of handling tissues gently. I was to treat tissues as if the patient had no anesthesia. It is amazing how well wounds heal when you treat the tissues with respect.      He taught me to treat the patient and not just the disease or problem. My father also taught me to listen to the patient. As Dr. William Osler taught many years ago, if we will let the patient talk, he will eventually tell us what the problem is. Unfortunately, today, we are great at ordering tests but fail miserably when it comes to listening or even asking the “right” questions. Dad taught me to spend the necessary time with the patient.      How do we make the patient realize we truly care for their well-being and are listening to them? Dad taught me to sit down when talking to a patient. When you walk into an exam room, sit down as you talk to the patient. When you are making hospital rounds, sit down as you talk to the patient even if it is just on the bedside. He pointed out that even if you are only sitting for a few seconds, the patient perceives that you spent much more time with them. This has been something I have practiced for years and found to be very true.      Another thing he taught me is that sometimes plans have to change because patients must be seen no matter the time of day, the day of the week, or whatever else might be planned. How would you feel if it were your family member who was put off with the possibility of the condition worsening? There are times when the lights cannot be turned out.      Years ago a now-famous pediatrician was teaching a rather unorthodox, somewhat unheard of method of rearing children. My father was appalled at this teaching. Not being one to sit by idly when he believed children were being wronged, he countered with his own book, The Discipline of Raising Children¹ that espoused a time tested, successful method of raising children. Dad did not believe the lights should be turned out on an entire generation of children. Dad’s book was not a best seller as the other book was, but a few years ago when the other author issued a national apology saying that his recommendations had been all wrong, Dad felt vindicated.      As my father’s career is ending, I am going to miss his guidance and wisdom. I shall continue to “mine the gold” as long as possible so that even at this stage in my career I can continue to learn. I hope you will also learn from my father that there are times “when the lights cannot be turned out.” Thanks, Dad.