Stories from the Stethoscope: November 2020

Read the November 2020 edition of Dr. Powell’s monthly column: Stories from the Stethoscope.

Dominic chose me as a provider because I had late Tuesday hours. In the early part of 2003, I assumed another provider’s time slot that lasted until the late part of the evening. It was usually quiet and those that took advantage of those visits had the opportunity to chit-chat with me. Dominic was in his late 50’s. He worked in New York City delivering soda all over Manhattan. He worked 6 days a week and had severe back pain due to heavy manual labor. He took so many Ibuprofen tablets over the years that when I first met him, he had significant renal failure. He did not have the time to see other doctors. He loved working and refused to give it up. I managed his kidneys with him. Management meant mostly advice about what not to ingest and how important it was to watch his status closely with laboratory values. Each visit he would allow me 10 minutes to discuss his health and then he would spend the rest of the time sharing his workday experiences and the people he met. He loved going into each store, spending time with the workers and patrons and discussing the latest current events. He smiled as he shared his work week. He never discussed his day off, only the days he worked. It was as if the day off was a necessary evil that he put up with once a week. We shared glimpses of our lives every three months for quite a few years. I enjoyed him as much as his customers did. Unfortunately, he suddenly died without a clear diagnosis. He had a limited autopsy, and it was felt he probably had a heart attack.

At first, I felt bad for him. I remember driving in my car thinking about him. Did he die lonely? Did he have any quality of life? He was never married. He never had children. He never traveled because he worked 6 days a week for years. Yet as I drove, a new realization formed. Who am I to judge the quality of one’s life? I have had patients tell me that I work too much. Perhaps to them, I do not have a quality of life. Life quality is a personal assessment. Dominic loved his job and loved the people he saw every day. The social support and social interactions he had with his customers made the six days a week all magical to him. He never wanted to miss it. He took ibuprofen for years and sacrificed his kidneys to spend time with those that brought him joy. 

He changed the way I view quality. Life satisfaction comes in many forms. When you open your eyes and examine what is around you, it may surprise you what you will find about yourself and others. As I prepare for Thanksgiving, I may not be able to share it with everyone this year, but I will thank them for the fulfillment I feel today and the quality they have created with me.

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