As I greeted my next patient of the morning, I knew from the early folder number that I had seen him six or seven years before.  I no longer expect to remember everyone I have ever met professionally. The man before me was tall, fit and well built. There is usually some inkling of recognition, but nothing about him was familiar to me at all.

We made small talk for some moments while I scanned his digital records for information.  He had consulted me for a vague nasal complaint in the past, and I had noted then that he was seriously overweight, a smoker, and possibly diabetic.  I had prescribed treatment for his ENT condition, and had not seen him since.  The clinical record bore no resemblance to the person sitting opposite me.  I began to check the details to see whether I had the right file.

Then he started to speak in earnest.

“Last time I sat in this chair, doctor, and you sat opposite me over there in that chair, you told me I was a ‘ticking time bomb’ for a stroke or a heart attack.  I want you to know that within 6 months I lost 45kg.  I stopped smoking.  I got fit.  I went out and did healthy things.  I sorted out my relationships. You changed my life around, and these past years I have never been happier.”

“You made the difference.  ‘Ticking time bomb!’  I’ll never forget it.”

His words opened up a chasm, digging directly to a soft core deep within me, calloused in quiet desperation at a career bogged down with negatives.  Managed healthcare agencies, medical insurers, coding requirements, malpractice agents, pricing regulators, inept medical administrators and bureaucrats, demanding patients, worried bank managers – all these over the years had chipped away at my sense of calling and enjoyment in being a doctor, to the point that I sometimes no longer believed I had made either a sensible or right choice of career.

And in that brief moment of enlightenment I knew why I will carry on doing what I do.  It is not for the day to day drudgery and regular frustration, nor the diminishing financial reward, but for the opportunity to be highly influential, not only by surgically cutting away problems, or hitting diseases with drug prescriptions – those are the easier things to do – but also for the licence to speak hard truths into people’s lives, and every now and then to see startling results.

For this is neither an easy nor a comfortable job.  But the rewards, sometimes hard to recognize, are every now and then overwhelming, amazing, euphoric.

I was nearly in tears as I told him how much satisfaction that knowledge brought me, and we moved on with the consultation.

My forgotten sentence all those years ago may have turned around my patient’s life, but the joy of knowing his positive outcome so much later, brought back in person, was a gift returned to aid the restoration of mine.

Martin Young is an otolaryngologist in South Africa and founder and CEO of ConsentCare.

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