“How many lives did you save today, Dad?”

That is what my kids would ask me, rather sarcastically, many years ago, when they were young and when I arrived home late, missing our game of backyard basketball. They knew I was a neurologist. And, of course, they knew I didn’t exactly save lives since, as I had explained to them many times, my job consisted of giving folks lots of medications for headaches and various aches in other body parts.

Now fast forward about 30 years. I saw Eleanor, an 86-year-old woman in my neurology clinic. She had a common neurological diagnosis, what we in the business call “little old lady dizziness.”  Of course, there was nothing at all seriously wrong. But during the visit, Eleanor told me her story. Her husband had died nine months earlier. They had met roller skating. She thought he was the cutest guy in the roller rink. They were both 19.  And for the next 67 years, they “skated” together. He was her husband, her lover, her best friend, her square dance partner, and her RV camping buddy.  As she told me the story, Eleanor had a good cry. She had a good laugh.  And though Eleanor was just as dizzy when she left my office as when she entered it, I felt good about the visit. I drove home that evening feeling a glow of satisfaction. On that day, I felt I had connected with my patient. On that day, I felt I had done something worthwhile.

And I had this thought:  Had my sons greeted me this night with their usual refrain, “How many lives did you save today, Dad?” now, after this encounter with Eleanor, I would have replied differently.

“Fellas,” I would have replied, “I did save a life today. I saw Eleanor. I heard her love story. I heard her grief story. I know she felt good talking to me. I know I felt good listening to her.”

But the life I saved was not Eleanor’s. On that day, in that encounter, I had allowed the joy and meaning in medicine to bless my own life.

There is a teaching in the Hebrew bible.  A rabbi asks his students that very question: “Where does God dwell?”

One student answered, “Heaven.”

Another answered, “We are only human; we cannot possibly know where God dwells.”

“No,” the rabbi replied. “God dwells wherever we choose to let God in.”

Perhaps the same question could be asked about the joy and meaning in medicine. Where does it dwell? And the answer may be the same. It dwells wherever we choose to let joy and meaning in medicine into our physician-healer lives.

As I look back upon my career, it saddens me to know that those doors to my dwelling were closed shut so often. For so often, I had not a clue as to where lay the key to unlock them. For so many years, this encounter would have been chalked up to another annoying, unfathomable “little old lady dizziness syndrome.” But, on that day, in that encounter, I was graced to have those doors opened by an 86-year-old, dizzy, square dancing roller skater.

I hope the doors of that dwelling never close again.

Scott Abramson practiced neurology with Kaiser Permanente Northern California for over 40 years, from 1979 to 2020. Throughout those years, Dr. Abramson was passionately involved in physician communication and physician wellness endeavors. Some of his insights and stories from his experiences in these endeavors can be found in video format on his YouTube website channel: Doctor Wisdom.

Others are available in his recently published book, titled Bedside Manners, for Physicians and Everybody Else. What they don’t teach in medical school or any other school.

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