Serendipity

Retirement is like a marriage. One never knows how it will work out. I enjoyed the practice of medicine and hesitated to take down my shingle when the time came. I was apprehensive because I was worried about losing the daily contact with my patients and my office staff. On the other hand, I was glad to get rid of the paper work and the constant anxiety created by the need to keep up on new developments in the field of medicine. Now it has been almost 10 years since I saw my last patient and still my former patients meet and greet me and look after me the way I once looked after them.

When I get on the city bus the driver says, “Good morning, you want to connect to no. 5 don't you?”

I question, “How did you know?”

“You used to be my doctor and I've seen you on the bus before. No. 5 is right behind us and I'll tell the driver to let you get on now, then you won't have to walk so far.” Indeed caring and thoughtful of her.

A few days later, as I stand in the cafeteria line trying to decide whether I should add cottage cheese to my salad, the lady next to me says, “Oh, you are Dr. Justin, aren't you?” I turn and find a plump, pleasant blond lady who, despite our loaded trays, is about to hug me. “Oh, I am so glad to see you! You delivered my baby 45 years ago, do you remember?”

What fun to be greeted by former patients in the restaurant, grocery store, and even while standing in line at the outdoor privy before starting out on our hike up the mountain. “Dr. Justin,” a lady calls from the back of the line, “what are you doing here?” I am tempted to answer, “Trying to use the toilet, same as you.” But I refrain and tell her, “We are going camping and you?”

It takes tact to answer this elderly stranger who approaches me with: “Hi, do you remember my mother, Mary? She was a real pill all her life and I appreciate that you were willing to take care of her. Do you remember her?” I do remember Mary (not her real name) and she was a difficult patient, but I don't need to share that fact with her daughter. My response is: “Yes, I do remember your mother. Thank you for speaking to me about her.” I am sure that patients who did not like me also recognize me, but they don't seem to have the impulse to talk to me.

Unexpectedly, I also meet former colleagues, a pathologist and a radiologist. We are glad to see each other and spend a few minutes chatting, catching up on what we are doing and commenting about the new hospital that has just been built in our community. As a retired family physician I know that they do not share my experience of meeting patients who recognize them. They do not have the privilege of knowing patients and their families for decades, celebrating as well as mourning with them.

Meeting patients, friends, or colleagues from the past is refreshing and often astounding because the old connections are not severed by elapsed time. Feelings and emotions change less than our bodies. We barely recognize each other because black hair has turned gray and posture, that once was upright, is stooped, but our shared memories have not changed—we remember the day of birthing in fresh detail. We can continue an intimate conversation that was started years ago when we run into our friends. What joyful reunions take place when old friends fall into patterns of communication that were established when young and energetic. So it is also with patients whom you have honored and respected, who bring you an unexpected gift of friendship when you meet in the cafeteria line.

The internet has made it possible for patients to track me. One lady finds me because her parents chose to give her the same name that I have. Another writes: “I looked you up on People Search.” She finds out from this resource where I live and what I am doing and writes to let me know about her family's social and medical history. Apparently I delivered her son and found him to have a heart murmur for which, at age 5, he had surgery in Texas. He is now 40 years old and well, with children of his own.

Recently I received this note: “On Friday evening I went to dinner at my favorite Italian restaurant. I mentioned to my friend that I had a great visit with you when you were in town. The waitress apologized for eavesdropping, but at mention of Dr. Justin's name had to intrude and tell us that Dr. Justin had delivered her and her 5 siblings at the local hospital.” Obviously I cannot hide. When I was still in practice there were times I wished I could wear a disguise, be invisible. If I was grocery shopping with my young children and a patient would engage me in a long conversation, it was hard to keep my little ones from becoming impatient and at the same time remain polite to the intruder. Now this is different. I feel pleased and complimented when a former patient speaks to me, and I no longer want to hide because it might cause me to miss being part of my patients’ lives once again, even if only for a brief moment.

Not all my encounters are joyful. One e-mail reads: “It is timely that you have reentered our lives. Mother was diagnosed with a far advanced brain tumor.” At that point I wish I could hurry to mother's bedside to comfort her and her family members, 3 generations of whom had been patients. All I could do was to continue to exchange e-mails. I regretted that I could not emerge from retirement to minister to this family during the crisis. Overall, however, retirement has been a positive experience. As a court-appointed volunteer I work with abused and neglected children. In that position I am able and allowed to bond with the youngsters and their parents to help them create a healthier family milieu.

It is humbling to experience the reversal of roles in which my patient, the bus driver, takes care of me instead of my taking care of her. I realize when I meet my former patients that the affection we had for each other in the past is still alive. I am deeply grateful for this as well as for the choice I made long ago to become a family physician who was able to form long-term relationships with her patients.

• Received for publication September 2, 2008.
• Revision received November 4, 2008.
• Accepted for publication November 10, 2008.