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For the better part of 40 years, I have worked on the administrative side of healthcare, spending much of that time at the CEO level for hospitals. As such, my role as a natural antagonist to physicians should be as inured as my personality. After all, hospital administrators and physicians are at the top of their respective food chains - one fighting to preserve resources in order to stay in business and the other demanding them for patients.
That was me, but not now, and not for many, many years.
This is the story of how Dr. Katz taught me that practicing medicine is not all science.
It was the summer of 1979. As with many newly married couples, my wife and I had little interest in starting a family. Two incomes, two careers, youth and resources; life was great. That is, until our biological clocks ticked their last seconds and exploded into a primal need to reproduce.
Suddenly, having a baby was the most important thing in life, a singular, irresistible impulse that would lead to the most gut-wrenching disappointment of our lives because, after months of trying, nothing happened.
Because my wife and I both work in healthcare, me on the business side and she on the clinical side, we did what keeps most couples together for 40 years - I made suggestions with comparative qualifications and analysis, and we went to see her doctor because he was “nice.”
So we did all of the tests, some unpleasant, some invasive, some creepy. I was sure we would find out what was wrong with her, and soon. After a week and three visits, sure enough, this doctor had it all figured out - we needed a urologist and male-reproductive specialist.
That’s when Dr. Katz came into the picture.
Dr. Katz had a small, but very busy office. His office manager, nurse, and billing staff - typical of most small practices at that time - was his wife, Kitty, and I am not making this up. Kitty Katz cut off my opportunity to make a joke with “and don’t bother with the cute stuff; I’ve heard it all.”
I said, “I wouldn’t dream of it, you’d probably leave me yowling in pain.”
It was two weeks before the shin bruise where my wife kicked me healed.
Dr. Katz came into the exam room, where my wife and I sat marinating in that sticky mixture of dread and anticipation that leaves you a little sad and uncomfortable, yet tingly with the danger of it all.
At that point, I was pretty used to dealing with doctors professionally, but not like this. While doctors frequently and freely said that my world was perplexing with observations like, “How anyone could come to make that kind of policy makes me wonder…” and admissions such as, “I won’t even try to follow your thought process,” I had to admit, this was one of those times where I began to appreciate the other side.
Dr. Katz smiled and dispensed with the small talk.
“Well,” he said, “I could run you through a battery of tests, but, the fact is, I have enough information to say with great confidence that, based on what I see today, the chances of you getting pregnant are very remote.”
He proceeded to tell us why, and recommended we consider adoption. We scheduled another appointment in six weeks.
When we returned, he ordered a pregnancy test. It was positive.
Dr. Katz correctly diagnosed us as trying too hard, which, combined with stress, caused temporary infertility. To say that his diagnosis and strategy were brilliant, even when the diagnostics supported infertility, is an understatement.
That day, and three children in the next four years, changed our lives in ways that make us forever grateful.
That day, I learned that if doctors and administrators worked together, and worked to see one another’s worlds from the other’s perspective, we could often turn tragedy into triumph, doing more with less, and collaborating with wisdom and, sometimes, a bit of larceny.
Like Dr. Katz.