My Doctor Dilemma

I arrived last spring for a regular check-up at my doctor’s office. I’d been a patient there for more than 30 years. My original doctor – whom I still miss – had suffered a massive stroke more than a decade ago, and never recovered enough to return to his practice. I’d visited several new (and younger) doctors whose names I’d collected. In the end, I became a patient of one of the two remaining doctors at the same office I’d been going to for years. By now, I’d become nearly as comfortable with Doctor Howard (not his real name) as I’d been with his predecessor.

Until the morning last spring when I was ushered into the examining room for a check-up. In strode, or rather hobbled, Doctor Howard. Shocked would not describe my first reaction. Beyond startled, I felt terrified. Perched uncomfortably on the examination table, I fought my impulse to jump down and make a dash for the door.

I’d always taken Dr. Howard to be about my age. On this day, he looked the same – but something was off. This once gruff, jocular, and overweight man was barely recognizable. I stared as he lurched in, one hand pushing a hospital walker, the other propping up his chin to keep it from collapsing onto his chest.

“How are you?” I managed to ask. “What’s happened?”

I’d no idea if this was the proper thing to ask.

“Much better,” Dr. Howard said.

If I had trouble finding the words to ask, Dr. Howard, once questioned, was like a spigot – the words poured from his mouth – the only truly functional looking part of his face.

The words continued to pour. I slowly grasped that he’d undergone some horrific type of spine surgery to correct a bone that threatened to grow into his shoulder.

His recovery had been slow but steady.

As I continued to stare in a kind of panic, Dr. Howard moved slowly around me on the examining table. Then, after somehow managing to ditch his walker, with his one free hand still holding his head aloft, the doctor struggled to give me a one-handed exam.

Seated in his office, several minutes later, Dr. Howard had a few questions for me.

“You still seeing Dr. Baxter?”

“My spine doctor,” I replied. “I see him every few months. Aren’t you receiving his reports?”

I don’t recall Dr. Howard’s response. But his eyes looked vacant, seemingly focused downward.

On returning home, I phoned Dr. Baxter.

“Are you still sending my reports to Dr. Howard?” I asked.

“Of course,” came the reply.

I wished the answer had been different.

It meant one thing. Dr. Howard was getting these reports and either didn’t remember reading them or wasn’t bothering to read them.

Either alternative struck me as dire.

I phoned my gynecologist – a colleague on the staff of the same hospital as Dr. Howard. “Have you seen Dr. Howard lately?” I asked.

“You mean he’s still practicing?” The doctor sounded genuinely shocked. “He looks like he should still be in a hospital.”

Between Dr. Howard’s scary looks and his failing memory, I knew it was time for me to find a new doctor. In fact, at least one friend thought this step was long overdue.

“You mean you’re still seeing that man? What’s wrong with you?” my friend Susan said.

She’d never forgiven Dr. Howard for wasting a week with half a dozen tests after I fell on my head and woke up one day partly paralyzed, before as a last choice, sending me for an MRI of my brain. It was fortunately in time – to diagnose the subdural hematoma which was the cause of my frightening symptoms, and to have the bleed safely excised from inside my head.

Thus began my search for a new doctor: one younger than me, who took Medicare, and who practiced in a hospital I’d want to be a patient in.

In the past, I’d changed doctors several times and, while daunting, it never seemed as challenging as now.

I collected names from friends, but none of these at the start panned out. One doctor said he no longer took Medicare (in fact, numerous New York City doctors no longer accept Medicare). Another doctor – who had briefly practiced with Dr. Howard – said he no longer took new patients.

My opthamologist told me to try phoning his internist, a man he swears by. “He has a ‘concierge’ practice but he’s cheaper than most,” he told me.

I couldn’t afford to pay for a concierge practice, which I’d heard can cost in the thousands. But I thought I’d give this one a try.

After the usual four to eight weeks just to get an appointment, I finally arrived.

Dr. Klingstein’s office looked out on Central Park. But its reception room was so tiny I had to walk through its door sideways just to keep from bumping into the receptionist’s chair.

The examining room I was in was not much bigger. After a few minutes, the receptionist returned, only she’d changed into a nurse’s outfit.

“You’re the nurse and receptionist?” I asked

“That’s right. I’m also the way you can always reach Dr. Klingstein,” she told me.

Dr. Klingstein soon entered and he elaborated on this system. “We have the luxury of only taking a few patients. But I’m available to them any time. You can phone this number and Murphy here will connect us, no problem. You pay $750 up front and then Medicare kicks in.

I’ve never had any complaints.”

What if Murphy gets sick? I wondered.

On the way out of his very tight quarters, I actually banged right into Murphy’s chair a second time. I ruled out the concierge practice. I kept worrying that Murphy would be overtaken by some calamity and I’d never be able to reach the doctor.

Another friend told me to try a Center for the Aging on the far East Side of Manhattan. You see many specialists, all in one place, and they take Medicare.

But when I took an Uber to the Center and found myself seated in a waiting room with half a dozen patients in wheelchairs, I became despondent. I knew I was old. But I didn’t like thinking of myself as that. old. Plus if I woke up with a bad sore throat, I liked the idea of being able to phone a regular doctor, not a whole impersonal Center, for advice. There was also no guarantee I would see the same doctor each time.

In desperation, I asked my longtime dermatologist, Dr. Soll, if he knew of any other internists who still took Medicare.

Dr. Soll told me that a few months ago, Dr. Howard had finally retired from practice. It was only then I learned his true age – Dr. Howard had retired in his mid-nineties. He was more than a decade older than me.

Dr. Soll gave me another name and I grabbed it. This doctor also had a concierge practice – but only for $500 before Medicare kicked in. He also had both a nurse and receptionist.

The doctor was a third-generation practicing doctor; his grandfather, in this same office, had treated the actress Sarah Bernhardt. I learned this during my first lengthy visit after I noticed a Bernhardt biography on a table in his office.

At our first meeting, I noticed one red flag. A highly respected gynecologist I used to see had an office so over-crammed with knick-knacks and doodads that I always wondered whether it was a symptom of complete insanity or a badly cluttered mind. There were lots of knick-knacks on this new doctor’s shelves and tables and desktop as well. But the doctor asked me intelligent questions. I didn’t think the doodads were leang his mind so crowded that he could no longer think straight. I decided that maybe Manhattan doctors’ offices are like the rest of the city’s apartments: too small to hold everyone’s belongings comfortably enough without driving their inhabitants totally nuts.

So I signed on to my new internist. And all has been well.

Except this fall, there's been a new problem. Dr. Soll, the dermatologist who referred me to my new internist, has been out on a long, unexplained medical leave.

And I totally dread having to go through another repeat horror experience lsuch as I’ve just survived.