Dear Carolyn: “Breaking up is hard to do”

3 Aug

by Carolyn Thomas    @HeartSisters     August 3, 2018

Breaking up is hard to do. That’s how my blog reader Tommie O’Sullivan described to me the sad news that she lost first one, and then a second trusted cardiologist. It’s nothing personal. Important family reasons. Retirement. She understands these things. But still. . .

As part of my occasional and ongoing “Dear Carolyn” series of guest posts written by women who have learned firsthand what becoming a heart patient is all about, I’m happy to share this, with her permission. Tommie’s words reminded me that, so far, I’ve been lucky in never experiencing the loss of a favourite physician. I suspect that – in this age of increasingly empowered patients, critical doctor reviews online, and second opinions from Dr. Google – her sentiments are what every physician longs to hear one day from their patients: “I will really miss you!” 

“Dear Carolyn,

“We moved to California about five years ago from another state, and finding good medical care was not only difficult, but critical if you have cardiac issues.

  Tommie O’Sullivan

“I left a wonderful cardiologist behind, who had been a professor at one of the universities known for its cardiac training, but he had retired from teaching a few years before and had begun to cut back on his medical practice. We knew it would be only a matter of time before we parted ways. We found a good primary care doctor right away, and after talking with us and looking at my medical records, she recommended a cardiologist she had just met. He was new in town, but she thought he was just the person I should see.

“She was right.

“UCLA seemed to be trying to take over most of the medical care in southern California at the time, and they had just opened clinics in our new town. The cardiologist that our family physician recommended had been sent up here from Westwood (what most of the UCLA employees refer to as “the Mother Ship”) to set up the cardiology clinic. He had been there two weeks, and I was one of the first patients.

“It turned out to be exactly the right fit. He was a brilliant young man who, after Yale Medical School, had studied at Michigan where they were concentrating on my particular cardiac condition of obstructive hypertrophic cardiomyopathy.* What are the odds?

“I knew before moving to California that I would need major heart surgery within six months to a year, but things progressed even faster than anticipated. I was soon the owner of a brand spanking new ICD (an Implantable Cardioverter Defibrillator) and less than a month later, I was having the heart surgery.

“What was needed was to reduce the septum between the ventricles in my heart. It was enlarged so that it blocked my mitral valve. (See the normal heart on the left, and the heart with hypertrophic cardiomyopathy on the right). My heart wasn’t enlarged, just the septum. The usual treatment is to cut open the heart and surgically remove part of the septum so that the mitral valve isn’t blocked any more. It’s a difficult surgery with a long recovery.

“But there was a relatively new minimally invasive procedure called an alcohol septal ablation. The surgeon goes in through your groin just like a heart catheterization and injects alcohol (ethanol) into the septum to kill the offending part of the heart muscle. Basically, they give you a heart attack while you’re on the table. It’s delicate. Inject too little alcohol and it has to be done again, inject too much and your septum is too thin and weak to pump blood efficiently, and that can’t be corrected.

“My cardiologist found a surgeon for me down in Westwood who, according to him and my electrophysiologist, had done more of these procedures than almost anyone. Even if they were exaggerating, it still meant he’d done a heck of a lot of them. I now recommend that patients should ask their physician these questions if they’re considering this procedure: how many have you performed? How many of those had to be repeated? If the answer is none, then how many repeats have you done for other patients? How many have led to over-reduction?

“Just a few years before then, this procedure was in the experimental phase. I feel really fortunate to have landed with just the right cardiologist, at the right time. Otherwise, I might not have survived.

“Once in his office, I said something about how he must get tired of seeing us, and he responded with ‘Oh no, you’re my fave… uh, no, not at all.’

“He always called me Ms. O’Sullivan.  After two or three years, I finally asked him to just call me Tommie. He said he didn’t think he could do that, it seemed disrespectful. I told him he had seen me without makeup. . . how much more intimate could we get?  He finally did, and began signing his emails with his first name, even though I still used ‘Dr.’ when I wrote with a question. He had earned that title.

“Then, a week ago The Letter from UCLA arrived, telling us he was transferring to another clinic about 60 miles south of here.

“We have seen him since The Letter.  Turns out his parents are having some health issues and he feels he should be closer to them.

“Yes, I understand. Yes, I’d do the same thing, but that doesn’t stop the feelings of abandonment.

“I really believe that this man saved my life. I don’t think I’d be alive today if not for him, and even if I was, I know I wouldn’t have the quality of life that I’m enjoying now.

“When we saw him last week, he said that he’ll miss us, and that I had been one of his very first patients in that clinic, within the first two weeks of opening.

“He also said he considers me not only a patient, but a friend.”

“Right back at you, doc!”

Tommie O.

Q: Have you ever lost a trusted physician – or two! – as Tommie did?

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NOTE FROM CAROLYN: Please remember that this site is not meant as a substitute for your own physician’s advice.  See your doctor for information about your heart health.

* For a translation of cardiology terms, see my patient-friendly, jargon-free glossary (which I was also able to include in my new book, A Woman’s Guide to Living With Heart Disease  (Johns Hopkins University Press, 2017) – all 8,000 words of it!

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See also:

4 Responses to “Dear Carolyn: “Breaking up is hard to do””

  1. Meghan August 5, 2018 at 11:14 am #

    I think this is a very important topic and I completely relate to and agree with Tommie’s feelings. It’s really hard to lose a trusted healthcare provider no matter what field he/she is in.

    I have not lost a cardiologist, but the nurse practitioner in my cardiologist’s office recently left to move to another state, and I will miss her. She was a kind and sympathetic listener and explained things very clearly, and was a great source of encouragement to me right before I had my first cath and stent placement.

    I did experience losing a physician several years ago (long before my heart issues started) when my family doctor moved to another state to be closer to her aging parents. While I understood the need for this, I felt very betrayed and abandoned when she left. I had a difficult time adjusting to her diagnosis that I had Type 2 Diabetes and she put up with a lot from me as I worked through my denial. I didn’t trust the technology and the numbers were just a mystery to me back then. Although she knew her stuff, she came across as kind of a flake. She had a funny and gentle style of relating to you. Being in that office on a Friday afternoon was like a party because all the nurses loved her and she kept it fun for them. Her Friday outfits sometimes bordered on outrageous. I argued with her on how to manage the diabetes, but I liked and trusted her. Looking back, I see that she was doing all the right things for my care. She brought my A1C down from 11 to somewhere in the 7’s with the right medications.

    They gave her a going-away reception so patients could say goodbye to her and I remember that on that day I was very conflicted about whether or not I wanted to go, and I ended up staying home. I genuinely felt betrayed by her leaving — sometimes emotions are kind of irrational — but I should have gone and wished her well. I still feel bad about that, many years later, and once in awhile I wonder how she’s doing and I wish I could just let her know how I’m doing.

    She invested into my life and health, after all, and I think it was hard for her to leave her patients behind. When a healthcare provider gets to be like a friend (especially those with whom you share your difficult emotions), the lines of professionalism get a little blurred and the relationship becomes very personal. (Especially if it’s a cardiologist who basically saves your life or does something to make it a lot better, as was the story here.)

    I should also just mention that my health got a little worse after this family doctor left. I stopped seeing any doctor for a long time, didn’t get an A1C test or take care of myself very well. Eventually I did start seeing another doctor in the practice and one of their nurse practitioners who I just love. I guess it worked out for good in the end.

    Liked by 1 person

    • Carolyn Thomas August 5, 2018 at 1:09 pm #

      Meghan, I had a thought while reading about how you regret not attending that goodbye reception for your former doctor. Why not take a few moments to tell her that now?

      Find out her office address if she’s still practicing, and drop a note in the mail telling her what you just told me. I know that physicians – like all of us! – treasure kind gestures like that – they can make a bad day much better. She sounds like a real character and would likely get a kick out of your note…

      Like

      • Meghan August 6, 2018 at 5:32 am #

        Thanks Carolyn for the advice. I do agree with you and maybe I should do that. (And yes, she was a real character!)

        Liked by 1 person

        • Carolyn Thomas August 6, 2018 at 5:43 am #

          Let me know if you do send a card, Meghan – it would probably make her day!

          Like

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