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When medicine meant care

After 50 years, a doctor is retiring from a health-care system in great decline.

In the novel Arrowsmith, Sinclair Lewis dealt with the life experiences of a young, idealistic physician who tries to challenge and improve the medical system in the 1920s. Though Dr. Martin Arrowsmith is confronted with myriad temptations - including prestige, money, and power - he dedicates his life to his patients and finding a cure for infectious diseases.

My father was inspired to become a physician after reading Arrowsmith as a teenager. He, too, learned to navigate the many temptations of the medical profession and devote himself unconditionally to caring for his cancer patients from northeastern Pennsylvania's anthracite region.

After 50 years of service, my father, who considers himself a "dinosaur" in a rapidly declining health-care industry, has decided to retire.

Health care has changed dramatically during the last half-century. Once considered a calling, the profession has become a business in which the bottom line often matters more than the quality of patient care.

Malpractice rates

Meanwhile, insurance companies are charging physicians exorbitant malpractice rates, which in Pennsylvania has resulted in an exodus of physicians to other states. Others, mostly specialists, try to recoup their financial losses by ordering more tests and procedures than are necessary.

High premiums have also driven physicians out of medicine altogether and limited patients' access to care. Nor do hospitals always provide adequate follow-up care for elderly patients who wind up being readmitted repeatedly for the same problems.

For my father, the practice of medicine was an art - the art of caring. Growing up, I'd sometimes tag along as he made his hospital rounds and house calls (remember those?). I always knew the entire day would be shot, because my father loved his patients. He considered them as friends and, sometimes, family. As a result, each visit could take an hour or more.

nolead begins

Always positive

My father was a compassionate caregiver. Realizing that a cancer patient's attitude has a significant impact on his illness, he was always positive, though realistic about the diagnosis. He was careful to answer questions and explain things in an understandable way. And his earthy sense of humor almost always left them laughing.

Since my father treated many poor people, he did not always bill for his services. Having grown up during the Great Depression, he knew what it meant to be poor.

When a patient died, my father did his grieving in private. He tried to find solace in his efforts to improve the quality of their lives.

Though his patients often spoke of him as their hero, I know that my father was embarrassed by the praise. A hero is extraordinarily selfless, committed to his calling, and a cause for hope under the worst circumstances. While I believe my father's career reflected all of those qualities, he'd give greater credit to the partnership he developed with his patients.

"We plugged along doing our best," he'd say, as Dr. Arrowsmith did at the end of Lewis' book. "It's all we could do, or we'd fail each other."

That's what it means to care.