Doc Boomer Hits Half-Past

(a hands-free cell phone conversation in a car) 

By Michael Siegel, M.D.

>>  Marty? Hey, Marty, it’s Ben!

>>Yeah, Ben Abrams, from— Right! How’re ya doin’?

>>What’s it been? 15 years, like? So, tell me—

>>Fan-tas-tic. Great…

>>Oh, that’s great. The kids are, um…?

>>You. Are. Kidding: David’s at Moorhouse, Bernstein? Wow!

>>Man, that’s one helluva school your girl’s gotten into: you should be proud, buddy. Very—

>>Fine, they’re really fine. We have Amy at the Kauffman school, now—which is a pretty good deal, considering how hard it is to get kids into the better private schools and how mediocre the public schools turned out to be around here. Jeez…

>>Don’t tell me: 10 acres for how much? We moved to Meadowville—and paid an arm and a leg for a house there—just for the schools, and so the kids are in private—

>>Woo… good memory! Jennifer is waiting for her college acceptances, and, if she got into Penn, that would be what Sue wants, but there’s absolutely no shame in going to a UC.

>>—and… it would be a whole lot chea—

>>Sue? Sue’s still working part-time. Yeah, for Pharmex.  Consulting, too.  Free-lance.  Marty, even with a nanny, she still drives all over creation in the afternoon taking kids hither and yon, so it sorta has to be part-time…

>>—which has been a godsend, man, ’cause I don’t how we woulda made it through the nineties without her bringing home that check, lemme tell ya, especially with a mortgage like we—

>>Yeah, well you were never hit out there by that managed care B.S. like we were, boy!

>>Me? Ya know… same old, same old. A little of this, a little of— Huh?

>>Um… No. We didn’t, uh, we couldn’t, that is, I couldn’t keep doing that kind of thing. Joe and Betsy are great folks, pals even, great docs. But…

>>Ya know, Marty, hey—I’m not cut out for that Marcus Welby shtick. See? It’s Makeus Sickby is more like it, hahaha…

>>No, my friend, no, no, no: not hardly. In today’s medicine, the great commodity is time.

>>Yeah, I said time. It all gets away too soon, and then where are ya?

>>Never mind that. Joe and Betsy are trying to be all things to all patients all the time. They still work nearly 80 hours a week: and why?

>>That’s ri-ight. They refuse to get with the program. Simple math: you make less per patient, you see more patients. That’s how I do it. They would rather take all day and part of the evening to—

>>Well, sure. Sure, Marty. But, look at it this way: change or die. You don’t do neurology with a “pin and hammer” any more, do ya?

>>No, you have to give people what they want, and if that’s all their tests and services under one roof. And speaking of what people want: it’s tests. Don’t you think so?

>>I’m sure. You were always very strong clinically, and I think I’m strong clinically, and our whole program was that way, but that’s not what matters.

>>Hey, I don’t know who you see, and how savvy they are about medicine, but everyone around here has a laptop and a PDA, and they are wired, and can get information faster than you can, boy.

>> —because they don’t know what to do with it, and you do… so maybe, just maybe, they actually need you for something. Mostly, though, your opinion, your judgment, is irrelevant. That’s not what they need. Or want.

>>Sure, Marty—here’s what it is: your ability to order tests.  And prescribe drugs, but mostly the former. And while I’m learning to live with how disrespectful all of it is… why not also do the tests?

>>Oh, I know. But I’m careful not to do too much of that.  Can’t send yourself too many patients, old bud. Remember Art Goldman, when we were residents?

>>OK, I was always more friendly with him…

>>So, well, for the first 10 years after I moved to California he kept begging me to come back and join his group. I dunno… five, six times, Marty.

>>You, too, huh? How’d you like to make rounds on 50 patients every weekend, my man?

>>Yeah, we did too in ’84, ’85, but I’m talking 2004—hey, those nuts work longer hours than Betsy and Joe and they see more patients per hour than I do.  Plus, they’re doing so many tests—

>>Here’s what I think: you do that many tests, a lot have to be completely unnecessary: what I was talking a minute ago about Art when I said “sending too many patients to yourself.” Listen to—

>>—anyway, I heard this lecture a few years ago by the chair of their department at Rocky Point, ummm… Pat Dooley—the MS expert—and she told me, not having any idea how tight Art and I used to be, what a bad rep he’s got. I swear.

>>An animal, I swear, Marty: a wild animal. That’s why he’s making twice as much… Ohhhh, yeah.

>>Not just that. Please. Please, it’s not that. It’s time, like I said. That AAN meeting in San Fran a couple years ago? I met Art, and also Bob Wysnewski, and Jim Hartford—

>>Yeah, the “fearsome foursome.” I know they used to call us that. Anyway: we’re all about the same age. So—

>>So, guess who looks 10 years younger than the other three, and guess who’s not 30 pounds overweight?

>>Hahaha… That’s ri-ight. Yours truly, and you know why?

>>—now, he’s full of Botox, dude.

>>No way. I’m not killing myself like Art and Bob, and even Jim, are. Rounding on 50 patients Saturday and Sunday! Hell, no!

>>Look. I’ve seen that model. Harry, Sue’s dad: worked like an absolute bow-wow for 45 years before anyone could even talk retirement to him. Wouldn’t discuss it…

>>And then what? Know what happened? Six months after he stops working—Bang! Hits him…

>>You didn’t know? Oh, I’m sorry: dead from an MI. Poor bastard. Harry was so…

>>Yup, it’s a freakin’ classic case. 

>>A classic “died-with-their-boots-on” case: and that—

>>Wait! Marty! That: is “my friend and yours” Art Goldman in another few years. Well…I’m just saying it ain’t me, Babe. I wanna enjoy while I’m still young enough to enjoy, ya know what I’m saying?

>>Right. Yes.

>>And, oh yeah… Why’d I call? Why not? It’s only been a few years, right? So. The 25th Reunion is coming up, and we were hoping you…. 

Dr. Siegel is a neurologist in San Mateo.