Monthly Archives: May 2012

The Greater Good

During a recent visit to the National Institutes of Health (NIH), I met a very pleasant young intern who had recently abandoned a career in law to take up a career in medicine, all because he’d wanted to use his talents to make the world a better place. Apparently most of the lawyers he’d met in his former life had been miserable, self-centered creatures.

He hadn’t wanted to end up like them.

So far, the intern had found the people of the NIH to be far better company than the rapacious lawyers he’d fled from. The intern observed that everyone at the NIH was there for the public good, even the patients, people who were willing to undergo trials that may or may not directly benefit them, but which would most certainly benefit others. As the intern put it, the institution was filled with do-gooders, “from the bottom up.”

I did not resent the intern for classifying patients like me as being at “the bottom” of the NIH heap. I deserved that. I myself have made a similar observation about the outstanding qualities of the good people I meet at the NIH, although in my self-serving version, “the bottom” is occupied by the NIH cab drivers —a demographic consisting primarily of highly educated immigrants, like the driver who’d earned a medical degree in his former life back in a war-torn African nation.

I don’t take anyone’s status too seriously, including my own. Status is subject to abrupt change. Things can be going fine, and then along comes a war. Or a disease. There are many paths to the NIH, indeed.

I wanted the good intern to like me. I did not correct his assumption that my primary motivation for participating in the trial for DAC HYP was a selfless one. My actual motivation was anything but selfless. DAC HYP was the only drug I’ve taken that managed to stop the progression of multiple sclerosis (MS). When I’d heard it was being taken off the North American market, I’d panicked. I’d made a few phone calls, and tracked down the doctor whom I’d initially begged to prescribe it. Joining her study at the NIH was the only way I could continue to take a drug with a known benefit.

There hadn’t been any risk involved in joining the study that I hadn’t faced already. There wasn’t even a risk of my being placed in a control group and receiving a placebo. I wasn’t at the NIH to make the world a better place. I was at the NIH to continue to take a better drug.

From what I’ve overheard from other patients at “the bottom” of the NIH barrel, we are all there primarily for our own private good. Did we want our disease cured? Hell, yes. Getting to the NIH meant cutting to the head of the line. No one gets an NIH ID without having struggled for it, including those who arrive in a wheelchair.

Human beings are complex. As for those selfish lawyers the intern was fleeing? Maybe some of those miserable human beings do in fact inadvertently contribute to the greater good while in pursuit of those big fat paychecks. More power to them.

I’d like to imagine that one or two of those fat cats may one day get sick, and have to claw themselves to “the bottom” of the heap at the NIH, where they may make their own contribution to the greater good through their rapacious pursuit of an elusive cure. The intern may think better of his former colleagues once he meets them as his patients. He may think that they have undergone some spirtual transformation. But they will be the same ambitious bastards they always were.

We all contribute to society in some way. Like the intern, I’d rather hang out with people whose positive contributions to the world are deliberate, and not inadvertent. Yet by now I’ve learned that no one’s motivations are as clear as we would like to think.

Dump Him

Mother’s Day, 2012

“If you want to know how a guy is going to treat you down the road, take a look at how he treats his mother. If he’s respectful of his mother, he’ll be respectful toward you. If he’s a jerk to his mother…you’d better dump him. Fast.”

My mother’s guidelines were intended to direct me to a suitable marriage partner. I applied them accordingly, and married a guy who adored his mother. That was twenty years ago. My mother’s advice proved so effective, I thought I’d never have the need for it again.

This summer, I was given a rare opportunity to apply Mom’s precepts to a relationship in an entirely different sphere. The man in question had done some business with my lady-parts, but that did not make him a potential romantic partner. The man in question was my urologist.

When I’d met the urologist in his clinic, I’d been dressed in a johnny coat. He’d been dressed in a suit and tie. His old-world formality, his swarthy complexion and his slicked-back, jet-black hair reminded me of my dear departed Grandpa Blanco. But despite the family resemblance, deep in my heart I didn’t trust the guy. I thought he was a show-off. He seemed more interested in impressing me with the latest gee-whiz treatment than in treating me appropriately.

A relationship with a doctor ought to be strictly professional, not personal, so I put whatever personal reservations I might have about him to the side. Yet a nagging voice inside me wondered if perhaps this man’s showmanship might lead to a less than desireable outcome. I was on the fence about seeing him again, or pursuing his “cutting edge” treatment, in part because I didn’t want to go through the trouble of shopping for a new urologist, and in part because mere intuition didn’t seem like a reliable measurement of a doctor’s professional aptitude.

As fate would have it, my intuition would be proven correct, luckily without the messy consequence of an undesired clinical outcome.

In what would be my last encounter this urologist, I was dressed in street clothes, and he was dressed, as always, in his suit and tie. I was carrying a parcel, a bright silk dress I’d purchased off the $50 rack in the back of the shop, which was nestled in the heart of the self-proclaimed “largest bridal district in North America.”
We both did a bit of a double-take, as sometimes happens when you run across a familiar person in an unfamiliar context. My husband and son arrived at the shop, having finshed their task of getting measured for tuxedos across the street. I introduced them to my “doctor” without spelling out his specialty for all the assembled would-be brides and bridesmaids to hear. And then the explanation for the urologist’s presence in a bridal shop became clear. A little old lady hobbled over to us on the arm of a lovely young college girl. The urologist introduced us to his daughter and his mother, who had just flown in that morning from Iran for a family wedding.
I couldn’t help it—I shared my delight at the bargains on the fifty dollar rack. “You couldn’t buy this much silk for fifty bucks! It’s Dupioni.”
As it turned out, the urologist knew all about the $50 rack. They were only there for the bargains. As nothing on the rack “carryies her size,” the urologist was planning on driving his mom to Goodwill to peruse the dresses there.
Goodwill? I wondered if his shopping plans weren’t a bit labor intensive. Why not pay full price at one of the 250 bridal shops within these scant two blocks? Hadn’t the urologist’s mother already had quite a day, flying all the way out to our fair midwestern city from Iran?
“She’s made of iron. Look at her.”
At this point, our party of two families had moved onto the street. My husband was halfway down the block, in a hurry to get to the car so he could deliver me from this unpleasant awkward encounter here in bridal shop purgatory. My son was halfway between his dad and his mom, tarrying in case I needed an arm. The urologist was keeping up with me, while the urologist’s mother, that stalwart traveler, was shuffling slowly but determinedly past the fifties-era storefronts, unaided by her granddaughter or her son.
At that moment, I made my decision. Dump him. The urologist wouldn’t wait up for his ancient mother, no matter how I tried to slow our pace. The man was too cheap to buy his mother a new dress for a wedding she’d traveled a long way to attend. If he could afford a plane ticket from Iran, he could afford a full priced dress.
My husband pulled up alongside us. My son opened the car door for his mother.
That is how it’s done.
When I waved goodbye to the urologist, I knew it was forever. The next specialist to weigh on the situation was a gynecologist recommended by my local MS doc. She told me that if I were to continue to follow the advice of that urologist, I would end up in bad shape. Not that I needed a professional opinion to confirm …Mother knows best.