My Mother, A Professional Patient

Steven A.Wartman


Health Affairs. 2006;25(5):1407-1411. 

In This Article


If your mother is anything like my mother, this will make perfect sense. Shortly after becoming a widow fourteen years ago, my now eighty-eight-year-old mother began to progressively increase her schedule of doctor visits. She lives alone in a large apartment in Philadelphia, while I, a physician and her oldest son, throughout my career have lived and worked several states away. Despite--or perhaps because of---this, in recent years the number of phone calls from my mother about her medical care began to increase, with requests to find her a doctor, call a doctor for her, get her an appointment, change her appointment, cancel her appointment, and reschedule her appointment, as well as questions about whether she should take certain medications or have specific tests.

In my efforts to help her, at times I felt that I was well on my way to wearing out my welcome with the bulk of physicians in Philadelphia. Indeed, she was seeing a seemingly endless progression of specialists---some new, some old, and some recycled. As best I can recall, they included internists, cardiologists, dermatologists, neurologists, ophthalmologists, rheumatologists, orthopedists, gynecologists, urologists, otolaryngologists, plastic surgeons, oral surgeons, neurosurgeons, endocrinologists, and gastroenterologists (I've probably overlooked a few). Furthermore, with a few notable exceptions---such as with her general internist---my mother rejected much of the advice these physicians gave her or, at best, grudgingly agreed. Basically, if my mother didn't hear what she wanted to hear, then off she went to another doctor. And speaking of hearing, my mother has had what she considers to be an ongoing battle with hearing aids; the problem is that she hears better without them.

The truth is that my mother does have an assortment of medical problems, some serious, some not. Yet the real reason for her frustration was that no physician was able to make her feel the way she felt, say, ten, twenty, or even fifty years ago. I was frustrated, too, and was becoming increasingly uncomfortable at using whatever academic title I held at the time to gain her access to busy practicing physicians.

Sometimes I was amazed by my mother's reactions to her medical problems,either real or perceived. Last year, for example, while running to catch a bus, my mother fell and broke her nose. Visiting her shortly afterward, I managed to get her an appointment with a well-known ear, nose, and throat specialist. I went with her to the appointment, and I thought the doctor did an exceptionally good job of examining her and talking with her. After he pronounced her to be doing well and not needing any further interventions, my mother suddenly announced that she wanted a "nose job" to fix the almost-imperceptible bump the fall had caused. The physician was taken aback (as was I), and he suggested that my mother and I talk about it. Later that day I said, "Mom, do you realize what a nose job involves? They'll need to put you under general anesthesia to fix this minor cosmetic problem."

"I don't like the way this looks," she replied.

Finally, after much back and forth, I put my foot down and told her that I could not recommend that she have that kind of surgery.

"OK," she said. "You call the doctor and see what he says."

When I spoke to doctor on the phone and expressed my opinion, he sounded relieved. "I was really hoping you'd tell her that," he said.

I've spent most of my career in academic medicine, immersed in medical education at one level or another, but even so it took some time for me to come up with a solution that---almost overnight---made both my mother and me less frustrated and perhaps even a bit more comfortable with her life and medical situation. I called someone I knew at a medical school in Philadelphia and asked if the school had a certain program. "Certainly," was the reply. Then I asked how my mother could interview for it.


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