Chinese dragon statue closeup 

“Doc, I think it is time for you to call it quits.”

“What?” He was almost shouting.

“It’s time you called it quits,” I raised my voice louder.

“You mean stop practicing?” He leaned forward, turning his good ear toward me.


“Look, I’m fine…” He leaned back against the chair.

“No, you’re not. Your neuropsych testing shows moderate cognitive impairment and you are nearing stone deaf.”

“I haven’t hurt anyone.”

“Yet. That you know of.”

The color left his face.

He stared at me, arms crossed over his chest, holding tight as if to prevent his insides from spilling out onto the floor between us. 

He was considering.

He took a long, deliberate breath then nodded his head slowly, acquiescing. I was relieved. I did not want to have to involve the state medical board. Nasty business. My hands were shaking.

“I have spent my whole life pouring myself into this profession. All of the sacrifices I have made… It becomes your singular identity, you know. There is nothing left of me without the practice of medicine. It’s very hard to let it go.” 

I murmured an understanding mumble that I was certain he could not hear and shook his hand.

He shrugged sadly, then shuffled out of my office. 

Three months later he was dead.


120 thoughts on “Identifier

  1. I have a very discerning son-in-law who is determined nobody will tell his mother she cannot drive. Getting out of the house to do her “business” is all she has left. Once a chemistry teacher at UNC, she has given up a lot in recent years.


  2. This happens so often. We’re conditioned to put everything we have in at work, and it becomes part of us. I’ve seen it before. It must have caused some awful thoughts for you, and I’m sorry for those. You couldn’t let him keep on practicing for the sake of the patients.

    Liked by 1 person

  3. Whew, that must have been so hard – someone who you knew and respected who you had to tell that he was no longer fit. Many professions say they self-patrol their colleagues to do precisely what you did but very, very few will actually step up and take the initiative. And, as you said, it becomes so messy and destructive to involve the officials.

    When I was the safety manager at a large trucking company, I had to assess divers regularly and it was part of my job to draw the line and tell them they could no longer get behind the wheel of our trucks. Most drivers will look forward to their retirement so it was rare that I had to remove a driver for age problems. The biggest issue i had was drivers who were distracted by family or health or relationship (or occasionally mental health) issues. Sometimes it was medical issues as well. I rarely got any support from our operations crew or even the management – I was on my own. Even the owner would sometimes call and plead the case for a driver who i had removed. And they were employees -it would be many times harder for a colleague – as was your case.

    Liked by 5 people

      • yeah, I’m with you there. i actually had one driver whose mental acuity dropped significantly when his home life became very disruptive. i made him have an evaluation by a psychologist before i would let him back. You have to remember these guys were driving a huge truck with two trailers behind and hauling 15,000 gallon of gas. One small mistake could become a disaster. I removed another driver who had fainted while dong a check of his truck.. i made him see a medical professional and get a signed release saying he was OK (turned out he wasn’t and he didn’t come back) He was so angry at me – I thought he would punch me in the face – although not the first time for me to be hit when giving bad news.. I always give options as to how they can get back – but not all chose to avail themselves.

        Liked by 2 people

  4. A wake-up call in more ways than one.
    I often experience a degree of angst that I never found my niche in a profession; even envy, occasionally, towards those (in general) whose paths were cut clearly enough for them to be able to see the process through to a rewarding, useful, well-respected and well-defined function in the world. But as we see in your post, there are dangers, sacrifices and costs aplenty there . . . And on the other side, there are benefits to being in a near-constant state of search and diversification, disappointment and instability: one is forced to, shall we say, sunder one’s heart and let it find its home in many places . . . There is much grief here too, of course, but it comes, perhaps, in smaller doses, spread over a longer time.
    To paraphrase Boris Pasternak, The living of your life is not a walk across a field . . .
    Take care of yourself, Victo.

    Liked by 2 people

  5. Every day when have the tough calls to be made it is good to know that you making them fairly and with sensitivity but those calls are part of your role in doing your job correctly. So go ahead with a peaceful heart.

    Liked by 1 person

  6. How very sad. I know of a lady who was totally independent, living on her own, and keeping up with everything in her life. She was forced to give up her home and go into a care home by ‘well meaning’ family. She died 6 weeks later. 😦

    Liked by 1 person

  7. Dedication to a profession is a great thing, being able to move on and make the necessary changes is sometimes the problem. That’s why having hobbies and varied interests keep a person active and growing even when there time to retire comes. Work and no play is a sad thing for many. Have a good weekend! We are!

    Liked by 2 people

  8. Incredibly sad!! Your position of having to tell someone they can no longer do something they love. The patient’s position of defiance, denial, and acceptance. But, did he really accept with his death occurring three months later? Sad all the way around.

    Liked by 1 person

  9. Hey Victo,

    You are an excellent writer with depth and style who cuts a dash with eloquent appeal. Reflecting on your thought-provoking and engaging posts, I am often left considering aspects of life that I might otherwise never encounter or remain ambivalent to explore further. Should you ever tire of being a Physician, or have its enjoyment wane, perhaps the hours of your day could be refilled with words as often as your shrewd pen and inkpot would allow.

    It is as Eliza Waters suggests: ‘who you are, is not what you do.’ But passion for what you love doing is a difficult muse to either ignore or part with.

    Namaste 🙂

    DN – 26/02/2016

    Liked by 3 people

    • @ Dewin Nefol,

      You quoted an Eliza Waters saying “who you are is not what you do”. I disagree.

      Being somewhat long in the tooth myself, I can see that what one does for a living very much becomes “who you are.” When I read obituaries, and I admit that I do so regularly, I invariably look for the person’s livelihood. It defines a person.

      The great economist, John Maynard Keynes, once speculated about what would happen because of the obvious labor-saving benefits of the economies of scale brought by the industrial revolution and technology. He thought everyone would eventually become people of leisure who spend most of their time studying and appreciating philosophy and the arts. Obviously he was completely wrong. Work gives meaning to life. A feeling of control and accomplishment is essential to mental health. It’s a social thing. The greatest insult is to be ignored and mere opining, except for the talented few, gets little respect.

      Liked by 1 person

      • Hey Jim,

        In response to: ‘I can see that what one does for a living very much becomes “who you are.”

        Eliza’s words intrigued me. This line from your comment intrigued me.

        One of the pleasures of writing poetry is the joy to be found in the purity of words and their alternatives and meaning. I was eager to know how I could replace, ‘who’ and ‘what’ in your sentence without confining its significance. And so I went online, and found just the one replacement for the word ‘who’, which was, ‘that other’.

        Sitting to reflect upon my reflection in a mirror, I asked the question, ‘who are you?” and then repeated the question with, ‘are you that other?’ ‘Other what’ I asked myself? That ‘that other is you?’ It sounded more a statement than a question and left the riddle unanswered. This question had my thoughts tied up in knots for hours until, in a bid to differentiate myself from ‘myself’, and the myself of ‘that other’, I lost ‘myself’ in myself, and in the ‘myself’ of ‘that other’, and found myself in the Self of another! At that boundless point, I believe my thinking gave way and became an acceptance of ‘something else’, or perhaps it was ‘something other?’ It was all really quite confusing. There were no relative relationships to reference, and no rationale by which to conceive boundlessness, and yet I seemed able to accept it as readily as I would the abstract notion of Infinity. I paused to wonder if boundlessness and Infinity were actually one and the same thing, and concluded that both concepts were so unfathomably expansive that to consider their magnitude further would have me meet myself and ‘that other’ all over again. And ‘who’ would I be then? Myself or ‘that other’? I do believe Infinity is to be found everywhere if one were able to see deeply enough into the very fabric of time and space but, if could that, ‘who’ would I be then, again? These thoughts of boundlessness and Infinity created something of a dilemma for me. How would I determine the extent of the ‘who’ in your sentence, and derive a sense of meaning, when the ultimate extension of ‘who’ is Infinite and boundless?

        And so I ask, at what level of extension were you referring to in your sentence. Who is the ”who’ in the who?

        But I digress, and let my mind wander and work away, forever finding riches and richness in the ebb and flow of day. It’s just one of the reasons why I chose to be born on this beautiful polished jewel called Earth: to experience its colour and wonder. And yes, I do like to believe I was given the choice to come here, otherwise it would be difficult to determine the nature of my existence or the reason and purpose for this particular visit. And ‘who’ would I be then?

        And so to my job, Jim. I work as an office administrator and carry out my duties with honesty and integrity, and with the same degree of care, consideration and regard as I do for all else in my life. What I don’t inject into the job is the same degree of passion as I would invest in creative pursuits or imaginative endeavours. I am not immersed within the job and it certainly doesn’t ‘become me’ in any way at all. If it did, ‘who’ would I be then? Neither does the job define me, other than in the manner I manage my work and the way I choose to present myself in accordance with policy and process. Like all who dream of one day stepping away from the 9-5, I am still desk-tied and leathered for 40+ hours every week whilst I watch the hands of the clock turn backwards. Liberation from such tethering comes through my imagination, and exercising that faculty as often as time allows is my passion. And this was the point I was making in reply to Victo’s post: that we do indeed sit in light of our own truth in the chamber of the heart, and sometimes-difficult choices, compromises and sacrifices have to be made to follow a dream with passion. This is the driving passion that defines us, becomes us, inspires us, overwhelms and encourages us to always reach beyond our grasp and aim for the stars. It is not always the job that we might unwittingly slip, slide and fall into that ignites the flame in our heart, unless of course we choose do opt for that route with deliberate intention. We are the self-ruling sovereign of our own being and responsible for our choices.

        I write from the perspective of an artist and poet and rather than prattle on further, I thought I’d leave the following passage. It is taken from Carl Gustav Jung’s, ‘Modern Man in Search of a Soul’. I’ve lifted the text directly from his tome. This extract has Jung describe something of the essential nature of the creatively driven mind. Reading the full article is illuminating. I have valued his insightful and highly intuitive mind, and always believed in the passion of his erudition. Perhaps you may have read this work before or other papers by him, he is very well known? And if not, I hope you might appreciate it as I do.

        ‘Every creative person is a duality or a synthesis of contradictory aptitudes. On the one side he is a human being with a personal life, while on the other side he is an impersonal, creative process. Art is a kind of innate drive that seizes a human being and makes him its instrument. The artist is not a person endowed with free will who seeks his own ends, but one who allows art to realize its purposes through him. As a human being he may have moods and a will and personal aims, but as an artist he is “man” in a higher sense ‘he’ is collective man, one who carries and shapes the unconscious, psychic life of mankind. To perform this difficult office it is sometimes necessary for him to sacrifice happiness and everything that makes life worth living for the ordinary human being.’

        ~ Musing ~

        Muse for the Mystical Goddess am I,
        She entices me into a stupor!
        Clay for the Pottering God am I,
        He crafts me at His leisure.
        Vessel for the Spirit of God am I,
        He fills me with abundant measure.
        Body for the Flesh of God have I,
        to fulfil His every pleasure.
        Heart for the Love of God have I,
        His flame burns my golden centre.
        Soul from the Mine of God have I,
        to receive his Eternal treasure.
        Psyche for the Musing Goddess have I,
        to think on her sweet fantasy.
        Spirit for the Love of Life have I,
        to believe in it’s reverie.

        DN – 29/02/2016

        Liked by 1 person

  10. Yikes…very sad ending. Leaves one guessing how he passed, but it brings up a good point about a doctor’s identity. I try to emphasize to med students I connect with via social media that they should invest time to develop themselves as individuals rather than solely on their career.

    Liked by 1 person

  11. Good for both of you. I imagine he was a wonderful doctor in his day, because even as hard as it obviously was, he put his patients first. And you did too. And that’s what the oath you both took is supposed to ensure.

    But life is so much harder than that, isn’t it.

    This piece was one of your most poignant, VD. Brought tears.

    Liked by 2 people

  12. Pingback: My Article Read (2-26-2016) – My Daily Musing

  13. I’m torn between the glory of having one driving purpose in life, a mission, a calling, and what we would want to consider a “balanced” life. I think monks and nuns have it right, in a way. A singular purpose and identity must be a serene way to live, unless that purpose is lost, that is. I like the way you have written the story. Clean and unsentimental, yet the emotion isn’t lost.

    Liked by 2 people

  14. Growing up my father never talked about work (he was a general surgeon), and then he retired suddenly at around 65-ish because his practice had become a business (younger doctors fighting/competing for patients), and over time after retirement he began to tell me stories.

    The most difficult time he had as chief-surgeon was letting people go – some were easy (they agreed they should not be doing surgery) and some were difficult (they would not admit it). He told me about a doctor who he had taken away his surgery rights (not quite clear of the proper term), who ended up leaving our hometown to begin practicing elsewhere. For whatever reason, there was a very long period of time it took before State Medical Board caught up with him and barred him (an incredible amount of surgical errors followed him everywhere). My dad said there are always pressures with surgery (all of life has pressures, pressure is very relative), but what bothered him the most (an unexpected burden he found when he began practicing) was knowing there were doctors who should not be practicing medicine, and definitely not doing surgery… Great post.

    Liked by 1 person

    • Your father was absolutely right. It bothers me, too. It also bothers me that some physicians refer to those incompetent people. Is it political? Are they themselves so awful that they do not recognize the dangers? Dunno. But it bothers me, too.


    • I have patients who cannot work, who can no longer see to read, who have arthritis that keeps them from all of their hobbies and limits their mobility. All they can do it watch TV all day long. I hope I do not have to experience that first hand. I imagine that it is torture.

      Liked by 1 person

      • <blockquoteI have patients who cannot work, who can no longer see to read, who have arthritis that keeps them from all of their hobbies and limits their mobility. All they can do it watch TV all day long. I hope I do not have to experience that first hand. I imagine that it is torture.

        And that would be, I submit, the best reason in the world to want to have descendants who care about you. That is one’s last resort.

        Liked by 1 person

  15. This is a great example of how the profession becomes the whole identity of a person. This happens in many professions and hits men more than women. When the only identity is lost, death comes quite quickly. It’s sad, particularly when it’s preventable.

    Liked by 1 person

  16. I’m going to hit the like button, because I appreciate this post. It’s so sad, though.

    “I have spent my whole life pouring myself into this profession. All of the sacrifices I have made… It becomes your singular identity, you know…”

    Is it selfless, then, to take back pieces of your soul? And live your life beyond your job? … I don’t know…

    Liked by 1 person

  17. Yeah… take a way a man’s dream…
    Not that you should blame yourself, you were only the messenger.
    (And someone had to do that, which is when everybody else just flees, right?)
    Thank you for sharing the story.

    Liked by 1 person

      • Understandably so. (Which speaks very highly of you) You may not believe it, but I have thought about this case several times since I read it. I wonder, if the case happens again and you have the power, if an… intermediate solution is not possible. Like opening up another position, as a “consultant”, half time, pro bono, not allowed to “touch” patients so to speak, but at least retain some activity? Dunno. random thoughts. 🙂 (and even though in the medical field one may rapidly become obsolete, I’m sure experience can be useful…) Sorry. Not my place really, just food for thought. Take care Victoire.

        Liked by 1 person

  18. This happens all too often. Recently we had a physician in our community go through the same thing. I don’t know the circumstances surrounding the man in your story, but the man I knew – it was very sad.


  19. My grandmother passed away the day after they put her in a home. She’d promised the family “Don’t take me away from my house; I’m doing just fine. That’s where I need to be.”

    They promised her she’d be in a good place where they could take care of her — the next day before dinner in the home, she just laid down and died.

    I can’t begin to know what that doctor went through, after ‘losing himself’ but I’m pretty sure we do the elderly a massive disservice by putting them out to pasture.

    He may not have been safe, and maybe he’d have dropped dead on that same date, in the middle of an exam…but he probably would’ve benefited from some kind of structured transition into retirement.

    This was so sad to read; I don’t envy you, and the position you have to be in, to help keep others safe. Keep fighting the good fight, Victo.

    Liked by 1 person

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