Dr. Santell's Rounds: An Introduction

Fat Doctor recently shared her grief over the loss of a colleague on her Twitter feed. My sympathy for her loss motivated me to begin a project I have been planning to share on this blog even before I launched it: Dr. Santell's Rounds.

Dr. Allen Santell was a hospitalist at my residency hospital, before the term was even coined. He joined the hospital in 1969, when it was a small rural facility located in the middle of a large agricultural complex. At that time, there was no family practice specialty. Dr. Santell graduated from medical school, did an internship and entered general practice at the hospital, where he ultimately grandfathered into the specialty of internal medicine, although his training was very much like mine: delivering babies, caring for hospitalized children, providing end-of-life care. He never left the hospital, not until the day of his death in March, 2006. On that day, he failed to show up for rounds, an unheard-of event in the history of the place. Investigators were dispatched, and he was found dead in his bed, having ended his life the way we all hope to do: naturally, in his sleep. He was 67 years old.

I'd only graduated about 18 months earlier. Up until the moment I heard of his death, I'd been practicing in Rural as if my work here were nothing but a prolonged elective away from my residency. I always believed I'd go back to my residency hospital, sit down with Dr. Santell in the charting room behind the Med-Surg nurse's station, and run through cases with him, as though I'd never left.

His death meant I was well and truly alone in my profession. Of course I had colleagues in Rural and among my residency classmates, now working in rural and underserved settings across the country. Yet it was Dr. Santell who, for want of a better description, influenced the core of my professional conscience. Now that he was dead, I believed I had no one left who would feel right from wrong in medical practice the way I did. It is not an overstatement to say this feeling was devastating.

Dr. Santell would hate this kind of melodrama. He'd shake his head at these words, but there would be a certain ironic humor in his expression. "You're making too big a deal out of this, Theresa," I imagine him saying.

In one of my journals last year, I wrote about driving home from the hospital in tears. I was yearning for Dr. Santell, just to talk to him one more time. I started making deals with the Universe, the way you do when you want to turn back the hands of time. I will give up a full year's earnings just to round with Santell one more time, I vowed. Just for one more day on the wards with the old man.

I waited for the thunderclap and the fissuring of the earth. Nothing happened, so I cried and imagined the day even a year's salary couldn't buy.

The dream of that day, that one day of having Dr. Santell back again, is elaborate and wonderful and doesn't begin to capture what it was about the man who--I'm not exaggerating--taught me everything important about being a doctor. I want to write about the lessons he taught me, before they fade into memory or become incorporated into the general "well-of-course-that's-how-I-do-it" automatic knowledge all seasoned doctors develop.

Periodically I'll be posting Dr. Santell's Rounds here at Rural Doctoring. These will be anecdotes and memoir mixed together, with Santell's clinical pearls at the center of each story. There will be no posting schedule, as I usually try to follow for a post series, because I don't want to be under pressure to write Dr. Santell's Rounds. I want to be able to savor every memory of him the way you cling to summer at the first silver tilt of autumn.

Comments

[Xavier Emmanuelle]

You're so fortunate to have had such a wonderful mentor. The pain you felt for having lost him must have been awful, but at least it's a sign of how great a man he was.

[T.]

My mom describes having this kind of mentor during her pediatric residency, and I was looking forward to finding one of my own during my training. It never happened...so I am looking forward to living vicariously through your writing! You are so fortunate to have had such a teacher in your life!

[Theresa]

Always. He's always sitting next to me, reminding me to do the right thing.

[rlbates]

Nice that you had such a grand mentor! I know you miss him, but I bet you still hear him (over the shoulder) now and then helping you out.