First Day in Private Practice

July 16, 1973

7:45 a.m.

Oh, what a day! I’d waited for it since I was ten years old.

If you’ve read my book “On Call in the Arctic” you may recall that I’d wanted to become a doctor since the day a family friend named Edith placed her nursing stethoscope in my ears and, for the first time in my life, I heard the sounds of a living human heart. When that happened, I was overcome with awe and decided that one day, I would become a physician in a small town, spending my days helping people in need. That day was about to begin.

Sure, I was a doctor in the U.S. Public Health Service in Alaska, but that wasn’t the same as opening my own office, with my own shingle and with my own personal staff. Today that was about to change. This was the day I would become a real family doc, just like Marcus Welby on television.

My emotions were mixed that day – a soup of excited joy tempered with anxiety. I had a loving wife who supported my every decision, two great healthy kids, and a huge desire to see my dreams come true. But I was also about to turn thirty and still had a bucket full of debt from medical school loans, no money, no home, no money, no furniture, again – no money – and nothing to really call ‘my own’ except a broken-down Pontiac station wagon that was aging quickly from the ravages of the Arctic north. Almost everyone I knew from high school and college had already accomplished many of the goals they’d set out to achieve. School and the military had taken up much of my time until now. I was a late starter who was desperate to catch up.

Today, that catch up would begin. Today was a case of do-or-die, and it was about to commence in fifteen minutes.

Earlier that morning, I put on a fresh white shirt and tie, combed my mop of sandy blond hair usually worn in a longish disheveled style, and donned a starched long white coat. I looked every part a real doctor ready to make his mark in the world.

My first patient in private practice was to be an elderly woman from a rather prominent family in the small, rural town in Oregon where we’d decided to settle. I’ll call her Mrs. Wilson.

Trembling with excitement, I heard a car pull up in front of the small office building the local hospital had let me use rent-free until I became established. I straightened my tie, took a deep breath, and readied myself to meet Mrs. Wilson.

My assistant ushered Mrs. Wilson into a bare exam room and took her vital signs.  She recorded her findings on a paper chart and told the patient to take a seat on the exam table as I would be right in to see her.

Mrs. Wilson squirmed and then stepped off the table to take a seat in a padded chair.

“See that he hurries,” she mumbled to my assistant. “I have a lumber mill to run.”

My lower lip trembled as I listened through the door to the exchange between my assistant and Mrs. Wilson. Patients in Nome were always pleasant and grateful I was there to help. They were never demanding or coarse in demeanor like this woman. I wondered if private practice patients were going to different.

But it really didn’t matter. This was it! Day one of private practice with my first patient. I took a deep breath, tapped on the exam room door, and entered.

“Hello, Mrs. Wilson,” I said with as much gusto as I could work up considering the nausea welling up in my gut. “I’m Dr. Sims. It’s a pleasure to meet you.” I approached her with my right hand extended.

Mrs. Wilson did not stand. Instead, she remained in the padded chair, looking strangely like a judge about to render a verdict. She did not extend a hand to meet mine and instead, raised her cane as if it were a scepter.

“Hello,” she grumbled. “But why are you in here? I’m here to see the other Dr. Sims.”

I wasn’t expecting that. “The other Dr. Sims?” I replied rather matter-of-factly.

“Yes, I’m here to see your father.”

I chuckled. “I’m sorry, Mrs. Wilson, but you don’t want to see my father. He’s a furniture salesman.”

Confusion spread across Mrs. Wilson’s face that promptly downgraded into a frown. “You mean you’re the only Dr. Sims?”

I nodded. “I am.”

“Well,” Mrs. Wilson said. “That settles it. I’m sure you’re a very nice boy, but I could never have any confidence or trust in a doctor as young as you.”

Her comment clearly caught me off guard, but before I could think of anything to say, Mrs. Wilson used her cane to help herself rise out of the chair and, like a queen about to address her subjects, sauntered out of the exam room into the hallway toward my waiting room door.

“Mrs. Wilson…wait!” I called out to ears not willing to hear me. There was no stopping her. She was intent on getting out of my office as quickly as she could. She saw me as incompetent and untrustworthy. She had called me a boy!

In an instant, I felt my life was over; my dreams shattered. What had I gotten myself and my family into?

I had brought my wife and kids to this town where evidently I wasn’t needed and, by the reactions and harsh words of Mrs. Wilson, wasn’t wanted. In an instant, she, with a handful of words, had made me doubt myself and my dreams. Was I competent enough to be a good doctor or, even more so, a good husband and father?  What was I going to do? What was I going to tell my wife, Pat?

I offered Mrs. Wilson my arm as she walked down the hall. She declined forcefully and raised her cane as if to strike me on the hand. Then, at the door and on the verge of bursting into tears, a miracle lit up my face.

My waiting room was stacked with people. Men, women, and children were sitting on chairs while others waited for seats as my assistant tried to locate folding ones in a back room. Others were standing in line shoulder-to-shoulder at my receptionist’s desk anxious to make a future appointment with me – the new doctor in town. By the end of my first day in practice, I had seen twenty-five new patients and had thirty scheduled the next day and daily for the next several weeks. By the end of the first month, my practice was completely full and I regretfully had to stop taking new patients.

I got home my first night after eight, too exhausted from the day to continue paperwork, but too excited to sleep. I found myself thinking about Mrs. Wilson and how I had almost let her unfounded, hurtful comments destroy my spirit when they were nothing more than her own simple, singular, private thoughts that, in no way, truly reflected my ability to be a good doctor.

I decided never again to let the opinion of one person change how I felt about myself. I was responsible for my own happiness and for the consequences if things didn’t turn out the way I wanted. It was up to me to control my life. No one else.

It is a lesson I believe to this day – after all these years.