Not your average doctor’s note

August 6, 2008

The letter arrived from Brigham and Women’s Hospital. On the outside of the envelope it said Division of Endocrinology, Diabetes and Hypertension.

My immediate thought was that if the letter contained bad news, or the people in the hypertension division had sent it just to drum up business by shocking recipients.

My second thought was that I had missed an appointment. My third was that they were asking for money or for me to participate in a study.

Had I posited more guesses or had more thoughts, I still wouldn’t have divined the news inside. Dr. Robert Utiger was dead.

His name still adorned the letterhead as if it was going to remain business as usual at the office. And indeed the tone and style of the letter indicated that the Division of E, D and H wasn’t going to slow down at all.

Here are the ways in which I determined Dr. Utiger’s death was either so shocking people couldn’t function correctly or that he wouldn’t be missed as much as his prominent place on the physician listing would indicate.

The letter was mailed in the third or fourth week of July, but was dated July 1.

It started out with a heartfelt “Dear Patient:” and ended with a blank spot where a signature should have been.

Perhaps something like this happens so frequently that the response is a standard letter detailing the ways in which the division will continue to provide superior medical care. The middle paragraph in the letter definitely went into clear detail about how charts and histories and covering physicians would respond to any decision one of Utiger’s former patients might make.

Who thinks of something like this happening and then plans for its eventuality?

Dr. Utiger saw me once at the request of my regular doctor. Our 11 minutes together didn’t leave a huge impression on me and I likely wouldn’t know the doctor if I ran into him again. But how odd and empty it must feel to lose your doctor and be told about it in a note.

Had the note been about my primary care guy, I’d be devastated and panicked. A mere paragraph wouldn’t easy my pain any more than a phone call from the physician’s secretary would.

Further, the secretary would be dealing with the same sense of loss – and he or she would also be out of a job.

How do you break the news that someone has died? Do you use the old “the cat crawled out on the roof” story or are you direct about it.

It’s hard on everyone, but it’s as regular as the seasons and the changing weather.

I just hope when my doctor goes, he dies without pain and leaves instructions for phone calls to be made or at least a signed letter be sent.

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