Who the hell cries over a doctor shutting down a practice?
Me!
Well…I’m not alone. There’s a few hundred of us grieving right now. We’re having to face the loss of a woman whose presence in our lives and our community goes beyond a doctor/patient relationship. We’re losing a woman of substance and virtue who champions us with enthusiasm, wisdom, authenticity and love.
When I moved to this small island 34 years ago and discovered a female doctor, I phoned and made an appointment. Nothing to it. No questions. No “meet and greet” session. I simply showed up for the appointment so Dr. Levitt and I could pursue the business of minding my health.
About four years later, Dr. Levitt left the island. Being in my 30s, it was of little concern. Besides, I simply stayed with Dr. Levitt’s replacement, Dr. Jan MacPhail.
Besides an opportunity to set up her own practice, Dr. Jan looked forward to some West Coast living and sailing with Tony, her university professor husband. Tony took a sabbatical from his professorial career to help Jan build her practice. After a decade, Tony returned to his work at Lakehead University in Thunder Bay, Ontario.
Tony and Dr. Jan maintained their marriage through distance and time – even before the internet. They even decided to begin a family. About 18 years ago, Jan gave birth to their son. Thereafter, Jan took leaves for significant periods of time so Tony and she could parent the young lad during his early years and, later, during school holidays.
Dr. Jan informed us months ago that she would be joining Tony in Thunder Bay after their son’s high school graduation. This June, I watched the young man proudly perform one of his musical pieces as part of his graduation class ceremony. I watched with “patient’s pride” – if there is such a thing – but it ripped a hole in my denial. Jan really would be leaving us now.
Besides being a phenomenal doctor who reduced fear while building character, Jan made significant medical contributions within our Province. Two examples – teaching other doctors about Women’s Menopause and supporting OPT (Options for Sexual Health) which now has 60 clinics operating in the Province. Hearing from various people within the medical community, gratitude for her teaching skills abound.
Jan loves music and even played the bagpipes in the Island’s Pipe Band. I would see her at different island events and each time I saw her performing, pride roared through me as though she was my sister.
Last night, the OPT team held a farewell function to honour Dr. Jan MacPhail’s incredible contribution to the sexual health of our society. They invited the community to come to the gathering. Most of the non-medical people present were her patients. The hall was packed.
Dr. Jan MacPhail *
Since Jan was the first speaker to be introduced, I watched the audience as she organized herself at the podium. Rows of people stood in a semi-circle, completely quiet, almost every person wearing a solemn expression. One face stood out – a beaming one, bearing beard and mustache – unmistakeably a professor and loving husband. Beside him was the expectant face of a proud young man bearing many of Jan’s features.
Tears welled and I realized how many would be carrying the same dread. Not one of the other doctors on the island has room for more patients. In the audience, I saw some of Jan’s elderly patients who must surely be filled with fear. I mentioned this to a woman who sat next to me. She was another of Jan’s patients, Aggie, about my age.
I said to Aggie, “We’ll need a ‘Jan’s Gone Support Group’. ”
She said, “We’ll call ourselves ‘Women Without Doctors’!”
I laughed and added, “We’ll be doctoring ourselves! We’ll share everything that Jan taught us!”
Jan overheard us and declared us Chair and Vice-Chair.
Dear Jan MacPhail! Off you go, beloved Doctor! I’ve cherished every minute with you. Yes, it’s time for Tony and you to begin plans for a shared retirement as you support your son through his University years. Thank you for giving us nearly 30 years of your profession, life, marriage, wisdom and love. We have been spoiled. Guess it’s time for us to join the voices that decry the questionable standards that have kept the perfect doctor from coming here to take over your practice.
I cried yesterday as I faced attendance at your farewell party. I cried through your speech. This morning, tears came through meditation. I asked for clarity so I could feel the gratitude I hold in my intellect for having your unmatchable friendship and support over these decades.
A peace settled in as I sensed this understanding, “You are being shaken out of security. It’s as though you are losing NOT your mother, but the security a mother offers. You may be homesick for some time. It’s time now to be a big soul.”
Aggie?! Let’s get that group goin’! I’ll wrestle you for the Chair!
Soul Dipper 
Gratitude.
Supremely grateful! I just have to get through my grief.
Amy, I just went through a change of my primary care provider too…it is so hard, makes you feel so insecure. She sounds like a wonderful person. Life seems to be just a series of changes to help us grow…and trust. Arrrgh.
About a year ago, it dawned on me that Jan just may start thinking about retirement and I must of filed the thought in denial. While I want the seasoned practitioner who has learned how heart is a magnificent healer, I’m thinking I want some robust 25 year old who’ll be here for 30 years! 😀
That’s lovely Amy. I wondered how you’d do….if I’d felt better I would have gone too…she was a good friend just as Ian’s mother and always had time for me.(you, us) Wonder if Aggie is the beautiful little woman who goes to my stretch class…..a countenance you wouldn’t forget….truly joyful. Have thought of you lots over the past few days…turns out I now have bronchitis, and probably should have gone to Dr. W sooner, but honestly felt to sick to even go. Good old antibiotics…..I toughed it out long enough thinking it would all just get better. I won’t try and phone until next week……still cough when I speak but feel so much better. Ready for some slow quiet visiting. XOXO
Hi, My Sweet Friend. Bronchitis – yuk! Does this mean we have to tie you to the gate so you don’t volunteer at the DayCare? Oh, I know that would be torture for you. Glad you are on the mend. I’m certainly up for slow quiet visiting. Just had dinner with a friend. She said the minute she saw me, she knew something was bothering me. Guess the bloom falls off the rose on occasion! 😀 Look forward to seeing you when you feel better. Even if it’s just a tea at my wee hoose.
I hope you find the perfect, holistic provider. I’d prefer the seasoned…the one I “got” seems a bit young and very rigid. Will not renew Rx’s until the day they are due, for example, while the insurances give you a week leeway. A bit scary when some meds I can’t afford not to have. At least she’s not the one who cares for my transplant. I’ll give it a chance…it just happened.
When I learned, Victoria, that you are convalescing from a transplant and dealing with the loss of your regular doc at the same time, I knew I could dry my tears and stop feeling sorry for myself. But yikes…who needs rigidity thrown in? Especially when we’ve seen enough of life to know the folly of inflexibility. I’m comforted by the fact you have a loving husband. A warm arm and a reassuring remark can override a blast of unseasoned fear I hope. Sending love and light, Victoria.
This is when it’s a blessing for me to draw on my nursing background. Don’t worry–I know how to navigate the waters. And then there’s the ‘roid rage, if it gets too bad.(Joke) Just look for someone you can trust, Amy.
I’m sticking REAL close to my RN friends! I confess I always have. Often these friends have put the meat on the bones served by our time-pressured doctors. They’ve helped put things into perspective. There’s something about a good hike or a delicious meal…it helps them answer questions beautifully! Amazing how that works. 😀
A devastating blow. I hope the vacant position is soon filled by someone with a bit of life experience but who has the years free to care for the Islanders.When losing someone as cherished as Dr.Mac you need to think the replacement will not just be competent and understanding but also has the maturity to develop friendships. I wish you well as I wish Dr. Mac a happy retirement full of the fond memories her friends like you have no doubt created.
xx Hugs xx
David, many thanks. Your sincerity comes through the distance and builds endearment. Even if we didn’t live on an island, I’ve learned our situation wouldn’t necessarily be remedied by simply driving to another area or city. The shortage of doctors stretches across our country. As a matter of fact, Dr. Jan will be filling a gap that has existed for some time.
I understand your grief, Amy, just reading this brought a tear to my eye.
We’ve imported a few good South African doctors to our island, Cin, but since they are younger, I suspect they move on because they want broader medical experience. Since this location attracts retirees, there’s an abundance of geriatric patients.
You have no idea how much I’d love to crash your housewarming in J’burg! Wouldn’t that be fun?!
This is so heartwarming, Amy! I never get to see the same doctor more than twice, even here in a village, on a small island. So I’ve never known the relationship you have with Jan, or felt that community spirit. (Moved about a lot in my previous life.) I love the fact that although you are all in grief, you are happy for her and her husband, grateful for the time she has devoted to her patients and considering workable alternative healthcare support. What strength that woman must have to imbue this positivity, yet she looks so mild and gentle! I’m also also being guided to think of myself as ‘elder’ now, no longer requiring permission (or fearing censure) from ‘mother’ to show the true ‘me’; accepting that I have all the knowledge, experience and power within me to ‘be a big soul’. Brilliant post, Amy, thank you so much for sharing! 🙂
Jacqueline, you’ve just been wrapped my soul in silk. Thank you. Yes, our island likely has the standard quota of doctors for 12,000 people, but the vast majority are elderly. I’ve always rebelled against Gov’t formulae and stupid bell curves that make no allowance for the little guy way off at either end. I seem to choose locations at those ends so I’ve been a bell-curve warrior as I worked in small places around this province. Time to harness my steed again, perhaps.
And I agree, Jacqueline. We are of the age and stage where we recognize the importance of using our voice. Seasoning counts so the trick is to overcome invisibility in creative ways to be heard. There’s a dignity about this and that’s a good steed to ride!
What a beautiful accolade for a good doctor. I dread my doctor retiring but as he is ageing alongside me he will soon I expect. If we are lucky enough to find a good doctor they are a treasure in our lives. Bless her and I wish her all the best for her future. A lovely post x
If you ask him, I bet you’d make some decisions about getting busy now to prepare. Maybe people talk about this and I’ve just missed the conversation, but who talks about “Doctor planning”? Well, Dr. Jan did. When she wrote a letter to all of us months and months ago, she encouraged us to begin finding a new doctor. She wanted us to know she would understand. Many of us just hoped another woman doctor would appear and take over Jan’s practice. That could still happen…but time is running out.
I feel your remorse about losing Jan. Funny doctor story. Some 30 years ago I, too, had a female physician. During the early 1990’s my nutty state was embroiled in a political tussle over abortion. I attended several demonstrations and watched one of our local male gynecologists stand up bravely at a podium in front of the Capitol. He rallied the crowd to support a woman’s dignity, intelligence, and value by protecting her choice to make her own healthcare decisions. I was both proud of him and frightened for him. (This was at a time when abortion docs were being murdered by right-wing zealots).
A short time later, while in my own doc’s office, I made the flippant remark that maybe now, in my 40’s I was old enough to choose to have my tubes tied. (I had been denied this procedure when I asked for it in my 20’s) My female gynecologist replied: “Oh heavens, don’t waste your time and money on that. Just get a hysterectomy. Get it all over with at one time.”
Me: “But why? I just don’t want to get pregnant.”
Her: “Oh, you’ll feel so much better! I just had one and the difference it has made in my life is unbelievable.”
Me: “But I don’t feel bad. I don’t have menstrual issues or PMS. I just don’t want to get pregnant.”
Her: “Well, you’ll end up getting one eventually anyway. May as well get it over with now instead of dealing with 2 surgeries.”
I never went back to that doctor. Instead, I called the brave gynecologist who had placed his life in danger for a woman’s right to choose. I was heart-broken when he announced that he was retiring a few years ago. But surprise….his son, having just completed his residency, would be taking over pop’s business! It was a strange transition. Son has so very many of dad’s mannerisms. I felt odd for the first few visits, but now, I’m happy that the dad had such a fine son to hand his practice over to.
Wow, Linda! Thank goodness you listened to yourself. Whoa! And I have a deep-seated suspicion that the reason Dr. Jan hasn’t found someone to whom she’d turn over her practice is because she’s been screening very, very carefully. Somehow our situation will sort out, too. It may be a bit bumpy and inconvenient for us, the hospital and other doctors for a while, but the “fit” is being honoured.
At Dr. Jan’s farewell, I was able to thank one of the retired male doctors who was such a champion in helping Jan begin her practice. She had a rough ride through testosterone turbulence at first and 2 male doctors stood by her. She came through with grandeur. She’s so very respected.
Hopefully our response to Jan’s need to go and be “family” and to help out the “under-doctored” Thunder Bay area will get the attention of anyone blocking our finding a suitable replacement.
Another well-respected doctor has been telling his patients he’ll be leaving. He married a woman from Scandinavia and promised her they’d go back to her home. That was about 20 years ago. She and the children recently went home and he’s going to follow. He was raised on this island so besides being a great doctor, he’s one of us.
Sadly, the other female doctor we had died of a heart attack last month. So we’re mourning lots of losses in our medical milieu on our tiny island!
What a lovely tribute to your physician. I have needed so many of them in the last few years that I cannot boil it all into one. Lovely post Amy.
Tammy…I’ve missed something over these visits to your blog. Why have you needed so many doctors in the last few years? Are you okay?
I am perfect but I did have breast cancer and all of the stuff that goes with it. It’s part of my resolve to be healthy and to help others be that way also.
Bravo, Tammy…well done! Keep right on with your fabulous message.
Sounds like you’ve had a wonderful doctor…not all are as lucky.
Isn’t that the truth, Charles. I wonder how much we patients contribute to their modus operandi…
If you can write so touchingly of your doctor-patient relationship, she definitely must’ve spread her presence beyond that role. I’m sure she will be carrying many, many warm memories of you all to make her smile and bring a tear.
Since I’m one of her healthy patients (that sounds like an oxymoron), I can only imagine her memories of patients who have come through huge challenges and terrible fears. Yes, Nadira, because of who she is, I’m certain she’ll have an abundance of good memories to see her through a robust elder age – when she gets there! 😀
Any auntie. I felt bit emotional while reading this post, even thought I have not met any of you in the real world yet. is it what we call power of words! or is it what what creativity dos when it takes control of our emotions. Your pain, your grief, your fear.. Doctor Jan’s sincerity, kindness and generosity… everything is so well described in this post.
You know that a young man living in a complete different part of the world always prays and wishes for your good health, happiness and peace!! 🙂
Arindam, thank you for your touching comment! I hope you know that this Aunt prays for you, too. I ask that you be blessed with all you desire – and in case you forgot – to give you health, wealth, love and well-being. Now…this is a good time to go and visit you!
All the best as you be a ‘big soul’. Hard to do 🙂 May the future hold new and rewarding relationships in the same area, Amy!
This business of being a grown up can be tough, Kate! 😀
Awwwww…what a lovely thing to be a part of. Sometimes communities get to ‘grow up’ some awesome folks. And when it’s a reciprocated deal, even the better. Small town doctoring (and we are well below that 12,000 mark!) has had it’s moments in the past 23 years. I’ve gone through a host of physicians. *sigh* Seems no one wants to settle in these parts for long–not in the medical profession, at least. Consider yourself graced to have had the whole lot of ’em.
And I’ll celebrate that the fella that’s here, has made it for three years now! *sigh* Not exactly a long time, but a good start?
I knew I was spoiled having Dr. Jan for decades – and I was quiet about it – but the reality of not having her was hard to imagine. So here we go. I’m off to phone a doctor for the third time – hoping he’ll even consider me. What do I have to have to be considered, I wonder… Don’t think I’ll ask!
What a beautiful, heartfelt tribute. I am so sad about her departure that I may be part of that support group, too! Xx
You’d certainly add some kick-ass vitality, Kim – as welcome as can be!
How blessed you were to have her in your life, and your tribute to her was touching. She must be a wonderful lady.
It’s kind of like coming out of a cocoon. I knew I was blessed over these years, and while I knew about this, I didn’t appreciate what was happening in our country with the shortage of doctors. Our Doctors take their turn at the hospital in the Emergency Ward. Apparently this factor has turned doctors away. So, this will be quite a challenge to be accepted into a doctor’s practice.