I was mid-allergy attack by the time my mom arrived at my preschool. At 3 years old, I had severe asthma and, like most asthmatics, a host of allergies. The peanut butter cookie I’d unwittingly accepted at lunch turned out to be the perfect catalyst for disaster.
Panicked and hysterical, my mom strapped me into the backseat of the car and called the office of Dennis Cech, a reputable local allergist whom I’d briefly seen once or twice before. The receptionist told her to bring me in immediately, despite their backlog of patients. When we arrived, Dr. Cech administered a few shots, reversing the effects of mounting anaphylactic shock and saving my life.
Following the peanut-butter cookie incident, I began seeing Dr. Cech (pronounced “check”) twice a week, every week, for allergy shots and asthma management. I looked forward to each appointment, the start-to-finish process still burned in my mind: There was a waiting-room painting of Warholesque Nike Swooshes. (“Checks.” Get it?) There was doctor-patient small talk — brief, friendly teasing to ease my needle nerves. There was playtime, courtesy of a collection of Happy Meal toys and Smurf figurines. There was learning; Dr. Cech had this picture of a dust mite that he loved to explain, in exacting detail and with childlike enthusiasm. And there were treats, not at Dr. Cech’s office, but right down the hall, at a snack shop where my mom let me have a bag of Skittles and an orange Sunkist after every appointment. Basically, Dr. Cech’s office felt like home.
To a kid — especially a terrified, sick kid like me — a doctor-patient relationship is built on one thing: empathy. Dr. Cech was a master of allergens and asthma, but also of emotions. While I’m sure he saw plenty of allergy-prone kids just like me, he always made me feel like I mattered. My mom and I weren’t just another chart in his files. It’s possible, however, that my affectionate rapport with Dr. Cech was more the exception than the rule.
It’s a testament to Dr. Cech that all those hours I spent getting pricked and inspected ended up in my brain’s “happy childhood moments” file.
“There is some research suggesting that patients tend to depersonalize physicians,” said Lauren Howe, a psychologist and postdoctoral researcher in the Mind and Body Lab at Stanford University. According to her work, many people see doctors as “professionals who care for a patient,” which makes the formation of a personal relationship with those professionals less appropriate for those patients.
A few studies from psychologists at the University of California, Berkeley, support the idea that “people who really need healthcare tend to forget information about their providers’ personal lives,” such as their marital status. Later studies from the same group even revealed that patients perceived their doctors as “emotionless.”
But Howe’s own research points to the benefits of treating doctors as more than white coats. “In one study,” she said, “we found that patients who saw a provider as likable and credible showed a greater response to a placebo cream that was placed on their allergic reactions.” The big idea, Howe explained, is that patients who develop stronger connections with their doctors may respond better to the medical treatment they administer. Based on my own experiences, I believe it.
I continued to get allergy shots well into my 20s. When I left my hometown of Cleveland after college, I found a new allergist in Manhattan. Though experienced and effective, he was no Dr. Cech. Still, I loved going to the doctor. I know that’s not something people say too often.
Around that time, I began experiencing the first signs of major depressive disorder and generalized anxiety. One thing that always comforted me was a trip to the doctor — any doctor. My Manhattan allergist’s office didn’t have punny art in the waiting room or Smurf figurines lining the stodgy exam rooms. But it was still a doctor’s office, a place that felt familiar and secure amid a maelstrom of conflicting, confusing emotions. It’s a testament to Dr. Cech that all those hours I spent getting pricked and inspected ended up in my brain’s “happy childhood moments” file.
When I moved back to Cleveland in 2015, my depression followed me home. It was during this period, a particularly rough few months for me, that I heard about Dr. Cech.
My mom called me, in tears.
“Honey, Dr. Cech passed away last night.”
Over the years, every so often, I’ve gotten the news that someone I knew growing up had died. It’s always sad, but usually in that abstract, “all death is sad” sort of way. This time, there was nothing abstract about my sadness. I hadn’t seen Dr. Cech since I was in high school. And for the most part, he lived in my memories, alongside former classmates and crushes. But he felt like more than just another person from my past.
My mom passed along funeral details. We wanted to pay our respects, but we didn’t know the proper etiquette. Do former patients and their parents belong at doctors’ funerals? We weren’t sure.
The issue of doctors — or nurses, therapists or other healthcare providers — attending patient funerals has been explored as a personal decision and a matter of medical ethics, both in formal studies and op-eds. The opposite situation, of a patient attending a provider’s funeral, hasn’t received the same attention. That’s not surprising, given that doctors deal with patients dying on a regular basis.
But some of the factors that inform doctors’ behavior around funerals also come up when the tables are turned. Danielle Ofri, an internist and regular New York Times contributor, wrote about attending patient funerals. Parts of her essay could apply to either side of the patient-doctor relationship:
… In the clinic, relationships between doctor and patient often last years. They can be tightly knit and heavily nuanced, a rooted connection that feels like family… Attending funerals holds an unusual place in medicine. On the one hand, a funeral can be an intensely private family experience, uncomfortable for those who are not part of the deceased’s immediate circle. On the other hand, the funeral can be the sunset point in the arc of a doctor-patient relationship.
Jeff Riskin, my therapist in Cleveland, says the doctor-patient relationship is a delicate balance between detachment and compassion, which both parties must navigate with care and respect. One issue that providers need to consider, but which patients aren’t bound by, is confidentiality.
“In my case, I see a lot of people who tell me things they’re not comfortable telling their family and friends. So if I become a friend, or am viewed as a part of their family, that confidentiality is compromised. But, in your case — wanting to attend your doctor’s funeral — you owned that confidentiality,” he told me.
“When I pass away — a very, very long time from now,” Riskin joked, “I would hope you’d feel empowered to make that choice, and that it would be your way of acknowledging our time together was meaningful.”
As Dr. Cech’s funeral drew closer, my mother and I made the decision to go. We both felt a need to visit Dr. Cech one last time.
In retirement, as I learned at the funeral, Dr. Cech had let his hair grow well past his shoulders. It was platinum silver and flowing, exactly the hair I would’ve expected from the guy who, chuckling to himself, once explained that his Smurfette figurine was missing an arm because “she had a rough night with the rest of the Smurfs.”
I approached Dr. Cech’s wife, Stella, who was also his former receptionist. She used to call him when he was in with us (and other patients, too, I’d assume), and he’d just hang up on her. It was hilarious every time. She made those calls, she told me, to warn Dr. Cech that his appointments were going to back up if he didn’t stop socializing with us. Talking to us. Learning about us. Treating us like more than billable time.
I mentioned my intention to write this essay, and asked for Stella’s blessing. I told her that I’d do my best to explain how much Dr. Cech affected me, and how important it is for a child to have a good doctor growing up.
“That’s definitely important,” she said with a warm smile. “Dr. Cech would agree.”