Doctors are not supposed to become friends with their patients,  and friends aren’t supposed to ask doctors who are friends about health conditions. This happens however, and the consequences of it are even more difficult on us.

Two weeks ago I attended the wake of a good friend of mine. He started out as a patient, a patient that other doctors would not operate on.  I did.  It turned out that eventually he needed more operations as I diagnosed the cancer that ultimately took his life. But between those events he became a friend.

Both of us became fathers later in life. he attended my wedding, and his wife helped my wife when she moved into town, and had no idea where to get things for our son (who was still in utero).  I saw him as he progressively declined, and he always had a smile on his face. When he came to my office with medical problems my staff always knew he would take a lot longer – and I would always come out of the room in a better mood.

His wake was on a busy clinic day- and I got to it on time. I joked with his wife that Brad always made me late for my patients. His wife gave me the biggest hug, introducing me to all his friends and making me sound like I should win the Nobel Prize for surgery (if there was one).  I miss him. It’s  hard to give a patient the diagnosis of the cancer that will take their lives, it is even harder to give that to a friend.

Last week the son of a good friend of mine died after a six-year battle with brain cancer. He outlived 99 percent of patients who get that diagnosis. His dad and I served on some charity boards and became good friends, and his son and I became friends also. His son gave me some great advice about my son, telling me that “sons are like puppies- you have to wear them out.”

I knew the cancer would come back, that type always does, and yet his parents thought he was going to beat the odds. When it became apparent last August that he wouldn’t, they were devastated. He did ok the last year- but when I returned to Alaska and saw my friend in horrible shape I knew he wasn’t doing well. He died Friday. I’m glad I was there for that time.   It is hard to tell someone that the cancer they have isn’t going away- especially when you are a doctor and you know better.

Then I heard a father and daughter died, on two separate days last week, both from heart disease. I knew and loved the entire family and had operated on all of them. Over time they had become good friends, and had celebrated with me and I with them. It is difficult to see heart disease take family members – especially when you are a doctor and have tried all you could to hold back the disease.

Being a doctor means you have insight into people they don’t have. It means sometimes spending nights up worrying about them, or with them. It means knowing what the end will be, and it means sometimes you see it before they do. It means we have a longer good bye, and when we become friends, it means our hearts ache just a little longer.