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Short pieces on a new theme every month
 
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This month...
  Afraid
 

I Need a New Stethoscope

Jenni Levy

I need a new stethoscope. I have to wrap my fingers around the fissures in the tubing to make this one work.

For me, these days, listening to the patient's chest is more a ritual than a means of diagnosis. After twenty years as a primary-care internist, I now work full-time in hospice and palliative care. I spend more time listening to stories than to hearts and lungs. Even so, there's something about leaning over and finding the right spot on the chest that makes me feel like a real doctor and helps my patients know that they're being cared for.

Every morning I put this stethoscope around my neck and walk down the hall of our inpatient hospice unit, and every morning, I forget until I touch the first patient. I wonder about the silence in my ears, and then I remember and close my fingers over the stiff, unresponsive black tubing.

I keep making mental notes to order a new stethoscope, but I want to keep using this one.

My very first stethoscope was made of red plastic. It came in a cute little blue bag with the visiting-nurse outfit I wore for Halloween when I was six.

I loved that stethoscope. My dolls, my stuffed animals and my two-year-old brother submitted to my examinations with varying degrees of patience. I felt frustrated, though, that the red plastic stethoscope was too stiff to fold up the way my father's did. I could always see a curve of rubber tubing sticking up out of his jacket pocket. There was usually an extra in the back seat of his car, and yet another hanging on the valet in his bedroom, where he left his keys and change at the end of each day.

For most of my childhood, my father worked seven days a week and took call almost continuously. Even so, he was still more available to my mother, my brother and me than most of the commuting, golfing, poker-playing, lawn-mowing dads of our suburban community. If he wasn't working, he was home, reading and watching TV and listening to music, and never too busy to talk to us.

When early-morning choir practice forced me to walk to school before sunrise, Dad decided that this wasn't safe, so he started driving me every morning. This meant that we had to leave the house in time for him to start office hours, at 7:30 AM. I was always the first student in the building, forty-five minutes before classes started, and it was worth it to have time with my father.

I went away to college, then came home for med school. Dad no longer drove me to school, but he answered my questions and annoyed me by figuring out the diagnosis in every case study before I'd even understood the description. I didn't have to search for a mentor; mine was sitting at the kitchen table every night, deeply pleased to share his love of medicine with me.

Although I moved 3,000 miles away for my residency, I still called home to talk to Dad about the puzzling cases. I wanted to tell him about the triumphs and needed to hear his voice for comfort when I'd stumbled, or thought I had. (In these instances, Dad always disagreed: "You did fine, honey. You did just fine.")

Dad told me about his challenging cases, too. He sent me articles and interesting EKGs. One memorable day, he even called to ask me a question. I knew, then, that I was really a doctor.

I was still living 3,000 miles away, in my third year of residency, when Dad had a heart attack.

As far as we could tell, he recovered without incident. He certainly never mentioned any problem. He couldn't disguise or deny the growing weakness in his legs–-but he wouldn't discuss it, and he expected us all to go on as if nothing had changed. We did, because we had no choice.

Twenty years later, he had spinal surgery and spent six weeks in rehab, sternly informing me over the phone that there was no need to interrupt my life to come visit. By that time, I was living two hours away, working part-time in private practice, teaching in an internal-medicine residency and sending my father regular emails with pictures of my small daughter. He printed the pictures and hung them in his office.

After rehab, he returned to the work he loved. He couldn't see patients any more, but he still read echos and EKGs and taught fellows, residents and med students.

Two years after the surgery, Dad died on the way to work, in the driveway, in his jacket and tie. Sudden cardiac arrest.

It's fitting, I suppose, that I heard the news in my office, with patients in the exam rooms and charts on my desk. I left the patients–-but I did finish all of my notes and sign off on all of the correspondence, fulfilling professional obligations just as my father taught me.

I was my father's daughter when he was alive, I found myself musing. Who will I be now that he's dead?

My husband joined me at the office so I wouldn't have to drive to my mother's house alone. When we walked into the kitchen, I couldn't look at the empty chair by the phone. Dad always sat there, because Dad was always on call.

The phone rang all that day and evening, and none of the calls were for him.

We answered the phone and the door so many times that I'd lost track by the time Mary arrived. For more than thirty years, she had worked for Dad, following him from private practice to community hospital to county medical center, managing his office–-and much of his life.

The morning he never arrived at work, she gathered up his things, emptied his desk and brought everything to us. An offering.

The box contained pictures of my daughter, a pile of certificates and diplomas, Dad's favorite rollerball pens–-and three stethoscopes, all permanently arched from being jammed into his pocket.

These were ordinary Littman scopes; my father the cardiologist didn't believe in fancy specialty stethoscopes. When he gave me my first Littman, his note in the box said, "Remember: the most important part is what's between the earpieces."

I didn't need three stethoscopes. I didn't need even one–-I had my own–-but I saw Dad's initials stamped into the tubing of the top one. I took that one upstairs and put it in my suitcase.

A week later I returned to my own office, carrying my father's stethoscope. It became my talisman, my connection to my father's wisdom and comfort. My father was gone, yet he still came to work with me every day. I didn't shove it into my pocket; I wore it around my neck, and the tubing took on my curve instead of Dad's.

Nothing lasts forever. Eight years after my father's death, the tubing that bears his name is stiff and cracked. If I hold my fingers over the broken spot, it can still transmit sound.

Eight years ago, I was broken, and this tubing helped me heal.

Now I wonder if I am healed enough to let go of my lucky piece and trust my own heart to keep beating on its own.


About the author:

Jenni Levy worked as a primary-care internist for twenty years before becoming medical director of St. Luke's Hospice in Bethlehem, PA, where she is also on the faculty of St. Luke's University Hospital's Hospice and Palliative Fellowship Program. She is a trained facilitator and is currently vice-president of internal education for the American Academy on Communication and Healthcare (AACH). Her writing on parenting and adoption has appeared in Huffington Post and the Motherlode blog of the New York Times, and her poetry in Annals of Internal Medicine. "Narrative is integral to my work: I spend my days listening to people tell me stories and trying to figure out what they mean. I've seen myself as a writer ever since I was lucky enough to study with Doris Patrao and Del Shortliffe in high school. They encouraged me to write poetry and held my prose to a high standard. Over the past few years I've started writing regularly again, and I feel as if I've regained a part of myself."

Story editor:

Diane Guernsey

 

 

Comments   

# Sara Taylor 2015-09-02 16:29
Thank you for sharing such a personal story, so beautifully written. I really felt the connection between you and your father through your words. I also loved the symbolism of your stethoscope and the impact of your last sentence.
All the best,
Sara
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# Amato P. 2015-08-29 11:22
Almost deleted without reading, which would have been such a terrible mistake. The piece added such a wonderful feeling of warmth and beauty ,as it describes the fine balance that the physician wholeheartedly tries to maintain between love of family and commitment to his patients/practi ce. It seems that today the stethoscope is slowly being replaced by the keyboard and mouse.
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# Chris S. 2015-07-07 13:24
A truly moving and well written piece. My heart goes out to you and the work that you do each day. Your patients and nurses are lucky to have you at their side. You have made your father proud for sure, and you imprint a part of him on each person that whose life you touch. A truly treasured memory and I will hold this story close to my heart in my own practice. For the record, I think your father would be honored to have his stethoscope hanging in your office, and a new one being used that you could then leave to the next generation :)
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# Kelly 2015-07-06 22:56
Beautiful and moving piece...thank you for sharing.
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# Marybeth 2015-07-06 10:26
Just simply beautiful.
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# Robert Holman 2015-06-29 17:22
Thank you very much for this gem. Having a grandfather, father, and an uncle in medicine made this all the more touching.
--Robert
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# Deborah 2015-06-22 13:35
A precious story told most eloquently. He passed doing what he loved to do, living his life to serve others. Now you carry that mantle and legacy. I see the next generation in your child and rejoice at what a beautiful heritage he left.
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# Michael Goldstein 2015-06-22 10:57
Thanks so much Jenni for your story!

It is truly moving and 'heart warming"! I couldn't help but think of my dad, who had a solo practice in our home and was my role model and hero!

Warmly,

MIchael
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# JHall 2015-06-22 08:48
Beautiful and thought provoking. I loved the way you saved the fact that it was your father's stethoscope to the end...as most of us wondered while reading through the piece, "Why doesn't she just get a new one? She can certainly afford it." It made perfect sense at the end.
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# Ron Banner 2015-06-21 12:46
Dear Jenni,

BEAUTIFUL! and I read it on Father's Day!

A very male comment: I, too have struggled when my stethoscope tubing has breaken, since my belle/diaphragm has been with me through Viet Nam. Solution: replace the tubing (I know that you father's initial were on it - have that and use it somehow) and save the listening apparatus.

What a great doctor and teacher you are!
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# Terry Hourigan 2015-06-20 16:43
Your story was both painful and a trigger for gratitude. I never knew my grandfather, but I have his stethoscope, and I am nursing it through another year - it's my one tangible connection to him. Clearly "You can't take it with you," but I can't let it go, not yet. It was so good to be reminded, through your memories.
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# Scott Newport 2015-06-20 14:50
Hey Jenni, what a great story for Fathers day. After reading your essay I felt inspired to write my own about my father after visiting him today in a cardiac unit. I really loved this line in your work, “I keep making mental notes to order a new stethoscope, but I want to keep using this one.” Thanks so much for making my Fathers day special.
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# Anne Louise Curran 2015-06-20 13:14
Yes, I really like this story, the way it hangs together with the stethoscope as a central theme, and much deeper themes resonating. As a reader I rate this highly.
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# PROMILA 2015-06-20 12:37
Thanks Jenni

as I started to read your story told very simply there came a point where I couldn't see anything.so I had to stop, wipe my eyes and carry on reading.it left my eyes feeling wet but my heart feeling warm.

Thanks to you once again!
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# Pris Campbell 2015-06-20 06:09
This brought tears. What a beautiful story. I had a good, loving father, too, both to me and in his work. We can be grateful we were so fortunate.
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# Muriel Murch 2015-06-20 04:44
Dear Jenni.
I loved this story. You have told us about the tools of your trade that are such a link between patient and doctor. If you have time, do read Permisso, a piece I wrote about the stethoscope and the ties that bind, physician to patient and patient to physician. In murielmurch.com in medical writing. I should be able to make the direct link but haven't figured that our yet. Lovely story. Thank you.
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# pam mitchell 2015-06-19 23:36
Thank you, Jenni, for this eloquent and moving piece.You have captured the sacred in a truly tender way. I hear breath sounds. May you continue to feel that sense of regaining a part of yourself!
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# Lou Verardo, MD 2015-06-19 21:56
What a great story for Father's Day; thank you, Dr. Levy, for sharing it with all of us. Not a day goes by that I don't think about my own father (an engineer, not a physician) and the impact he had on my life.
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# Cortney Davic 2015-06-19 21:34
lovely. And it arrived on the anniversary of my Dad's death. He wasn't a doctor but a writer, and he was my mentor. A touching and memorable story, beautifully told.
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# Paul Rousseau 2015-06-19 21:27
Wow, what a story. Left me speechless, and my heart aching. Your father was, and is, a wonderful human being. Thank you for sharing this story.
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# Sherrie 2015-06-19 21:16
Thank you for the beautiful story. Almost nne years after my father's death, I still wear his golf jacket for jogging. It's worn out and raggedy, yet impossible to throw out. One day I will, but not yet.
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# Ray 2015-06-19 21:15
So well told.
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# Dennis Saver 2015-06-19 21:14
A thoughtful and touching remembrance. A good life, a clean death; a heritage lovingly taught and lovingly received. Is there more that can be asked? The baton is passed well. The race is on.
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# Paul Rousseau 2015-06-19 21:29
Well said Dennis.
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