A toast to the years

His wife thinks he looks like Tom Cruise.  There is a resemblance, I can see him riding a motorcycle off the side of a burning building, jaw fixed, eyes on fire, ready to save the damsel…only he is not so short.  Funny, brilliant and genuine, we have known each other for exactly two decades, sharing the growth of our families, the anxieties of middle age, and the vicissitudes of life.  He is direct, aggressive, articulate, but considerate, honest and giving; the classic gentleman.  He is my teacher. He is my friend. He is my patient.

Today, honoring those 20 years, we drank a toast.  A single shot of Jim Beam, from plastic cups.  We raised our glasses, not just to his survival against the dread disease, but we remembered, pondered and relished the time we have had together.

A 52-year-old patient of mine died.  Her life ended, among family and friends, after a brutal struggle against an unrelenting cancer. She was an incredible person, which could not be diminished by the disease which punished her body.  There was purity to her, a gentle maturity and understanding that transcended daily events and rose above her struggle.  Joyous, giving, funny and creative she taught how wonderful life can be and how precious the time we have together.  She gave me hope, courage, friendship and added a special spark to life.  Though I am glad she is no longer in pain, I miss her deeply.

It is hard to cross that line, patient verses doctor.  The therapeutic relationship demands distance.  However, some of the most important moments happen, when the line blurs.  This week my wife and I shared the hospitality, warmth and teaching of a patient of mine, celebrating Passover Seder.  She, and her family, took us into their home for a perfect night of prayer, song, wine, food and laughter.  They trusted us with some of the most important moments in the year.   A powerful, passionate, loving and stubborn woman, whose focus in fighting cancer has inspired my staff and I for years, she welcomed us into the intimacy of her family, and touched our hearts.

Every high school, college and medical school student, every intern, resident and fellow, every junior or senior attending, hears these days, “why in the world do you want to be a doctor?’  The cost, years, and sacrifice. The loss of youth. The fading prestige. The nights worked while children grow up.  Penny-pinching insurance companies, pitiless lawyers, ponderous administrators, pesky vendors, pestering drug reps, angry patients and mounds of paperwork.   Grueling, lonely, exhausting and unforgiving, the money you make pays for massive loans.  It is not worth it.

You know what I say to every high school, college, med student, intern, resident, and fellow? There is no better career, no more remarkable experience, nothing better that you can do with your life, than to be a doctor. If you give yourself to this remarkable vocation, risk not just your body, time and mind, but your soul, then you will find a glimpse of the kaleidoscope of life, a deeper understanding of man and small insights into the incredible people who trust their care to you.  For moments, you will touch the divine.

I raise a glass.   I raise a glass to every patient that has honored me with their health, life and dreams.  Those who teach hope, strength, beauty, healing, and the battle of life.   May you live long, live well, laugh, learn, love and find peace at journey’s end.  I thank you, because no matter how much I try, no matter how much I give, I can never repay all you have given me.


  • Lillian walsh
    The last paragraph of this blog says it all. All my years of nursing summed up so simply. So many people/patients over the years stating that they could never be a nurse or do what I do. It must be so hard, so physically and mentally draining. Yes it is. And what I am given in return fills me up to overflowing. LW
    • James Salwitz, MD
      That is the great secret lost sometimes amoung the paperwork ... caregivers are often the ones who are given the most. ics
  • Alyce
    What a beautiful article. It touches the heart. You are a great healer. You give and your patients gain from your gift.
    • James Salwitz, MD
      Thank you very much. I hope you enjoy this wonderful spring day. jcs
  • Elaine Newcomb
    You are one in a million, Dr. Salwitz! Five years ago l was diagnosed with stage IV colon cancer metastasis to the liver. The oncologist looked me in the eye and said," Your condition is terminal. There are no treatment options. There is no hope. Go home. Enjoy what life you have left." I have never felt as alone as l did that day. Your patients never will have that horrible empty feeling. They are blessed. By the way there were treatments. I just had to find them on my own. Dr. David Geller, UPMC Liver Cancer Unit, was my knight in shining surgical scrubs. Keep doing what you are doing and keep writing these hart-warming blogs!
    • James Salwitz, MD
      I love "knight-in-shining-scrubs." KISS. How appropriate. Stay healthily! jcs
  • Bless you and whatever you celebrate today! When we're patients, and anybody taking Tamoxifen is still a patient, we need people who see what you see, and who share that wisdom with us.
    • James Salwitz, MD
      Thank you. I hope you celebrated a wonderful day, jcs
  • pam956
    Thank you for this thoughtful toast. I bask in the glow of your gratitude for your profession and calling. Can you be cloned?
    • James Salwitz, MD
      Thank you very much. Re cloning, my wife indicates that one of me is quite enough. jcs
  • Ray
    Several years ago my wife and I were facing a terrible situation. Her breast cancer had spread as she was labeled Stage 4. She insisted on interviewing several oncologists. After each interview she said we had to keep looking. When we found you we felt like we found home. From that time on we considered you our doctor and friend and also considered many of your staff in the same light. You guided us through the following 4 years of difficult treatments that ended last Sept. We spend the following 5 months at home until Dee passed in Feb of this year. You showed me empathy, understanding at the most difficult time in my life. You are a model man and doctor. Future doctors you come in contact with will have a real advantage as they move forward. I wish you and your family a long and happy life and I thank you for everything
  • Bill Wickart
    Wow. "Knight in shining scrubs" is a phrase I will keep in mind. We have a few thousand here, too.
  • From those of us who are not doctors... a big Thank You to you, for being one.
  • Penny egan
    This was a beautiful posting ... I thank you for all you touch and will touch in your life... We are blessed to know you...

Leave a Reply