Begin with the end in mind. -- Stephen R. Covey
Last month, Dr. Dave Fuchs wrote a retirement letter published by LNP. With great warmth and simplicity, he expressed his gratitude for a medical career spanning five decades serving Lancaster County.
First, he thanked his teachers and mentors, members of the medical community known for their dedication to both patients and their colleagues. Honoring our teachers by sharing their wisdom with others is a tenet of our Hippocratic Oath.  What a gift from a former pupil to recognize those who helped shape a career. He appreciated the technological advances made possible by partnerships between skilled physician and operational leaders -- advances far beyond other communities of this size. He thanked his colleagues at Oyster Point, who shared not just medicine but a greater vision of health care and I suspect the more mundane activities of daily living that define our lives outside of medicine. Most of all, he thanked his patients for sharing some of their most difficult and joyful moments with him and the opportunity to help them live the lives they want to lead. Meaningful work well done.
I came to Lancaster from a rural, hard-working community in the Adirondack region. While physicians there seldom posted retirement letters (most could not afford to retire), families and patients often took out space in the newspaper to thank their physicians, care providers, and supportive friends and families. Some did this on the anniversary of a loved one’s passing. It was high praise from families who had to sacrifice to place that acknowledgement and a badge of honor for the medical staff cited.
I confess I have thought about writing such a retirement letter. I commend Dr. Fuchs for taking the time to say thank you for what most physicians consider foundational elements to a fulfilling career. I would add to my letter recognition of my family, who have sacrificed to enable my service as a physician, and to my colleagues, who have made me a better clinician. As physicians weigh the marginal cost of another care transaction, or the opportunity cost of teaching future colleagues, I hope the expression of gratitude provides perspective on what defines a successful career.
Scientist, inventor and chemist Alfred Nobel (1801-1872) gained notoriety for discovering a way to stabilize explosives, nitroglycerin, into gunpowder and subsequently dynamite. I doubt anyone imagined the impact that discovery had or the human suffering it would bring.  Several years before his death, he read his obituary mistakenly published by a Paris newspaper. In it he was described as “The Merchant of Death” for his work in explosives, due to the pain, suffering and mortality they caused. As a result, he changed his will and dedicated the majority of his estate to establishing the Nobel Prizes to acknowledge those in service to humanity through the fields of Chemistry, Medicine, Peace and Literature.  Having seen the end gave him the opportunity to alter his legacy.
What lies behind us and what lies before us are tiny matters compared to what lies within us. -- Oliver Wendell Holmes

Lee M. Duke II, M.D.
Chief Physician Executive
Progress Notes' Editor-in-Chief

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