By Cory Michael, MD

Peg began internal medicine residency with altruistic goals. She didn’t want to become a specialist or seek personal financial wealth. She just wanted to help people. With a prior career related to her degrees in art history and sculpture, she had a unique way of truly embracing medicine as an art. Rarely spotted without a smile on her face despite long training hours in the hospital, she eagerly embraced taking care of the most underprivileged patients in the hospital who were grateful for her kindness. A model of physical health, her dedication to proper personal nutrition was the sort of thing that most other physicians talk to their patients about but rarely practice at her level.

About half-way through her first year as an intern, members of her medical team recall how she would brighten the mood during rounds. A certain intern on her team slated to pursue training as a radiologist the following year joked with her that she was going to one day save the world one patient at a time through primary care. Always a fun-loving colleague, she liked to banter back about his obsessive-compulsive tendencies that included the quirky way he would match his tie color to that of his argyle socks.

Many years have since passed, and it occurs to me that Peg really did become a modern heroine poised to save the world one patient at a time. In looking to the dictionary to examine the meaning of that term, I read “a woman admired or idealized for her courage, outstanding achievements, or noble qualities.” There are at least four reasons that Peg fit this description. First, she chose to practice primary care in an underserved area after finishing residency. Second, she bought into a private practice, thereby preserving physician ownership in an era when most doctors are forced to sell their labor to large companies or institutions. Third, she treated her own clinic patients in the hospital, thus becoming one of the last doctors to favor continuity of care over efficiency. Fourth, her practice included many Medicare patients, all of whom yielded lower reimbursement rates for her services.

As it turned out, the very things that made her a heroine coalesced to work against her. Forced with managing a practice with lesser financial resources, she wound up routinely working 16 to 20 hours each day seven days a week until she eventually had to close her practice. She was heartbroken.

Shortly thereafter, Peg took her own life. She had been in practice for less than six years. I guess some heroines just aren’t meant to walk the earth.

As much as this is a great loss to her family, her patients, and the medical system, losing Peg is a loss to the world, a world that really could use a few more heroines out there.

What makes this story particularly sad is that Peg did everything that our medical schools teach us to do, but modern American medicine simply no longer allows a doctor to build a practice based on altruism alone. Peg’s heart was just too big to deal with this economic reality.

Doctors are being pushed harder and harder for similar or less pay. Many of us find ourselves negotiating for more time with our families rather than asking for more financial compensation to fight burnout and prolong our careers. We can’t keep redefining our tolerable stress levels every year like this or else we will continue to experience losses like we did with Peg.

For those physicians who may have fallen desperate times, please talk to a friend, colleague, or medical professional. We can help you.

As I reached into my closet this morning, I picked out a green-striped tie and a pair of green argyle socks like I used to wear when I was an intern. For a moment, I was reminded of the warm smile of a true heroine who will live on in the memories of those who knew her. We will miss you, Peg.