Too Late

Updated: Oct 18



Watercolor Impressions by Dr Emily Wong
Tucson. Acrylic on paper. Discovery Bay, Hong Kong. October 2020.

One of my first mentors in business was a career health administrator who headed up outpatient operations at the University of Washington (UW), whom I’ll call Angela.


Angela


She was incredibly skilled at handling fledgling doctors with no prior business experience, gently guiding me to see how to handle personnel issues and customer concerns with tremendous tact and respect. My fondest memory of Angela is a moment I’m not proud of. I was hiding out in my office with the fire alarm going off in the building. All staff were supposed to evacuate the building when the alarm went off, but my usual routine was to refuse to leave and keep working. I was actually unpacking boxes in my new Clinic Chief office when Angela came and stood in the door with her red fire marshal hat on.


In that moment I “grew up” as a leader and that gentle lesson has continued to serve me, more than 20 years later.

Role models and behavior for leadership

Leadership


I told her about all the reasons why I didn’t have time for interruptions like fire drills and she stood and listened quietly. I told her not to wait for me, but to go on with her duties and she said, “No, I’ll wait,” and stood quietly looking down at the floor. I explained again that I wasn’t going to leave, and Angela said calmly, “You are the Clinic Chief.” The implication was clear: I was expected to role model the behavior that best served the team and institution, and holding up the fire marshal was not something a leader did. In that moment I “grew up” as a leader and that gentle lesson has continued to serve me, more than 20 years later. 


Retirement


Angela worked so hard as the head of clinic operations, and yet ironically never had the time to get seen herself by any doctor in clinic. I knew from my nurse manager that she had health issues she kept putting off because of work, and I could see that she was overweight, and had a nervous habit of nibbling at her knuckles which had callouses worn smooth with time. Angela had worked for Washington state for long enough to qualify for an excellent pension and benefits package, and was planning for early retirement at age 55. She and her husband John were looking forward to spending more time at their sunbird home in Arizona, and to supplement their retirement income through antique trading. 


Too Late


Not one year into Angela’s retirement, I received a call from St Joseph’s Hospital ICU, asking if I would evaluate and consider accepting Angela in transfer to our tertiary care hospital in Seattle.  I drove down to Tacoma to assess her - she clearly recognized me and held out her good hand, but she was unable to speak due to a stroke that had injured the speech center in her brain. She scrawled a message that was not in her usual neat handwriting - it was barely decipherable: “Too late”. The next day Angela had another stroke and never woke up from comatose state after that. A few weeks later she died in the UW ICU, despite having had the best neurosurgeons and specialists working on her.  



A different paradigm



And thus she taught me an even more important lesson: don’t wait to take of your health until it's too late. Angela came from a generation that sacrificed everything for work, deferring gratification and self care, literally working themselves in the grave. And many would argue we still have this culture medicine today. We compete to see who can come in earlier or stay later. Who can tell the more painful story of their own suffering or their patients’. But what if investing the time and effort to take care of ourselves now meant that we might be able to avoid tragic health problems and early death or disability? 


I don’t honestly believe that I could have convinced Angela back then that there was another way to live. Because I actually believed wholeheartedly in the self-sacrifice paradigm myself back then. But now I know that I owe it to her memory to remind myself and others that we cannot see into the future. We only have today and this present moment. This one precious body and mind. And we have the freedom to make choices now that will serve our future selves. We owe it to ourselves to be intentional about those choices.






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