Medicine and its Cost

““I haven’t got time to be sick!” he said. “People need me.”

He was a doctor; he did not know what it was to spare himself.”

-Don Marquis


For more than forty years I have had the privilege of being a physician. I’m one of those rare people who has been lucky enough to be able to work at what I want to do. Early in life I decided that I’d be a doctor. Life is hard and full of obstacles; mine has been no different. But when I look back, I can say that I have no regrets. No greater joy can befall a human being than to be able to become a physician; there is also no greater responsibility.

During my recent vacation I went to lunch at a restaurant. I noticed that one of the rooms was reserved for a prominent local attorney. He has a house in the same complex that we have our apartment. I decided that I’d crash his party in order to introduce myself.

He was very gracious. As I left the room I commented that he shared a name with a former girlfriend of mine. A brilliant; kind; sensitive; beautiful woman. When I decided to leave for the US to study medicine she dropped me. Did not want a long-distance boyfriend.

“She did not know what she was missing,” he said.

Maybe she did.

We laughed.

After I got home I began to think. The “Dear John” letter that she sent me was my first payment to mother medicine. In those days long distance was expensive. I did not have the resources to get on a plane, come home, make things right, and head back to St. Louis. No matter. It did not cross my mind to leave my studies. My classmates could not understand why I just let this matter drop. We got along well; our families liked each other; we had talked about getting married. But I had to be a doctor; I never felt that I had a choice.

Then the floodgate of memories opened. Maybe it was a matter of me being home; closer in touch with my youth. I took stock of other times when mother medicine came first.

The time when one of my daughters, not even a year old, had a seizure and a respiratory arrest while she was visiting my parents. When my father called me with the news (yes, long distance) I had thirty hospitalized patients. My first thought was about my patients; how I could not possibly leave them. It was only after I noticed the shock in my father’s voice when I mentioned how busy I was that I realized that I had to get on a plane, get her out of the ICU, and find someone to cover for me.

There were many late nights and cold dinners. Not as close to my children as I could have been. Maybe I set standards that were hard to meet, like I set for myself in my profession. They were just kids.

My wife is a nurse. She was trapped in the web as much as I was. The vacation days were few. It has been more than twenty years since I left the office without calling every day, or checking e mails and lab tests every few hours. When electronic records became the norm I was hooked. I could make diagnoses and prescribe medicine from a chair in front of the beach. I saw nothing wrong or twisted in that behavior.

Some patients don’t do well. Your soul hardens. You fail to take credit for the good you do; you’re constantly concerned about what might go wrong. This attitude dominates the rest of your life. When the kids go swimming you worry that they may drown. Roller coasters may cause back pain. Because you have so much power over pain and suffering it becomes hard to understand and accept failures; your life is slanted.

When my dad got sick it was a chore to visit him. Another failure. When my mom followed in his steps I did much better, but I did allow my wife to do much of the heavy work.

My practice thrived. Most of my patients loved me. It’s hard to describe the sense of joy I feel when I’m the fifth specialist that a patient has seen, and it takes me ten minutes to make a diagnosis. The anticipation that comes over me knowing that in three months this tortured soul is going to be close to normal. The joy of hearing them sing my praises. It’s as addicting as a drug.

I must look like I’m aging fast, because over the last year dozens of patients have asked me when I intend to retire. My answer has always been that I like what I do.

As if there’s nothing else I could like.

But life does not listen to likes, or wishes, or longings. This is the only chance you get.

I have decided that I will explore other venues. I need to find out what else I like, hopefully long before age no longer allows me to enjoy it.

There are several minor medical problems that need to be better taken care of. I need to take a long trip without checking for lab results in my laptop. There’s that second and third books that I just can’t get around to edit. My sister wants me to walk a half marathon with her…

I cannot practice medicine with half the usual effort. I’d never forgive myself if something went wrong and I hadn’t been “all in” with the process.

Accordingly I’ve decided that I’ll retire from the full-time practice of medicine. February 26th will be my last day at the office. I’ll do a small amount of consulting. Will become more of an advocate for the homeless and the abused.

It will be a painful and difficult transition. Hard for me not to be as useful.

I thank all of my patients for the unspeakable joy that they have brought to my life. It has been a privilege to be worthy of their trust. May God bless and keep them always.


For those patients who read this blog: please do not call the office for further information. The schedule is crowded; patients need to be taken care of. You will receive a letter this coming week. I will host a party at the May Center on Friday March fourth at 5:30 PM. The employees will be there to say good-bye along with me. I will respond to facebook comments (time permitting); if you’d like to come to the party please RSVP to


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This Post Has 13 Comments

  1. Irene Cowan

    WOW…Didn’t see that coming. Paco you’ve been a great friend and Doctor. It’s time to do and enjoy other things. . You will miss your patients and coworkers but you will learn to really enjoy retirement. Rich and I will be there on March 4th. Irene

  2. lolaroig2013

    Hope you enjoy every day in good health. You deserve to give yourself free time with your lovely family and so many friends that appreciate listening to your reflections.

    Sent from my iPhone


  3. Linda Ormsbee

    I can’t think of anyone as deserving of retirement life as you. I am looking forward to your next book. With that being said, I am in tears. I first saw you over 16 years ago. You asked me to bring my husband with me on my second visit so you could explain to both of us how our lives were going to change. You have no idea how much I appreciated that. I had no primary doctor, and you became mine (without even asking me), and I couldn’t have been happier. My family and friends all know about my wonderful doctor. Please leave me in good hands. I am going to miss you Dr. Garriga.

  4. Lois Allen

    Well, I DID see it coming and regret to hear it. I will not ever wish you other than the best however, as that is what you have always given to your patients. I will be praying for you during and after transition. I already experience what you soon will. I have found nothing more difficult as I get older than to learn to live with my limitations. But it’s okay. God provides the means and the grace. Thank you!!!

  5. Cordell Webb

    Dr. G. I am in shock I didn’t see it coming. You have been my doctor and friend for 40 years or more. Started on Washington across from the Johnny Londoff dealership and I just kept following you through all your moves. I will be looking forward to your letter next week. What is funny is I have an appointment to see you Feb.26th your last day in your office. I hope I get to come to the party.

  6. Gwen Holmes

    Wow! I can only wish you the best in this next chapter of your life. You deserve a wonderful and enjoyable retirement.Take time now to enjoy your familyand just being you. I thank you for being the doctor I needed for over 30 years. God’s blessings to you always.

  7. Gail Roberts

    Dr. Garriga, I’m happy for you; this is your time. I’m sad, however, because I won’t find another doctor as gentle and compassionate. I’ll miss you.

  8. margo

    Te quiero mucho Paco!
    Retirement is tough, you WILL miss your patients.
    I pray you find a way to continue to give of yourself.
    obladi oblada… life goes on…la la how the life goes on …

    1. Betty Townsend

      Wow!! All of the above. After 25 years, I’m not sure I will have the same confidence in any other Doctor. It’s a complete surprise, especially after starting a new practice. Hope you have a ball and get to do everything on your bucket list. See you at the party .

  9. nmedearis

    Dr. Garriga, Yes, it will be a painful and difficult transition for ALL of US! I know you deserve to retire and find your new venue and I wish you the best, but my heart aches. I think of what my life was like before I was referred to you and don’t know how I managed to wait until I found you. Skepticism and Anxiety came with me to my first appointment yet they both left quickly. You listened to me figuratively and literally. Recently, when I thought that you were retiring, you convinced me that you were not, and as soon as that sunk in, you announced that you are retiring. We will miss you. Can’t say that enough. Chronic pain does evil things to the mind, “chronic hope” does another. I would love to come to your retirement party and introduce you to my supportive husband, but I imagine being selfish and crying the entire time. I want to say that I appreciate EVERYTHING that you have ever done for me and your other patients. You are amazing. Thank you for being you and I know that your future will be amazing and you will have much happiness that is well deserved. I am so blessed to have found you. Thank you just seems so insufficient, but Thank you.

  10. Carol. Ackermann

    I will really miss you and no one can fill your shoes . I do understand though need to enjoy life and the family. As we all know you will keep busy I will be attending the party

  11. kathie Fitzgerald

    I totally agree with those who previously posted their positive opinions and feelings about you….and I have no doubt that you will use your God given talents somewhere!!! You are a blessing to me and the rest of the world…..God Bless You Always!!!!!

  12. Betty Townsend

    Well I hope you are enjoying your retirement. I wish you and your family the best. You are missed but life is change.