Leonard Sullivan, MD, age 59, has been one of three
general internists in Pumpkin Hills, Wyoming, for the past 30 years. He came
to Pumpkin Hills immediately after his residency, married a local woman, and
raised two children who are now away at college. Dr. Sullivan's wife died of
breast cancer one year ago.
Margaret Dinardo, age 60, has spent her life in Pumpkin
Hills and has been a patient of Dr. Sullivan's for nearly 20 years. Her
husband died two years ago, and her children are now married with families of
their own.
Ms. Dinardo returns for her yearly visit with Dr.
Sullivan. He finds her in continued good health, renews her Feldene
prescription for mild osteoarthritis, and schedules her yearly mammogram. Dr.
Sullivan reviews the results of his clinical exam, and they talk about general
preventive care measures. He notices that he feels uplifted by Ms. Dinardo's
presence.
"Enough about me, Leonard," Ms. Dinardo says
finally. "How have you been since Diane passed on?"
"It's been difficult, although the children have
been a great help," he responds. Ms. Dinardo touches his shoulders,
saying, "I know exactly what you mean," and leaves.
About a week later, Ms. Dinardo calls Dr. Sullivan at
home and invites him over for dinner. "I bet you don't get many
home-cooked meals these days," she says. He accepts the invitation, and
they spend the evening talking. Dr. Sullivan tells her about his life now and
the trouble he has had coping with his wife's death. In Margaret Dinardo he
finds an understanding and compassionate listener, who shares the experiences
she has had since losing her spouse. "Thank you, Margaret...I feel so
much better talking to you," he says.
"Any time, Leonard," she responds. "Call
me and maybe we'll catch a movie."
In the next few months, Dr. Sullivan and Ms. Dinardo see
each other regularly. They enjoy each other's company and consider their
relationship to be an evolution of their long-standing friendship. But Dr.
Sullivan begins to notice that he feels romantically inclined toward Ms.
Dinardo and wonders if she feels the same way. One evening, Ms. Dinardo says,
"Leonard, what is the matter with you? You've been fidgeting since you
got here." He blurts out that he feels attracted to her romantically, and
she replies, "Well, it's about time! I was beginning to think you were
just too old for me!"
They kiss passionately, well into the evening. He
reluctantly draws away from her and heads toward the door. "I really
should be getting home. I have a busy day tomorrow at the office. Good night,
Margaret."
"Oh, well, your duty calls. Good night, Dr.
Sullivan," she replies.
He does not sleep at all, feeling strangely disquieted
by the word "doctor." All day, he is troubled by Ms. Dinardo's use
of "Dr. Sullivan." After a long day at the office, he decides to
talk to her about it. "You know, I was always taught that a sexual
relationship between a doctor and a patient is wrong," he explains.
"If we're going to start something here, maybe you should consider
becoming Dr. Voorhee's patient."
Ms. Dinardo reacts with surprise and anger.
"Leonard Sullivan, you have been my doctor for 20 years. I trust
you–that doesn't just go away because we kissed. How can you even think such
a thing?" She refuses to consider seeing another internist. "Listen,
we kissed yesterday, and you expect me to give you up as a doctor? You must be
kidding!"
What should Dr. Sullivan do?
1. Defining a "Profession"