Gifts

As a senior medical student, I spent an outpatient January in the office of a suburban pediatrician who cared for the children of many doctors.

After the holidays, he mused about the onslaught of gifts that he received from people to whom he extended professional courtesy.

Some gave him conventional things—candy, wine, and so forth. Others aimed for something more grandiose. Like the one who the year before had sent him a side of beef.

This is the season when many people get to ponder the intricacies of giving and getting gifts. Knowing when and what to give, as well as how to accept, requires a lot of art and sensitivity. (“That's exactly what I wanted! How did you know?”)

Thankfully, such subtleties are less important for doctors, at least at work, now that health insurance and fixed copayments have made most professional courtesy obsolete. I doubt many miss it. Professional relationships work best when objectivity is not undercut by other considerations. Like handouts.

Gifts haven't gone away, though, even if we're going to have to do without pens, mugs, and sticky notes from pharmaceutical companies. Some of my patients still like to bring presents. One Russian patient handed me a box of chocolates covered in Cyrillic script and funky Russian, ruby-red graphics. I protested that she really shouldn't have (though of course not too strongly, so as not to offend). Bringing the gift clearly makes her happy, and my staff eats the chocolate.

Many of my Russian patients like to bring gifts. Besides chocolate, they present wine and other spirits. One Russian physician brought a bottle of Armenian vodka in a bottle whose odd shape I couldn't make any sense of until he showed me how to hold it: It was shaped like a boxing glove! I show it to house guests, but it's just too weird for me to open. (Some time later I saw another vodka bottle from the former Soviet Union, this one shaped like a submachine gun.)

Other ethnic groups bring presents too. A Chinese patient generally brings cookies from Chinatown, and sometimes tea. Pamela brings a loaf of Irish bread every time she comes for Botox. She says she knows how much I like it.

I have no idea how she could know this, since I have never eaten an Irish bread, but I don't have the heart to tell her. My head nurse, Faye, grew up in South Boston. (If you can't locate Southie on the physical and cultural map, check out Matt Damon in “Good Will Hunting.”) Faye likes Irish bread, including Pamela's.

So far the examples I've given reflect varieties of ethnic expression and traditional patterns of gift-giving left over from old countries. Other presents are personal expressions—authors bring in a copy of their latest book, musicians drop off a CD. One patient last year brought an art calendar her mother had illustrated. A very elderly gentleman came by a few years ago, and reminded me that I had seen him decades before when I first went into practice. In his 90s, he was still busy making mobiles, and he brought me one. I couldn't bear to throw it out but had no idea what to do with it, so I hung it behind a door for a long time. Eventually, like most such things, it went.

Then some gifts, like their givers, are just, well, odd. One gentleman came a few years ago for a minor problem that cleared by the second visit. Before he left, he rather solemnly announced that he was so grateful for my intervention that he had purchased a gift. He reached into a tin bucket he'd brought and withdrew a short, green brush, the kind you use to wash dishes, and presented it to me. The price tag was still attached—49 cents.

I was speechless. I still am. The gift brush sits on my window sill, reminding me of the importance of going the extra mile for patients, of washing dishes, and of buying things on sale.

Hope you had happy holidays (and got the gifts you wanted)!

As a senior medical student, I spent an outpatient January in the office of a suburban pediatrician who cared for the children of many doctors.

After the holidays, he mused about the onslaught of gifts that he received from people to whom he extended professional courtesy.

Some gave him conventional things—candy, wine, and so forth. Others aimed for something more grandiose. Like the one who the year before had sent him a side of beef.

This is the season when many people get to ponder the intricacies of giving and getting gifts. Knowing when and what to give, as well as how to accept, requires a lot of art and sensitivity. (“That's exactly what I wanted! How did you know?”)

Thankfully, such subtleties are less important for doctors, at least at work, now that health insurance and fixed copayments have made most professional courtesy obsolete. I doubt many miss it. Professional relationships work best when objectivity is not undercut by other considerations. Like handouts.

Gifts haven't gone away, though, even if we're going to have to do without pens, mugs, and sticky notes from pharmaceutical companies. Some of my patients still like to bring presents. One Russian patient handed me a box of chocolates covered in Cyrillic script and funky Russian, ruby-red graphics. I protested that she really shouldn't have (though of course not too strongly, so as not to offend). Bringing the gift clearly makes her happy, and my staff eats the chocolate.

Many of my Russian patients like to bring gifts. Besides chocolate, they present wine and other spirits. One Russian physician brought a bottle of Armenian vodka in a bottle whose odd shape I couldn't make any sense of until he showed me how to hold it: It was shaped like a boxing glove! I show it to house guests, but it's just too weird for me to open. (Some time later I saw another vodka bottle from the former Soviet Union, this one shaped like a submachine gun.)

Other ethnic groups bring presents too. A Chinese patient generally brings cookies from Chinatown, and sometimes tea. Pamela brings a loaf of Irish bread every time she comes for Botox. She says she knows how much I like it.

I have no idea how she could know this, since I have never eaten an Irish bread, but I don't have the heart to tell her. My head nurse, Faye, grew up in South Boston. (If you can't locate Southie on the physical and cultural map, check out Matt Damon in “Good Will Hunting.”) Faye likes Irish bread, including Pamela's.

So far the examples I've given reflect varieties of ethnic expression and traditional patterns of gift-giving left over from old countries. Other presents are personal expressions—authors bring in a copy of their latest book, musicians drop off a CD. One patient last year brought an art calendar her mother had illustrated. A very elderly gentleman came by a few years ago, and reminded me that I had seen him decades before when I first went into practice. In his 90s, he was still busy making mobiles, and he brought me one. I couldn't bear to throw it out but had no idea what to do with it, so I hung it behind a door for a long time. Eventually, like most such things, it went.

Then some gifts, like their givers, are just, well, odd. One gentleman came a few years ago for a minor problem that cleared by the second visit. Before he left, he rather solemnly announced that he was so grateful for my intervention that he had purchased a gift. He reached into a tin bucket he'd brought and withdrew a short, green brush, the kind you use to wash dishes, and presented it to me. The price tag was still attached—49 cents.

I was speechless. I still am. The gift brush sits on my window sill, reminding me of the importance of going the extra mile for patients, of washing dishes, and of buying things on sale.

Hope you had happy holidays (and got the gifts you wanted)!

As a senior medical student, I spent an outpatient January in the office of a suburban pediatrician who cared for the children of many doctors.

After the holidays, he mused about the onslaught of gifts that he received from people to whom he extended professional courtesy.

Some gave him conventional things—candy, wine, and so forth. Others aimed for something more grandiose. Like the one who the year before had sent him a side of beef.

This is the season when many people get to ponder the intricacies of giving and getting gifts. Knowing when and what to give, as well as how to accept, requires a lot of art and sensitivity. (“That's exactly what I wanted! How did you know?”)

Thankfully, such subtleties are less important for doctors, at least at work, now that health insurance and fixed copayments have made most professional courtesy obsolete. I doubt many miss it. Professional relationships work best when objectivity is not undercut by other considerations. Like handouts.

Gifts haven't gone away, though, even if we're going to have to do without pens, mugs, and sticky notes from pharmaceutical companies. Some of my patients still like to bring presents. One Russian patient handed me a box of chocolates covered in Cyrillic script and funky Russian, ruby-red graphics. I protested that she really shouldn't have (though of course not too strongly, so as not to offend). Bringing the gift clearly makes her happy, and my staff eats the chocolate.

Many of my Russian patients like to bring gifts. Besides chocolate, they present wine and other spirits. One Russian physician brought a bottle of Armenian vodka in a bottle whose odd shape I couldn't make any sense of until he showed me how to hold it: It was shaped like a boxing glove! I show it to house guests, but it's just too weird for me to open. (Some time later I saw another vodka bottle from the former Soviet Union, this one shaped like a submachine gun.)

Other ethnic groups bring presents too. A Chinese patient generally brings cookies from Chinatown, and sometimes tea. Pamela brings a loaf of Irish bread every time she comes for Botox. She says she knows how much I like it.

I have no idea how she could know this, since I have never eaten an Irish bread, but I don't have the heart to tell her. My head nurse, Faye, grew up in South Boston. (If you can't locate Southie on the physical and cultural map, check out Matt Damon in “Good Will Hunting.”) Faye likes Irish bread, including Pamela's.

So far the examples I've given reflect varieties of ethnic expression and traditional patterns of gift-giving left over from old countries. Other presents are personal expressions—authors bring in a copy of their latest book, musicians drop off a CD. One patient last year brought an art calendar her mother had illustrated. A very elderly gentleman came by a few years ago, and reminded me that I had seen him decades before when I first went into practice. In his 90s, he was still busy making mobiles, and he brought me one. I couldn't bear to throw it out but had no idea what to do with it, so I hung it behind a door for a long time. Eventually, like most such things, it went.

Then some gifts, like their givers, are just, well, odd. One gentleman came a few years ago for a minor problem that cleared by the second visit. Before he left, he rather solemnly announced that he was so grateful for my intervention that he had purchased a gift. He reached into a tin bucket he'd brought and withdrew a short, green brush, the kind you use to wash dishes, and presented it to me. The price tag was still attached—49 cents.

I was speechless. I still am. The gift brush sits on my window sill, reminding me of the importance of going the extra mile for patients, of washing dishes, and of buying things on sale.

Hope you had happy holidays (and got the gifts you wanted)!