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Today I saw one of my favorite and most challenging patients. She is 88 and sweet as pie. I have been seeing her quite regularly for a particular issue that remains unresolved. I see her so regularly, that I know her story before ever having to open her chart, which is saying a lot. She came today complaining of the same symptoms that she always has and we completed the same song and dance that we always do. I ask her how  (or if) she is taking her medications. She shows me a sheet of paper outlining how adherent she has been to the prescribed therapy. I ask her if she needs any refills. She tells me whether its time to call the social worker who has been helping her with purchasing her medicines (a resource I helped arrange).  She then brings up something about money, whether it be the rising cost of gas, the high cost of milk or the outlandish electric bill. This time she brought in her medical bills and asked if I would help show her which ones need to be paid. I, of course, obliged.    She then tells me how good of a doctor I am and how she doesn’t know what she would do without me. I won’t pretend that this doesn’t make me feel good, even though I have yet to completely resolve her medical issue.

Then, she told me about her pet cockatiel, Scout. She said that she went to the grocery store and when she came back Scout was lying on his back, dead. His body was still warm. As she teared up, she told me he had been with her  24 years. She loved how he would come to her and bow his head so she could rub his neck. I told her that I too had a cockatiel named Titus who my family bought when I was in 3rd grade. I pictured Titus bending his head to get his neck rubbed. I told her I was very sorry about Scout, gave her a hug and walked out.  As I sat at my desk, I felt tears welling in my  eyes. I felt a little awkward because a medical student on his first days of his OBGYN rotation was sitting across from me in my office. Was I sad because she was sad?  Was I empathetic because of my pet bird Titus? Why was I crying over a bird?

Then it hit me. I felt sad because watching my patient age means watching her lose the things around her she loves so dearly. It means having to write some of her prescriptions solely because her primary care physician, who she has seen for 20+ years, just died. Watching her age means that I am also aging and this is bittersweet.