There are few quiet moments in a doctor's office. Dr. Pintar managed to grab a quick lunch at the desk in her office, which looks as if it is seldom used. Then she was back on her feet at the nurse's counter, checking files and messages.
"My dentist is hounding me," she told June, looking at a message reminding her to schedule an appointment for a permanent crown.
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Photo by Kit Miller |
"I'm not a very compliant patient," she admitted, with a hint of perverse pride.
Then it was back to work. There were more snotty noses, slides to check for strep throat infections. An overweight high school student stopped by to have her weight checked. She had lost a couple of pounds and Dr. Pintar signed a slip of paper from her weight watching program and gave her an encouraging slap on the back.
Then there was another tough case. For a doctor there is no harder question than this one: What is a life worth? Yet, it is a question doctors face nearly every day.
For Dr. Pintar today, the question came in the form of a 3-and-a-half-year old boy with the mind of a 3-month-old. Born prematurely to a mother who abused drugs and is unable to care for him, the boy is confined to a wheelchair in a foster home. Tubes carry nutrition into his body and drain waste out because his guts do not function. An oxygen tube runs into his nostrils. He cannot see because he is cortically blind.
"Basically, he doesn't have enough brain," said Diane Miller, his foster mother. "But that doesn't sound very nice."
"There's not a nice way to say it," said Dr. Pintar, who regularly checks the boy and coordinates his hospital care, even though she feels deeply ambivalent about it.
More and more premature babies are being kept alive by extraordinary medical intervention, some after less than six months in the womb.
"I have difficulties with that," said Dr. Pintar. "I see the results. But I don't know what you can do ethically."
"We say it's OK to save these kids, but then we need to care for them," said the foster mother. "It's difficult to get doctors to see them," she said. "They're real complicated. They're scary little children. But we have a wonderful doctor who sees them. She treats them just like any other patient."
"How's my boy?" she asked Dr. Pintar
"His color is good," Dr. Pintar said. "I'll see you next week."
As the day went by the charts got stacked in the done pile. Dr. Pintar knew all their stories. With each patient, she was both hopeful and realistic, sympathetic and a little distant. A good doctor works with these dialectics to help the patient heal.
Every baby, every body, deserves a chance to be as good as he or she can be, Dr. Pintar believes.
She does the best she can for them and then it's out of her hands. She demands of patients, parents and kids that they take responsibility for themselves.
Late in the afternoon, Dr. Pintar's son, Andrew, called to remind her about his hockey game that night and to see if a friend could sleep over.
She felt bad about missing her time in his class the day before. She would try to make it up. Andrew was doing better in school since she had taken one day a week to volunteer in his classroom. She needed to get that day back.
"This year I haven't cut myself enough slack to be a good mother and a good wife," she said. "I'm not home. I'm too busy with work."
Dr. Pintar is working too hard. But she doesn't show it. She's driven and her kids are, too.
"I have lots of patience with children other than my own," she said, looking at pictures of the youth soccer teams her office has sponsored and her children have played on throughout the years.
That night she went to the hockey game at the pavilion in Mills Park with her husband, Sheldon Kop, who is a radiologist at Carson-Tahoe Hospital. They stood on the cold metal bleachers and cheered with the other parents. Andrew struggled on defense but in the final moments came down the ice and made a nice assist on his team's last goal.
Back at home, Dr. Pintar watched the kids eat soup while she checked in with the hospital. There was no school tomorrow. So the family could catch their breath together tonight, if there were no emergencies.
At least she and her husband were not both on call at the same time as they sometimes were when they were younger and doing their residencies in California.
Her husband can now look at X-rays on his home computer when he is on call.
Dr. Pintar talked with him about her efforts to recruit a partner so that she could get her day off back. She hoped that the same things that brought her home to Carson City would attract another doctor.
"I remember chafing at the bit when I was young because everybody knew where I was," she said. But she likes it now that it's her kids who are growing up in her hometown.
Her daughter Michelle came to sit in her arms in the living room. If their luck held, Susan Pintar could spend the rest of the evening with her husband and kids. She would undoubtedly have to answer a few calls.
But she might not have to go back to the hospital. The only thing making her toss and turn tonight would be the unresolved issue of "family and work," she said.
Her husband looked at her a little impatiently as if he had heard it before. "Just chill," he said.
"That was deep, insightful advice," she said. And then she laughed and hugged Michelle closer.