Goal achieved

Over the years, by working hard, patient-oriented and GP-oriented, I gained a good reputation and had built up two thriving practices. As time went by, more and more patients came to me from (far) outside the hospitals' catchment areas, even from Belgium and the occasional person from Germany. Fellow dermatologists also started referring to me because of the specific expertise I had built up in the field of contact allergy. While that stroked my ego, I was not happy with it. For most, I could not do much more than other dermatologists had already done, and the patients' expectations of my skills and abilities were usually (too) high. Still, I was able to satisfy many by giving good information. One patient, who had a very persistent condition, I think pustulosis palmoplantaris of the soles of the feet, I remember him saying: 'If my previous dermatologist had taken the trouble, in all the years I spent with him, to tell me what you have explained to me now, I could have saved myself a lot of time and useless treatments'. I had taken my time with it, but my message was relatively simple and boiled down to the fact that this is an extremely intractable skin disease, the cause is unknown, it is not harmful, is not a manifestation of a serious underlying condition, and is not contagious. While there are several ways to treat it, some of them are labor intensive, others can have serious side effects, and most importantly, any treatment is purely symptomatic, i.e. the disease may improve somewhat through therapy, but when you stop the treatment, it usually comes back. I sometimes told my family and friends that I 'talked my ass off' every day, but as exhausting as it was, I kept doing it because I knew how important good information is for patients.

 

With Janny en my secretary Corina in front of our new outpatient clinic, late 1990s

 

It is getting too busy

Anyway: so I had built up two thriving practices, but those practices were thriving a little too exuberantly and it was getting too busy for me. So I decided to transfer, read: sell, one of the practices. The choice of which hospital was not very difficult. Although I liked Willem-Alexander Hospital better, it at that time threatened to merge with the Groot Ziekengasthuis (which it did). The consequence was that I would have to work in a partnership with the dermatologists in the other hospital. Wicher Bergsma and Siebert Holla were nice men, that was not the problem (they always stood in for me during vacations, for example), but in the meantime I had become very attached to working solo and so I chose Carolus Hospital, much to the relief of Frank Vernooy, the director of this organization, and the entire medical staff!

The transfer of the practice at Willem-Alexander Hospital did not go smoothly. There were only very few candidates and all but one of them dropped out. Reason: they were afraid that many of the WAZ patients would follow me to the Carolus and that general practitioners, who initially always referred to me in the WAZ, would then start referring to me in the Carolus. My assurance that I would in no way try to get patients to join me did not reassure them. I could perfectly understand that, of course, because I would now have much more time at Carolus Hospital, so I could greatly expand the consultation hours. However, I have done this only to a limited extent: the years 1980-1990 had been tropical years for me and I did not want to keep working so terribly hard. In addition, of course, I had a savings from the sale of the WAZ practice. Goodwill on practice transfer had always been the 'retirement provision' for medical specialists. Only my colleague José van Ulsen from Rotterdam dared to step in my shoes and, as I predicted, she has never regretted it for a moment.

Farewell reception

A farewell reception for me cum introduction reception for José was organized. This became a bit of an embarrassing spectacle with a very small number of visitors, only a few specialists attended. I had never had any quarrels with the other specialists at the hospital or boundary disputes. Therefore, I assumed that people did not thank me for my departure to Carolus Hospital and possibly even resented me for it. The club had always been somewhat closer than at the Carolus and my departure might have been felt as a betrayal. Indeed, twenty years later, at a reunion, some specialists  - you can hardly imagine it - ostentatiously turned away when I walked toward them with an outstretched hand.

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