'Dinosaur' Doc Meets Terminal Illness with Dignity

The best part of my job is the people I get to meet—particularly the frontline, hands-on medical professionals who see their work as a calling. It sounds corny, but these people are healers in the noblest sense. In a world full of silliness and superficiality, selfishness, and cruelty, it's therapeutic and a great perspective adjuster to be around these well-grounded people.

So, it was with great sadness when I read last week that David Nichols, MD, a lifelong family physician in Virginia and dedicated healthcare professional confirmed that he is suffering from terminal cancer and has only a few months to live.

"I actually feel very well, but I know it's coming," Nichols, 62, told the Associated Press, in a piece you should post on the break room bulletin board. "I feel very blessed to have lived the life I have."

You probably have never heard of Doc Nichols. That's not surprising. Unless you're one of the thousands of people he's treated over the decades there is no reason to know him. People like Doc Nichols don't usually draw attention to themselves. They're too busy.

I was fortunate to interview him almost four years ago in a piece on rural physicians. He had just been named the 2006 Country Doctor of the Year by physician recruiters Staff Care, having been nominated on the sly by his colleagues.

Doc Nichols told me about his 90-hour work weeks, and his tiny three-physician practice in White Stone, near the mouth of the Rappahannock River in coastal Virginia. And he told me about his life's work as a volunteer physician on Tangier Island, about 25 miles out in Chesapeake Bay. For the last three decades, Nichols has flown himself and colleagues to the island every Thursday to provide the 600 or so residents of the tiny fishing community with, often, their only access to healthcare. This island is so remote that linguists claim the inhabitants still speak a dialect similar to Elizabethan English.

Doc Nichols was the subject of a piece I was writing about the good old fashioned family doctor in rural America, and what we're going to do when they're gone.

He said at the time that many younger physicians are talented and dedicated, but aren’t willing to put in the long hours that senior colleagues like him simply assumed came with the territory.

 “The next generation of family practice doctors doesn’t want to work as hard as we did, so it’s probably going to take two of them to equal what one of us has been doing. I can see that happening right now,” he said. “I don’t fault them for that. They have a different perspective, and it’s pretty logical what they are saying. They put a greater emphasis on family and time off and less emphasis on working all the time.”

He said all of this with no rancor, and acknowledged that he and his kind were a dying breed, adding "I know I am a dinosaur."

Doc Nichols said the working climate for primary care physicians isn’t helping, with Medicare reimbursements facing cuts and malpractice liability rising every year. The more time needed to complete paperwork, meet OSHA requirements and address other business-side concerns means less time with patients, reducing the quality of care, and revenue.

With all of those distractions, though, he had no immediate plans for retirement before the bad news came last month that melanoma he'd fought six years ago had returned and spread to his liver.

"He's been coming here since I was a little girl," island resident Jamie Bradshaw told AP, wiping her eyes after hugging Nichols. "I don't know what we'd do without him. I can't even describe in words what he's meant to all of us."

The terrible news comes as the island is readying-this week-the grand opening of a new $1.7 million medical clinic, five times bigger than the 1950s-era clinic that Nichols has staffed for more than 30 years.

Nichols told AP he'd hoped to stick around a little longer, but the cancer has other ideas, and he has accepted his fate with dignity. He plans to be buried in the church yard-a stone's soft toss from the new clinic. "It's the journey that's counted for me," Nichols told AP. "Sure I'll miss being able to do all those things I'd planned to do, but, gosh, this was so rewarding."

Thanks Doc.