Quotes of the Day

The patient in Room Four was a retired NFL lineman. None of the staff had ever heard of him, nor had I, but some of our patients had recognized him and were chatting him up — the buzz in the waiting room was palpable. In the glow of the football player's celebrity, our patients' usual cranky impatience — while waiting for X rays, cast changes, insurance calls, paperwork or simply their turn to be seen — had evaporated , eclipsed that afternoon by sheer delight.

They were waiting for the same doctor who, on the same day, would treat Johnny P.! How many people they would tell! And what confidence my patients had that day — in me. I heard no long-winded rebuttals based on what the lady in the checkout line thought I should do to treat their shoulders. So attentive and so agreeable, my patients hung on every word from Johnny P.'s doctor. Even my administrator felt the change: "We should pay that guy to come here. Everybody's so nice," she said as I gulped coffee between appointments.

A prescient comment, I'd later find out.

Helluva nice guy, this football player — and big. His knee was the size of my head. It was an arthritic knee, as you would expect — a routine problem, like hundreds of others any orthopedist sees every year. Was I extra-nice to him, though, his being a star and all? Did I do anything different that day, just a little? I like to think not, always having tried never to be a "respecter of persons."

But I was feeling the buzz. I'd never heard of Johnny, but my patients' had — and people think that sports stars automatically know who the best doctors are. (They are, of course, quite wrong.) It's a tremendous practice-builder to have a few celebs on your roster. It can also be, if you don't watch out, a tremendous ego-inflator. Not that a surgeon's legendary ego needs growth — it's usually huge enough already. Sometimes that's a good thing: Much as Johnny's star confidence elevated the mood of the office, the surgeon's big ego can often buoy up a sick patient, maybe even firing up a parallel kind of confidence in the patients, which really makes them heal better. Oft-disgusted by the surgical ego, though, I was feeling wary of it and a little embarrassed of myself.

There's a law called HIPAA (Health Insurance Portability and Accountability Act) that makes it illegal for doctors to reveal anything about their patients, not even their names; you are forbidden, for example, from having names written on charts visible to other patients. The goal, I guess, is to avoid situations like: "Hey, Mom, did you know that lady from church has syphilis?" Of course, we couldn't put a bag over Johnny's head, and he wouldn't have wanted that. He seemed happy for everyone to know him. The slow, cheerful deliberateness with which he acknowledged each of his new admirers shone warmly, calming the nervous air of my stressed-out suburbanite waiting room

The second time I saw Johnny P., it was a cold, rainy day. Bad weather brings cancellations and Johnny was one of the first patients of the day, so unlike his previous visit, the office was empty. We had plenty of time and he still had plenty of charm. We discussed his first round of treatment, which had been some pills and physical therapy. They hadn't worked that well but Johnny was OK with that. He made reference to some famous football stories, and I, clueless though I was, chuckled along knowingly. That got us onto the topic of other interesting NFL hijinks, including, naturally, sideline injections, which segued to arthritis injections, which were going to be an option for him, and, oh, by the way, had I thought about using new "superslime" injections for my arthritis patients in the future?

Wait. What?

Turns out the "sales" that Johnny P. was now doing for a living were in pharmaceuticals, and just recently, he said, his company had taken on superslime. Was I aware of the special introductory offer available to new surgeons, for a limited time only?

The pitch was surprising and off-putting — but salesman or not, this guy was my patient and he was in a lot of pain. I knew about superslime; there are quite a few drugs like it — injectable hyaluronic acids, basically artificial mucus, that seem to lessen joint pain in some arthritis patients. Their effectiveness in advanced arthritis isn't great, but they have little in the way of downsides — and what better psychic enhancer could I ask for than having my patient sell me the product? (Surely, it would encourage recovery more than his star power and my doctor's ego combined.) So, we went for the introductory offer, and he got his shots.

I'm happy to report that today Johnny walks, climbs stairs and cycles; he can even jog a little without knee pain. Was it the superslime? Probably not. Most likely it was the two knee replacements we did over the next six months. I see him now every year or so for a check-up. He's still a great patient and he's sent me other good ones. He called on us for a year after the surgeries selling superslime, but now only sells antihypertensives to the medical guys down the hall.

But missing now, when Johnny comes in, is the buzz. Everyone still likes him, but being a drug rep and having a couple of big knee operations somehow cost Johnny much of his celebrity status. He's still big and no longer sporting a limp, but not even his big, fat football ring elicits comments from the other patients anymore. Johnny's always still talking, joking and nodding, though — and the other patients still like him. There is a gift, some kind of divine favor that fills the air around him and it's not the football. Charisma, star quality — I've learned a little more about this good but mysterious thing since treating him. I doubt it's rubbed off on me, but I have forgiven myself for taking the extra minutes with other patients, even during busy office hours, to hear the stories.

Dr. Scott Haig is an Assistant Clinical Professor of Orthopedic Surgery at Columbia University College of Physicians and Surgeons. He has a private practice in the New York City area.

• Scott Haig
• It turns out that a football player with a busted knee can teach an orthopedist a thing or two about the practice of good medicine