i recently learned of the death of a doctor who had taken care of me many years ago. I had had not contact with the man for over 30 years, but my cousin, who'd referred us (mom and me) to Dr. Salib saved the obituary in the Boston Globe. This was quite a guy. And I realized that he was, and had been for years, a model to me of how a doctor should be. I consulted Dr. Salib because my orthopedist did not think I needed surgery, that my condition was not as serious as we thought it was. And seeking a second opinion only resulted in "Oh. Well if Doctor X thinks this, it must be true." And I couldn't get an independent opinion in Hartford. While Dr. X was a fine doctor who treated 3 generations of my family and who'd performed surgery on me when I was only 13, he held too much sway. He couldn't be wrong in his city after years of practicing medicine. I had to leave town.

Aas I remember it, Dr. Salib's first question to me after exam was "well, what do you want to do about this?" I wanted to finish college, dammit. I was half-way through my junior year. And he got me through - I really believe that. The situation was such that I needed a fusion Right Now, but he heard me, a 20 year old who was in the middle of college, and did what I wanted. And two days after graduation, he performed a laminectomy and fusion on me at Mass General.

Dr. Salib was, or became my new high water mark,my benchmark, my example for what a doctor should be. And I didn't quite realize it until I thought back to those days. I am only comfortable with doctors who measure up to his standards. Those include courtesy, professionalism, a good bedside manner, treating me like I have a brain, believing me when I say "I hurt" and listening. Listening really well. Answering questions.

Bill Gruber was that doctor - the orthopedist who helped me through when we first discovered my bone disease. And I've dumped more than one doctor who lacked one of the factors I need. I don't need busy, brusque, rude, uninterested - I don't care how well-recommended they come. I need...I need Dr. Salib.

Years ago, I volunteered for the Bread & Roses Festival, a huge fund-raiser concert for the Marin county organization founded and run by Mimi Farina. When Mimi died, I went to the website and wrote about how B&R and their volunteers showed me how to be a volunteer. And, I hoped, how to treat volunteers. Because they did it so well. I'd volunteered for dozens of things before (and since) from politics to conventions, concerts to parades. but it was Mimi and her staff and mostly Mandy Carter who well, offered, many of the same qualities noted above. And now when I look for volunteer opportunities, I look for...well, I look for that organization and its people. (And finding Mandy on-line I was finally able to tell her.)

And on it goes. When I find one person who acts as if customer service matters, who writes me that three page letter explaining, apologizing and answering me, I use that as my model. I know it can be that way. And it tends to exist in every aspect of my life. Sure it does -it probably does with all of us. We have expectations. And they come from real life examples, experiences. I would not have expected that Italian sodas with cream can be that good except I had one like that once, (actually it was my first one) and now I won't settle. I've worked in data entry and computerized billing so I know that your sorry excuse about how you can't do that isn't accurate and you should follow a better model. I know how good and kind and caring people can be, and while I don't expect that of everyone, I think I'm lucky enough to know that people can be that way. So once in a while I expect it. And luck out. And get rides to shops miles away, and get help from strangers when the wheelchair battery fails, and hear compliments I never expected.

I guess I'll call it the Philip Salib rule of good behavior in medicine. But there must be a more general form.

Do you have suggestions? Do you have baselines against which you measure things? Where did they come from?