By Janis Greve

One mark of middle age is the disconcerting fact that, increasingly, your doctors are younger than you. Out of the blue this realization hits with sudden force, and you’re left scratching your head, wondering  when and where you crossed the line into the Land of Younger Doctors.

Of course, younger doctors get older, too, and if you have one long enough you begin to notice some wear and tear showing up in all the predictable places. Therein lies reassurance, but once younger doctors start appearing in your life, they’re likely to keep appearing as you need more doctors, the older ones passing on, the younger ones moving in.

For me as a cancer patient, the question of younger doctors is only rarely one of expertise. For better or worse, I trust the rigors of med school, with its hurdles of internships and residencies. What perplexes me instead is just how to relate to a doctor who is ten years my junior—not young enough to be a son or daughter, but clearly of a different generation. 

When I sit shivering on the examining table, johnny opened in the front or back, I feel young, very young—much younger than the younger doctor. I’m around 12, or on a better day, 16 or 17, with all the usual emotional and physical vulnerability, infinitely primitive in my medical knowledge. I’m young and old at once, and wonder:  How can I be old when I feel so young, no older than you? Do you like me? Could we be friends?

My unease may be expressed in a more practical question: What should I call you —Dr. So-and-So or by your first name?  

Not long ago I went to a breast cancer support group. As we sat in our rocking chairs and couches,  I told my story in the opening go-round. When I brought up my plastic surgeon, a friendly woman in her thirties interjected, “Oh,  Simone?”  I was instantly jealous. She was, after all, my Simone, and no one else’s—I don’t care how many patients she sees. But I was also envious of this woman’s attitude of intimacy, her ability to first-name our shared plastic surgeon. Was that because they were closer in age? By what divine right could she call her by first name and I couldn’t?

That was back when I was still seeing a couple of younger doctors quite regularly. I began to revel in their doctorly love. Of course, I knew they spread their love around, but I took it for what it was. I knew they’d  break up with me, and I prepared myself for the blow. Already, my surgeon has ended it for good. My plastic surgeon has called it off for six months, after which she’ll take up with me again, for a limited duration. The radiology-oncologist I saw at Mass. General—an older man—loved me twice and that was it, though the second time was better.

When my plastic surgeon and I were still going strong, I liked her quite a bit, and wanted to call her Simone. But I just could not break free and address a medical superior by anything other than "Doctor."

Personable as she was, I feared a rebuke: a funny look, a raised eyebrow, anything that said “And when did we get so friendly?” I worried that she’d think I undermined her authority. At my last meeting with her, perched once again at the end of the examining table, johnny opened in the front—that was always her way—I said goodbye,  thanked her for everything, and failed both of us miserably. I wanted so much to hug her after all we’d been through together. But I couldn’t do that either.         

I’ve now moved on to an older doctor—my oncologist—and so sit comfortably once again in the  navy blue recliner of being the younger one, getting my chemo through an IV, along with a sweet, 98-year-old woman named Agnes.

Through the open door, I catch a glimpse of my older doctor whisking down the hallway with such panache and authority it does me proud. With her quick gait, long cardigan, skirt and low heels, she keeps me in my place, quells my inner fitfulness. Daily I hear stories of her former patients, and I know she’s an institution unto herself, formidable in her reach, and though nice as pie, an absolute monarch. 

Yes, I still want her to like me and think me stylish, but I wouldn’t dream of calling her by her first name. And in spite of the lingering discomfort of the Adriamycin she’s just pumped into my veins, I lean back in my recliner and relax, feeling young, feeling free.

Janis Greve teaches and advises in the English Department at the University of Massachusetts Amherst.

Read her essay: Breast Cancer at 50: What I know now.