“People have the same desire to enjoy life and be healthy – to make the most of their God-given talents – at whatever age they happen to be.” This is the lesson that cardiologist Robert Lees learned long ago about his older patients.

His insight corrected a view that he held when he was a young doctor. Then, writing in the “New England Journal of Medicine,”  he had suggested that the benefits of controlling high cholesterol apply only to people under age forty. Of that view he now says: “I look back on my foolishness and smile because, of course, life begins at sixty-five.”

Dr. Lees, during the course of a wide-ranging interview at his office in the Kendall Square section of Cambridge, emerged as the kind of physician who brings to medicine what is missing in too many doctors’ offices these days. Granted, he has the advantages of an academic base at MIT and Harvard and does not work under constraints imposed by the managed care system. The directive to increase the “relative value units” and other jargon-laced requirements inspired by business management fortunately have no effect on his practice.

Instead, this middle sixytish, mild mannered, genial veteran of his profession believes in giving his patients all the time they need. This unhurried approach allows patients to share with him their hopes and desires for the future, as well as their anxiety and fears about their ailments.

Beyond that, he believes it desirable to become friend and confidant to them, something that gives him much satisfaction. He often finds himself treating several members of the same family in relationships that last a long time. And one of the major things he does for his patients, and a service they appreciate most, is to find other physicians for them, specialists whom he knows to be outstanding in their fields.

However, Dr. Lees recognizes his limitations. “I don’t try to substitute for God,” he says. “I certainly try to help God along as best I can but God helps me more than I help Him.”

In keeping with this philosophy, Dr. Lees takes a realistic view of the human condition. “Nobody gets out of this world alive,” he observes. “The doctor’s goal should be to realize patients’ limitations but to maximize their ability to meet expectations. Many older people have heart disease that cannot be reversed, but that does not mean they can’t be treated and cared for and made to feel comfortable.”

Dr. Ann Lees, Robert’s wife and collaborator at their nonprofit Boston Heart Foundation, graciously took part in the interview. She is a researcher rather than a clinician but thoroughly approves of her husband’s approach to medical practice. Often during our three-part conversation, she offered supporting views drawn from her own experience.

Asked if being a friend to his patients sometimes causes problems, Dr. Robert Lees admits that he does get emotionally distressed. However, he says, “I don’t think it has affected the way I take care of them.”  He likes to bring others into difficult decisions: “It’s an interactive thing,” he explains, “I’m not acting on high.”

Thus his common practice is to involve other family members to help the patient with such decisions. He approves of patients’ asking for second opinions and says their doing so would not hurt his feelings. He himself habitually consults other doctors about his own recommendations.

Asked about the influence of spirituality on health care, Robert Lees readily admits its importance. “It’s the sense that there’s some meaning to life, there’s something that goes beyond them” – this is what he thinks contributes to people’s good health. However, despite his having mentioned God several times in the interview, he feels reluctant to discuss his own spiritual life.

Asked what the interviewer should have asked and failed to, Dr. Lees raises the problems people have with the way many physicians practice in this era of  managed care. He clearly has little tolerance for the “get them in and get them out fast” approach.

“Do not be satisfied,” he would advise people who receive hurried treatment. They should “find another doctor who will take time to help them.” He also agrees with me about the importance of patients bringing an advocate with them, if possible. If social service agencies can find volunteers or others to serve as the patient’s companion and facilitator, that is a fine idea.

I came away from this interview, initiated by the Boston Heart Foundation, encouraged to have discovered an older physician who is both in touch with up-to-date medical science and, at the same time, deeply committed to health care that is personal, humanistic in its goals, and aware of the part that spiritual values play in overall well-being.

Undoubtedly, many other physicians approach these ideals of health care but, at a time of widespread dissatisfaction with the system on the part of both the professionals themselves and their patients, it is reassuring to talk with a doctor who gives every evidence of putting these ideals into practice.

Richard Griffin