You know, the private planes, the chauffeured cars waiting on the runway that whisk you off without your ever setting foot in the airport or having to find baggage area B-2. Some doctors who provide outreach to patients in rural Kansas experience a muted version of this, with an emphasis on muted.

On a recent morning, Gary Doolittle, MD, flies out of the Executive Beechcraft area of Kansas City’s Charles B. Wheeler Downtown Airport, as he has for more than a decade. There are flight crews in sharp uniforms and magazines featuring a lifestyle beyond the rich and famous sprinkled about the lounge. There are glimpses of parked jets that glitter like jewels and contain cabins outfitted with plush chairs, bars, and wood accents, all shined to a high polish.

Doolittle, however, climbs into a simple turboprop. The plane can hold five passengers, if the fifth sits up front next to the pilot. It would be a minivan with wings, if only it were a little larger.

Doolittle has been flying to Hays, Kansas, to maintain an oncology clinic there for 11 years. It’s a 540-mile round trip, which he makes twice a month to see an average of 20 patients. He has logged approximately 142,560 miles in just over 11 years, making approximately 5,280 consultations.

Doolittle insists he is not a savior, riding in on his white turboprop horse twice a month. He talks about his colleagues in Hays. “There are so many docs out there doing it day in and day out. There are two full-time, well-trained oncologists and they practice very sophisticated medicine.” When asked why he still makes the trip, he says, “I want to help. And I still learn from my colleagues in Hays.”

Shawn Mulkey, RN, is the nurse who assists in Doolittle’s clinics. She attests what his experience brings to Hays. “He is knowledgeable about the specialists at KU and can immediately recall their area of expertise off the top of his head. The patient who needs a consultation knows who they should see very quickly when Dr. Doolittle is here,” Mulkey said.

The plane lands at Hays, and there is a car waiting on the tarmac, a state-owned station wagon. Doolittle gets in up front next to Jayne Inlow, the continuing education coordinator who works for the KU Area Health Education Center in Hays, a satellite office of the KU Medical Center. He says, “Let’s go, Boss.”

Boss: that’s a familiar word around Doolittle. When he arrives at the clinic, he asks Mulkey, “What’s the day like, Boss?” Everyone is his boss. The pilot, the driver, the nurse, and, most importantly, the patients are all “boss”. Doolittle has a lot of bosses.

He walks into clinic rooms to see patients. He calls them boss and asks them a question unusual in doctor/patient relationships: What are we going to do today?” In our culture doctors are respected and authoritative.

Doolittle reverses this role and empowers his patients. He earns his respect and authority with kindness and experience.

But this boss thing takes the relationship to a new level. When an oncologist and a patient meet in the clinic room, in a treatment room, or in the doctor’s office, cancer is the boss. It is never said, it may not even be thought, but the human relationship in that room is about beating the thing that brought them together. When Doolittle gives the power to the patients, it is not only his own role that he is reducing. He is also giving patients power over their disease. Above even a cure, it may be the biggest gift he can offer.

On this partial day at the clinic, Doolittle sees 13 patients. He sees the final patient after noon and, though he tried to stay ahead by dictating charts between patients, he still has a mound of paperwork to complete. He finishes some of his paperwork before he climbs back into the car for a 10-minute drive to the Sternberg Museum to address a group of 42 nurses, physician assistants, and other health professionals as part of a continuing education event.

A large, western-Kansas storm blows in during the second hour of the presentation. The trees outside the building sway, and the town is pelted by a fat, hard rain. The wall of the storm is just to the east of Hays, an imposing bluff of grey. The winged minivan takes to the skies and banks due north to circumnavigate the storm. The flight is remarkably peaceful. Soaring over Kansas, somewhere around his 143,000th mile, the man with many bosses falls asleep. +