A one year reflection and memorial for Adolf Stocker -- a life well lived with thoughts on what clinical care could be in small communities.

By Douglas Lyon for The Mountain Times

The following is a note I put together for our clinic and staff that I wrote after the loss of a patient last year. It’s about caring for Adolf Stocker toward the end of his life.  It sets the tone for what I believe we all hope we can find in a local clinic and their providers  -- whether medical doctors, nurse practitioners, or physician assistants. Adolf’s nephew has given us permission to share this story with our community.   

Adolf was one of my first patients in Welches after the clinic reopened. He was Swiss, immigrating to the United States and the Mt. Hood area in the 60s. He was a mountaineer and skier and had worked in most of the resorts on the mountain and in many different local jobs over the years. Almost everyone on the mountain knew him. At age 95 he was frail, and suffered from severe lung disease and valvular heart disease.  He lived constantly short of breath and with the anxiety that comes with this. We worked closely with his cardiologists and pulmonologists to care for him. Most importantly, we were the place where he knew he could be seen on short notice by people who knew him.  

Although he had no children, he had a nephew, Art, in Vancouver (Canada) that would drive down monthly to visit. Over the year we cared for Adolf, his nephew had been with him at two or three of his clinic visits. When the nephew wasn’t present, there was usually a neighbor or a good friend that accompanied him.   

In the spring of this last year (spring 2025) his cardiologist repeated studies that indicated that Adolf might benefit from a procedure to replace his aortic heart valve. Instead of traditional open heart surgery, this is done by going through an artery in ones’ groin or neck. Adolf had the procedure done, but he never quite recovered to his pre-surgical health. He spent the first month after the procedure recovering at the home of a local family. After a month, though still quite weak, he was adamant to return to living on his own, and returned to his house near Brightwood. We had arranged home health and we saw him in clinic almost weekly during this period. I communicated frequently with his home health nurse and his nephew.   

Adolf was one of our most outspoken fans, although we were just the generalists caring for him. He trusted us as doctors trusted us to make sure everything possible was done. We were both his advocates in the system and his care providers, adjusting critical medications and keeping tabs on home care. He spread the word widely that it was our little clinic that had kept him alive, and that it was a place where people cared and made time for you  -- from the front office to those directly providing care.   

Some weeks before his heart procedure, Adolf  had been started on a new medication by his pulmonologist, to help decrease the need to be on constant high doses of prednisone (a potent steroid medication with significant side effects). On a Friday, my usual day off,  I was contacted with the information that the medication was waiting for him at the pharmacy in Sandy and that he did not have a way to get it that day – none of the usual folks that helped him were available.   I was grocery shopping in Sandy with our little kids. I called and spoke directly with Adolf. He was anxious, and anxious to start the medication.  It’s important to note, he was constantly short of breath from his chronic lung disease. I let him know that I would pick up his medication and drop it at his house in the evening. At the pharmacy, it turned out, there was a sizeable copay for the medication. I covered the copay out of pocket with the plan to mention the cost to Adolf when he was feeling better. We dropped the medication at his house that evening on our way back from town.      

From that home visit onward, whenever I saw Adolf, there was something different in his eyes.  Since we first met, I believe he had felt the end was rather near -- that he had a year or two at best. After that visit I had the sense he felt a greater peace with this -- he knew we would be there and would do everything possible to help.   

Three weeks before he died he started to give things away. He gave away the Koi fish (Japanese carp) from his pond. He made a clinic visit to specifically let me know he’d like to leave me a painting and that I would have to make a visit to his home to choose; he asked me how much he owed me for the medication I had picked up for him the month before. I dodged the question and said I’d have to check. I dropped by his house over the weekend with our kids in tow. 

I chose a painting from the 50 or so on the walls of his living room. In discussing paint and brushes, we never got around to the cost of the medication. He eventually tracked down the amount I had paid. The week before he died, he found a friend to drive him to the clinic to catch me at the end of the day, outside of a regular clinic appointment. He had seven $20 bills to reimburse me, and I think he wanted to say goodbye. It was the last time I saw him.  

I suspect he shared the story widely --  his doctor picking up medication to help in a moment of need.  I believe it was part of the reason he so believed in us -- we put the patient first and we find creative ways to help whenever possible. Although some might criticize me for crossing this boundary with a patient,  I believe it was the right thing to do. Some would argue that this would set a bad precedent. Others might argue that we put ourselves at professional risk. I did this of my own volition and on my own time, as both Adolf’s doctor and friend/member of a rural community. We are not the big city or the suburbs: we are a little hamlet on the edge of a mountain.   

It’s important to note that core to the philosophy of family medicine and the training of family doctors is their connection with patients and community – home visits are a part of that training. I suspect if one queried rural family doctors, one would find that they all have similar stories. 

I received another phone call from my office two weeks after my last visit with Adolf. The office had been contacted to let us know he was in the hospital on “comfort measures only,” and surrounded by family and friends. He was not expected to make it through the day.  An hour later, I was able to speak with the hospital nurse who was caring for him. She told me he had passed. She talked about his last hours and the gathering of those that loved him, saying what a special thing it was to be there. It wasn’t a video call, but neither of us had dry eyes.  

 Our clinic staff let her nephew know I would be pleased to speak at any service held for Adolf.  A date and time were chosen for the local Lion’s club. I wrote and printed a piece to read.  It wasn’t until we arrived that I realized I had left my written message at home. With a 2 ½ year old on my shoulder and 4 ½ year old holding my hand in front of an audience of 40 or so community members, I found words that were close to what I had written.  

I found the piece the next day,   

 I was Adolf Stocker’s doctor in Welches, though he had a host of others helping in his care -- cardiologists and pulmonologists.  He was an immigrant from Switzerland arriving in our community almost 60 years ago. Many knew him for his years on the mountain working and teaching. I got to know him and his kind, gentle spirit in the last year of his life. I spoke with many that cared for him this last year – our clinic staff, his hospital doctors and nurses, family, neighbors, and friends, and the nurse who made home visits. They all said what a joy it was to have the chance to get to know and care for him. Everyone affectionately referred to him as Adolf. All of those around him made time and went the extra mile to help.  There were tears when we feared we might lose him, and many more at his passing.  For me, he is an example of how to walk gently though life and love and be loved by others.     

Several weeks after his death his nephew Art dropped a couple of paintings at the clinic. He also let me know that he had a special plant for me that had come from Germany 50 years ago. His nephew was his medical power of attorney and the curator of his estate. I asked him at that visit if we might have some cuttings of flowers/plants from Adolf’s yard to put in front of our clinic.  I liked the idea of coming to work in the spring and summer and seeing flowers that had come from Adolf’s garden and seeing his artwork on our walls. I had the idea that planting specimens in front of the clinic would be a good clinic bonding experience.  

For those in our clinic, I hoped the story of our care of Adolf during his last year of life would become one of the iconic stories – one that could be told and referenced as we cared for others.    He was grateful for our care and we were grateful to have had the chance to care for him. 

Although I no longer work for the same clinic, it’s my hope that there will be staff available for our community with the creativity and energy to go beyond routine when there is a need.  It is my hope their systems will recognize and reward this approach. Medicine in small communities is not simple or  predictable. It works best if those with the responsibility of care have the tools, resources, and flexibility to continually adjust and adapt their efforts.    

When I reflect upon and share my experience of working in Welches, I often tell the story about caring for Adolf and what a privilege it was, how his life should be an example to us all – everyone loved him and everyone wanted to find a way to help and care for him, especially through the last and most difficult years of his life.