Sunny Saturday thoughts

What a year!  One year ago I left my half-teaching half-clinical life to become a full-time outpatient doc.  That was a remarkably difficult transitions in ways I hadn’t anticipated, but of course, most difficulties are the ones you don’t anticipate.  But thanks to the guidance of my partners, staff, and patients, I’m enjoying my gig tremendously.

After a year, the line between my patients from my old office and my new one is blurring.  I’m having trouble remembering which is which.  They all have become part of what I do and who I am.

At the end of every week, we scan obits in the local fish-wrapper and in the weeklies from the two large ethnic communities in our area.  We almost always find out about patients who’ve died.  When a family member reaches out during their grief to tell you themselves, though, it’s—I’m not sure what word to use: “heart-breaking”? “heartening?”  I guess it’s a feeling of accomplishment, knowing you’ve touched a family deeply enough that they would include you in the grieving process.

And it is a grieving process.  In addition to liking my patients it’s me they turn to for help; it’s me they entrust their health to, and when they die, how can a doctor not feel just a little bit of failure?  Death as an endpoint is unavoidable, but individual deaths sometimes are avoidable.  But when you back up a bit and look at the bigger picture, fewer fall into the second category.

I had a med student once, a number of years ago.  She admitted an octogenarian who had a particularly painful episode of gout.  Two nights after she was admitted, she was dead.  The med student was devastated.  What went wrong?  All she was here for was gout!

I sat her down and opened the chart. “Gout was what brought her in—this time. Look: ‘coronary heart disease’, ‘chronic heart failure’, ‘chronic kidney failure’…She was not a healthy woman.”

This morning I woke up.  My first thought was “Holy crap, I’m awake!”  I had been dreaming that my wife bought me a combination coffee-maker/espresso machine and had it installed in my car.  Now awake, I didn’t smell coffee, but saw sun pushing between the slats of the blinds.  We don’t get much sun here in the winter, and by the character of it, I could tell it had snowed.  It was just a dusting, not enough to muffle the sounds outside, but just enough to add a cheery albedo to a winter’s day.  Since I’m not working and have some extra time, I drove out to the rail trail for a run.

A colleague of mine gave me some running pointers yesterday, mostly about warming up and warming down.  It helped.  The first ten minutes was unpleasant, but the rest was great.  I could have run forever.  But I didn’t.  I thought about what’s in store for this nice, long weekend.  I’m covering a Christian colleague at the hospital on Christmas, and later, we’re off to the movies and a Chinese restaurant. All around, a very traditional Christmas.  Some of my patient’s seemed excited for the holiday, others apprehensive, and every feeling in between. Holidays are often difficult for people, and when I  can, I try to help them through it, not just because it’s my job but because I genuinely like them.

1 Comment

  1. You sound a lot like my doc. I’ve known him for over 20 years now. He heard through the grapevine I’d been in an accident out of town, and he insisted I come in to see him for follow up. Not often you get a doctor phoning you at home to tell you to come in to see him right away. We’re lucky to have him as our doctor.

    My only ‘problem’ with him is that he’s about my age so he’ll be retiring just as I’m entering the age where I may be needing to see a doc more often. But he’ll probably ensure his successor is good–I can’t see him allowing any old doctor to look after his long-term patients.

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