Thursday, January 31, 2013

The Final Week

     The last week of any job is ethereal.  If it weren't, it would hurt too much.  The future beckons with such magnetism that it's hard to keep remembering that the present isn't over yet.
     Separating from the smooth regularity of clinic operations and my excellent, reliable staff is not going to be easy.   If it weren't for my patients, and how some of them need help with the transition to a new medical clinic, I might have called in sick this week.  But I don't recall ever having called in sick, or rescheduling patients because I didn't feel like working.  That sort of thing just isn't done in the medical profession.
     Therefore, here I am, all week, as usual, moving up and down the clinic halls to pick up one chart after another, and see patients in their turn.  It's almost like every other week.
     I am holding people's hands and escorting them across what feels like a swinging rope bridge, over what must seem to them to be the jagged canyon of their health and well-being.  They need help getting to the other side, where another doctor can be found.  
     They speak to me along the way.
     "Where will I go?"
     "What will I do?"
     "This place is like family."
     "I'll never be the same."
     "Your staff--they're my friends."
     "You saw me through the worst period in my life."
     "I'm afraid."
     "I can't possibly change doctors."
     "What about my medicines?"
     "No one else knows the things I told you."
     "I can't believe you're leaving."
     "Do you think I'll be all right?"
     "You helped me when no one else could."
     I think all doctors have patients whose connection to them runs very deep.  Rupturing this connection can have dire consequences.  Most of the time, however, people find their bearings again with a new doctor.
     My answers to their questions sound lame.  I give them names of other doctors, choosing the ones whose personalities seem like good matches.  I tell them that they'll be all right.  I write their prescriptions and make eleventh-hour referrals.
     Meanwhile, what I want to say to them is this:  I care about you, but everything else in doctoring is gadgets and props.  The real medicine is inside you.   All you need is someone who can help you turn it on.
     Although this has been my guiding principle for twenty-five years, in this last week I'm not so sure any more.   So I say thank you back to them, when they thank me, and I summarize their health status in a final chart note, and hand them the entire chart to take to their next clinic.  Then I work on closing the clinic, as patients' voices echo in my thoughts, late into the night. 


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