17 February 2010
I won’t whine about working so late
For I know that the stress will abate.
Things will get better
For I turned in the letter,
May 24th is the date
Early in the graying morning I retrace my old steps to Mercy Medical Center to visit the newborn and dismiss her. When I arrive the doctor’s parking lot is still empty, the lounge is quiet. The nurses, however, are at shift change and the manic spirit of those about to go home mixes with the optimism of those coming on. I look north down the main corridor and I point out the beautiful golden morning light staining the walls at the end of the hallway, rays coming horizontally, flush with the wall.
OB and nursery are on the top floor of the old part of the hospital. Twenty years ago I came here a good bit, now it’s rare. I’m trying to get out of the baby delivery business.
I won’t miss Mercy. A couple of years ago they installed a highly dysfunctional medical records system and a group of cheerleaders to deny that there was anything wrong with it. I’ve done my best to stay out of there ever since.
Rounding at two hospitals is fabulously inefficient, seeing two patients generally took an hour and a half with more time spent driving than spent face to face with patients. Our group split the work of the two hospitals about six years ago, so that one doctor would round at one hospital instead of six going to both hospitals, and then we rotated weeks, coming into the office an hour later when we had hospital duties. Then when both hospitals installed hospitalist programs we could give over almost all of our patients to docs who do nothing else. We still see our own newborns, they’re the most fun thing in a hospital.
I go down the back stairs, an architectural remnant of the times when people used the stairs a lot, and I read the funnies in the doctors’ lounge while I eat an orange.
The sun is bright when I leave the hospital, a relief to the eyes.
First thing at the office I pick up the dictating machine. I went through one about every seven years, this one has lasted longer because we don’t dictate with the new system. I dictate my notice.
It’s not easy to do. I have to look at a calendar to find the Friday before Memorial Day weekend. It will be the day before my wife’s birthday.
I carry the recorder back to the transcriptionist. She’s been working with me for 18 years. Back in the day, one afternoon my nurse, the transcriptionist, and I went to lunch together, and I found out I could dictate in macros, which saved me about 20 minutes a day. I still didn’t get out earlier.
I warn her to get out her Kleenex.
An hour and a half later she comes in with tear-stained cheeks and hands me four copies, three of which I sign and one of which I casually stash in my desk drawer, a single sheet bringing an end to 22 years of service, almost a quarter century of watching the drama and irony of the human condition in one place.
The day goes long, and I go to the gym when most people go to supper. I have just worked up a really good sweat when my beeper buzzes on my hip. Our Urgent Care needs me; they’re backed up. The doctor on call for the group serves as back up when the regular staffer at Urgent Care is overwhelmed.
For an hour and a half I explain to concerned parents why the child doesn’t need antibiotics, to another patient why he does, and to one other why he really, really needs a CAT scan tonight.
I get home at 9:30, and I know I should go right to bed, but I start with a limerick and I can’t stop.