Telling my patients goodbye, lessons from old doctors and lessons to new ones.


 

I have started saying good bye. 

My patients are asking me why.

            I say with a smile,      

            A year’s just a while

But I hear the tears and the sighs.

I have ninety-one days left on my familiar ground.

On rounds at the hospital I run into a new family practitioner.  He looks awfully young, probably because I’m pushing sixty.  He wears a nice suit.  I welcome him to Sioux City, ask where he’s from and what he does for fun.  I tell him to keep playing guitar, he doesn’t know it but someday it will be important.

The patient I delivered last night and her daughter are doing well. 

Morning clinic starts half an hour late, a frustrating experience.  I don’t know that late starts have a cure, and they always put the session into a rush. 

Of course for the rest of the session the patients grow more and more impatient, and deservedly so.

Ninety-one days hence will be my last day, and I explain to my patients that their three-month follow-up will most likely be with someone else.  They ask me whom I recommend.

The best doctor in the world can’t please everyone.  Each one of us in the clinic have our strengths and our weaknesses.  I take a lot of time with each patient, I go into problems in depth, and I have a sense of humor.  Each one of those characteristics has driven patients away and brought patients in.

Some of the patients struggle to hold back tears.

One nonagenarian remarks that the doctors keep leaving, and lists them.

One of those retired well, he’s still alive and active.  He shoots frequently at the gun club and he has had a remarkable photographic career.  He was a good example, he retired bit by bit.  He frequented the doctor’s lounge for a long time and he always had a good joke.  He shines as a positive lesson.

A young couple comes in with their one-year-old for a well child check.  They have blossomed with parenthood as individuals and as a couple.  The complicated pregnancy produced a baby with normal growth and development.  They receive the new of my departure with little surprise.  I will miss them, miss seeing the rest of the soap opera unfold, miss seeing a family grow well.

When I leave, each one of these patients will be a loss, greater or smaller, for me.

Five patients come in to discuss their lab results and talk about choices of treatment.  The problems include B12 deficiency, testosterone deficiency, high cholesterol, low thyroid, high thyroid, vitamin D deficiency, and hepatitis C.  I enjoy saying to a patient, “We can make you feel better,” and mean it.

At five I start working on messages.  At five-thirty I get a beep from the Hospice nurse.  She asks me about an order for an antibiotic I gave an hour before.  I allow as how I didn’t give the order, it couldn’t have been me, but it sounds like the right thing to do, and if the patient can’t take the pills, liquid will do.  After I hang up I confirm with my nurse that no, in fact, we didn’t take that call.

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