Scarlet fever, saying goodbye, and taking a one month gig


Frequently the eyes are not dry

When I announce I’m saying goodbye

            With a bad case of strep

            I took the next step

Explaining the rationale why.

I’m saying goodbye to families and to individuals.

Two members of a family I’ve taken care of for years came in, a parent and a fifteen month old.  We played our way through the well-child check, the patient and I remained friends after I got a good look at the throat.  At the end of the visit, I said, “Next well child check is in three months.  I won’t be here at that time, my last day here is the 22nd of May.”

I’ve started reaching for the box of Kleenex right after that.  Most of the patients will ask who will take my place (we still have hopes of recruiting a new doctor), or they’ll ask which doctor they should see.  I give an honest appraisal of my partners’ individual strengths.  Mostly, the patients have met the other doctors in the office, and it comes down to how well personalities mesh.  The parent announced the intention to take the patient to the pediatricians’ office.

“I take that as quite the compliment,” I said.

Our pediatricians are very good doctors, every one of them patient, knowledgeable, up-to-date, and very good at what they do. 

I will miss the family.  They are easy to get along with, good parents who lovingly raise well-socialized, respectful children, and who treat each other with tenderness and joy.  I have attended them through several pregnancies and deliveries. 

One patient announced the intention of seeing me every week till I leave, and following me promptly when I take my new position in 2011.

Sometimes I don’t tell the patient that I’m leaving, especially if the follow-up would be before my departure date, or if the patient has another doctor in the office.

A sick-looking pediatric patient came in with a parent and a complaint of a “rash,” pretty dramatic, red and bumpy with the texture of sand paper, heavier in the midline than towards the sides.  As I looked in the throat, I asked if the patient had complained of sore throat, the parent said no, then I asked the parent to look at the bright red throat.  Sure enough the kid had big lymph nodes in the neck, and the parent volunteered the information (right before I could ask) that there had been a pretty strong tummy ache.  “Scarlet fever,” I diagnosed, explained that it was an extreme strep infection, and prescribed penicillin.  The parent leaned forward and asked if the family could transfer to my practice. 

Of course I had to tell them no.

Our practice has always operated on the principle that everyone wins when the patient sees the doctor they want to see, and in-office transfers have been the norm. 

I’m quite comfortable when patients with whom I did not get along transferred to other doctors.  Not everyone gets along with everyone.  I have a sense of humor, and the patients who don’t have a sense of humor generally don’t like me.  They find other doctors with whom they get along better. 

Over the noon hour I spoke with a recruiter offering me a one month position in the Mountain Time zone.  Eight to five, Monday through Friday, weekends off, no call.  I took the offer.  It’s the first time I’ll have had a new job in more than 22 years.

It will mean meeting new patients, moving away from the familiar, dealing with strangers.  I’ll have to settle in with a whole new group of people again.

I’m looking forward to it.

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