November 7, 2021
Rescue dog
The past 3 months have been more draining than usual. I announced my retirement for the first of February next year. Since then, my daily meetings with patients to say goodbye and talk about their futures leave me empty. Each conversation is a mix of bitter and sweet, thanks and angst at the same time. I am lucky to be reminded that I have made a difference to so many, but so tough to say goodbye and worry if they can find the right fit with their next provider. We have shared so much over the years.
The truth is I am ready to give up my primary care practice. I am ready to let go of the responsibilities as primary care provider. Last week I completed my last week of call. During our 4 weeks of call each year, we take calls from patients, usually not our own but from other doctors in our call group. We are asked by patients to solve their problems, answer their questions, reassure them, listen to them, give advice, and more. Sometimes we feel we helped, sometimes we feel resentful, but this past weekend was tougher than usual for me. By the end of the weekend, I thought I had killed three people. Really, I thought that. Really, I didn’t. But that is what can happen when a doctor is tired and vulnerable. A woman called Friday night saying her husband was having “a mental breakdown”. I couldn’t reach her or him, despite calling several times; I worried, but chose not to call the police to do a welfare check. By Monday morning, I believed they were both dead. Of course they weren’t. I talked with their doctor who reassured me they were fine.
Another woman called Sunday afternoon, with a positive COVID test, immunodeficient despite vaccination with boosters. She was at risk for severe COVID. I tried to get her scheduled for monoclonal antibody infusion the next day, rather then send her to the emergency room on Halloween. But I couldn’t get Epic, our electronic medical record system, to make it happen. She was running out of time to get the antibodies within 5 days of symptoms. By Monday morning I convinced myself I made the wrong choice and should have sent her to the ER. But of course, I got her scheduled, she received the treatment by 10 AM, and she miraculously felt better the next day.
That is the way it can go for many of us. We worry we do more harm than good. So much is expected of us and we often don’t get the good feedback we need. We convince ourselves we failed, even when we didn’t. One error can undo all the good we have done, if we aren’t careful. I have felt this way before and hope to not feel it so strongly again.
All of these emotions plus a new puppy have made it hard for me to write in the evenings. Barlow is growing so fast. He already weighs 30 pounds. Judging by his feet, he still has more growing to do. Little Barlow has been doing his job well. When I sit for a while in the evenings, he comes and insists that I play with him. Especially when my laptop is open, he reminds me that play is more important than most everything else. The truth is I have needed rescuing. Play on.
Wash your hands, cover your nose, keep safe six when needed, get your booster if needed, and don’t forget to play.
And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.