A Thousand Goodbyes

The rush to retirement seems to be moving ever faster.  A goal that was a million miles away now is approaching at light speed.  In December of 2016, I purchased tickets for the play “Hamilton” for a show date in September 2017.  That date, which seemed ridiculously far away, has now passed.  In July letters were sent to my referral sources, and to my patients.  I gave them almost 6 months of warning of my leaving.  That half of a year has now evaporated into two and a half months.  

I have slowly prepared for my retirement for over a decade.  Impossibly distant at one point, it is now looming… and I am confused.  I clearly want to move forward, but I am ever aware of what I am leaving behind.  In the past, I knew exactly how my life would change when I retired… now, I’m not so sure.  To appreciate the sweet, I must taste bitter.

My yesterday was a typical Monday.  At least typical for the last 30 years.  It was a long work day that started at 8 AM and ended at 8 PM.  The flow was the same, patient followed by patient, any free time filled with phone calls and paperwork.

But when is there ever a typical day?  Each one becomes unique when I am willing to pause and ponder.    Monday, October 2, 2017, a day of patient care, but also a day of goodbyes.  

It is now 5:59 AM Tuesday,   I’m sitting at a little round table at the Starbucks on Chicago Avenue and I am listening to straight-ahead jazz as I type this post on my phone. The distance from yesterday allows me the safety to bring my emotions forward.  I find myself tearing up.

I saw a fairly new patient yesterday.  He was the last new patient that I accepted, and I have only seen him a few times.  He underwent the loss of a beloved pet a few weeks earlier.  The safety of my office allowed him the protection needed to put aside his tradesman’s toughness and cry.  He was angry that those close to him were moving on and appeared less devastated in grief. I drew together the pieces of this tragedy, and showed him that those close to him weren’t trying to be disrespectful they were just grieving in their own way. Relief crossed his face.

A woman came in.  She desperately wants to have a significant relationship, but can never find Mr. Right.  Counselling her, I drew her back to her middle school years, a time when she was bullied mercilessly.  I connected that time to her current fear of being vulnerable, a light bulb flashes off in her mind. A routine connection for me, a completely new concept for her.

And then there were the goodbyes.

The women who clearly didn’t like me on our first visits now offers me comfort as she recounts her own retirement story.  Over the time that we have worked together we have gained an appreciation and respect for each other.

A lady that I worked with since 1993 sits down on my leather couch..  When I first started working with her she was crippled from relentless panic attacks.  Now, 25 years later, she coordinates care for 7 busy physicians.  She is the go-to person when disasters happen. We reminisce over the years.  “I never thought my life would turn out like this.  I am happy,” she tells me.  At the end of the session she hands me a card where she wrote that she was blessed to have me as her doctor and life counselor.  I am grateful that I didn’t read the note in front of her, as I would have been embarrassed to have her see tears running down my face.

A few months ago a long-term patient had sent in a “release of information” to have his records transferred to a new psychiatrist.  He was moving on to a new provider, my function no longer needed.  At the time I felt surprised by his actions.  I remember thinking, “Wow, after 30 years I can still misjudge someone.”   I had thought that I had made a significant and meaningful impact in his life, but it seemed like my assessment and his reality were misaligned.

I was surprised to see his name on my schedule yesterday.  Indeed, he had secured a new psychiatrist, and in fact he had a bridge script form his primary care doctor to last until that meeting.  There was no practical or functional reason for him to have an appointment with me. He had made the appointment to thank me and say goodbye. “When I first came to see you it was a very dark time for me.  I couldn’t see a way out.  Now I feel normal.  I no longer see you as my psychiatrist, I think of you as my friend.”  I held back more tears.

Another long-term patient entered.  I had worked with him since his late teens.  At that time he was plagued with depression and psychosis.  He now works in a highly technical field installing and programming complex industrial machines. He is a very smart guy. He showed me a photo of a beautiful wood carving that he created using a C and C machine.  He tells me, “Doc, I always wanted to be respectful of your boundaries.  Now that you are retiring I hope we can share more.”  I once again hold back tears and I reflect on how this former frightened teen has become a respected and incredibly nice man.

I ready myself for today’s workday. I have no idea what I will face.  Angry people?  Sad people?  Indifferent people? Thankful people? The clock keeps ticking, and I am awash with feelings of every type imaginable.

I know I must move forward, but I am acutely aware of what I am leaving behind.  Dear reader, I will continue to keep you posted on my journey.  Thank you for caring enough to continue to read these long, self-indulgent posts. I may be a psychiatrist, but I am also a person. Writing helps me share.  It gives me comfort to think that someone is listening to me.

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