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Facebook Reality

There are aspects of my work that I will miss, and aspects of my work that I am happy to leave. Talking to nice people fits into the former category, begging insurance companies to uphold their obligations falls in the latter category.

Yesterday, I was talking to a client. She is a nice lady who I have known for a number of years. She was recounting a recent trip back home, and she was surprised that the trip had gone well. You see, she comes from a large family of successful siblings. She noted to me that she typically feels like the failure of the family. She is a single mom, and all of her siblings are married. They seem to have charmed lives, financial wealth, fantastic kids… well, you get the picture.

I looked at her and said, “Let’s review your life.” She had a look on her face that suggested both surprise and concern. I reminded her the following:

You have successfully raised a wonderful daughter, on your own.
You have supported yourself for most of your adult life.
You own your own residence, in a nice community.
You are saving for your retirement.
You have friends that care about you and a daughter who loves you.
You drive a safe care.
… and so I went on.

I concluded by reminding her what a great success she was. She not only managed to take care of her needs but her daughter’s needs as well. Naturally, her life isn’t’ perfect. There are always areas of wants. Perhaps a little more money, a bigger place to live, a solid romantic relationship. However, her wants were insignificant compared to all of her successes.

As I was counseling her I was also thinking. Why is it that we are so programmed to look at other people’s lives through rose-colored glasses, and our own lives through dingy and dirty ones?

Of course, there are many reasons. One is the reasons is what I like to call Facebook reality.

I share stories with my patients if I think that they have therapeutic value. I’m not the stereotype blank screen of the 1960’s psychiatrist. I think it is important for them to know that I am like them, a real and relatable person.

This is the story that I told her…

A number of years ago I started to make dinner with my kids. My wife had returned to the paid workforce, and the kids were complaining about the switch from homemade food to frozen pizza and bagged burgers. I thought it would be both fun, and a learning experience to make real meals together. We would plan, cook, eat, and clean up together. This has been a wonderful family experience, and my kids have become competent cooks of real food.

Part of this new tradition is that I post a photo of our finished meal on Facebook. That food shot is taken before we sit down to eat. I prepare the plate carefully. I choose the nicest piece of chicken, the plumpest crescent roll, the most artful salad. I’ll usually take the photo at several angles, and I’ll pick the most flattering one. I then edit the photo. I crop out distracting elements, add a vignette, and do other things to draw attention to the food. It is only then that I post the photo under the title “Cooking With Dad Thursday.”

This ritual has become a somewhat of a family inside joke. It doesn’t show the burnt rolls or the piece of chicken where half of the breading has fallen off. It is reality, but a carefully crafted reality that shows only the best that we have to offer, and that best is shown in the best possible light.

I asked her if she was dealing with Facebook reality when she visits her family. Only the best pieces of her sibling’s lives are shown to her, and only in the best possible light. How easy it would be to feel like a failure if the only point of reference that you had was artificially perfect.

We see Facebook reality everywhere. The model with perfect makeup hawking a beauty product. The “real lives” of people on TV who live in multi-million dollar homes. The neighbor’s recounts of their fantastic exotic vacation. It is so easy to become dissatisfied with our truly real lives where we compare them with the Facebook reality of others.

I think it is important for all of us to remember how fortunate we are. How the positives in our lives usually greatly outweigh the negatives. Our lives were never meant to be perfect. We can choose to celebrate our blessings or choose to live in a cesspool of dissatisfaction and envy.

Breakfast for dinner
Only the best piece of chicken and the plumpest crescent roll.

Intermission

The first half of the performance had ended, and the lights in the theater came up. My wife Julie and I had just seen act I of “The Million Dollar Quartet” at the Paramount theater in Aurora.

It is the story of Elvis Presley, Johnny Cash, Carl Perkins, and Jerry Lee Lewis, and their interactions during a recording session at the famous Sun Records in 1956. The event was before my time, but I am still familiar with their stories and music.  That was not the case for Julie, as she was raised in a Time Life, “100 Most Loved Classical Music Compositions” kind of family. During the intermission I was explaining to her the various sub-plots of the play.

It was clear that the man in front of us was listening to our conversation.  After a minute or two he turned to us and flashed a big smile.  I’m guessing that he was around 80, but a healthy looking 80.  He had clear skin, sparkling blue eyes, and a very infectious smile.  

He started to talk to us. It was the effortless kind of talk that gently tests the waters of a new connection.

Not surprisingly, he started by asking a few questions.  Were we enjoying the show? Where we married? He then offered a little information about himself.  He was in the Army at the same time Elvis was in the service (1959) but he never met him.  He was Lithuanian, but spent his early life in Germany. He came to the states as a child. He lived in Genoa IL.  Then more question for us. Did we have kids? Did we live in Aurora? At some point he introduced us to his wife who was sitting next to him.  She was stylishly dressed, and also had an inviting smile.

Our conversation continued throughout the intermission and ended only when the second act lights dimmed.

When the show ended, we were not forgotten.  Our new friend made sure to say goodbye, and to wish us a good evening.  Both of us commented on how pleasant he was, and how we enjoyed our little interlude with him… and there was the problem.

Dear reader, the problem wasn’t this delightful man, or even our interaction with him.  Rather, it was my awareness of a skill that he had that I lacked despite my many years of training.

As I enter retirement one of my main goals has been to acquire a comfort level connecting with strangers.  I certainly know the protocol, but I have been unable to implement it.  My dear friend Tom connects effortlessly with strangers.  I have watched his behaviors and I have mimicked them.  If I have the security blanket of Tom with me I have no problem engaging with a new face. In fact, in most cases I am successful.  However, I can’t seem to initiate this behavior when I’m by myself.

Why is that, dear reader?  I believe it dates back to my early childhood when the message I received was that I was a troublesome burden when I asked questions or wanted attention.  Dear reader, my goal is not to constantly bash my parents, or to blame my problems on them.  I am an adult, and I am responsible for my behavior.  With that said, it amazes me that I can be impacted so significantly by the past.

Yes, I am an introvert, but that is not the issue here.  If a stranger engages with me I have no problem connecting with them.  In my professional life I am a professional interviewer, I don’t bat an eye asking a total stranger the most intimate of questions. I can lecture to an audience of 500 people without difficulty. Once I have established a connection with someone I have no problem re-engaging with them. Via this blog I am acquiring the ability to write about very personal parts of my life to a wide-open internet public.

Over the last few years I have taught myself the skill of making initial small talk with strangers.  The one to six sentence interactions that others do so effortlessly.  It has work for me, and the more that I do it the easier it becomes.  However, the ability to connect on a more substantive level has remained illusive.

You may ask, “Why is this a big deal?  You have gotten this far without this skill, why bother now?”  Dear reader, one of my goals is to connect with strangers outside the confines of my professional office.  I want to photograph them.  I want to write about their lives.  I am fascinated by the wonder of the common person.  When you get to know someone the common becomes uncommon.  The routine becomes unique.  The ordinary becomes extraordinary.  …but I am stuck.  Stuck with the burden of thinking that I am bothering someone by starting a conversation with them.  That there is something wrong about wanting to connect with them. Stuck with the fear that I am wasting their time.  I do not feel worthy.  I am back in my childhood.

At this point I will continue to push forward.  I will continue to try new strategies.  I will continue to take risks.  I will continue to pray for courage.  But, I am saddened by my lack of progress.

What can I do? One foot in front of the next. I have climbed many mountains in my life, this is just another one.  I already know that to accomplish my goal I will need the help of others.  Perhaps one of them will have the key to solving this issue. I am not one to give up.  I am not one to give up on myself.

Rain

I walked in the rain this morning.

A light rain, more annoying than preventing.

It did not prevent me from walking.

It did not prevent me from thinking.

It will not prevent me from going to work today.

It did make my walk less enjoyable.

It did make me feel less comfortable.

The rain will not stop me from moving forward.

Initially, I thought it would hinder me.

Now, I’m aware that it will shape me.

Today I will accept the rain, and realize that the sun will follow.

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.

Who Am I?

A cooler morning today. More fall-like, more in tune with the expectations of the season. When I left the comfort of my home I was met with 50 degrees of briskness. It felt right.

I don’t usually plan what I write about, I typically hope for some sort of inspiration. This morning my thoughts were cluttered, none able to gel into a ball of coherence that could be expanded into a missive.

If there was one theme it would be, “Who am I at 64.” I’m not sure beyond a laundry list of titles: father, husband, friend, doctor… none seem to define me very well, likely because many of them are in transition.

The other day I told Julie  of my inability to be. It is almost impossible for me to not be productive. I always feel an internal push to do something. I always have a need to justify my existence. I don’t attach a “good” or “bad” valence to this quality. With that said, there are times when I wish that I could just shut it off and be.

And so it is with my next chapter of my life. In two and one-half months I will enter phase one of my retirement. What will become of me?

In the 10 plus years of planning, I have held onto the idea of returning to my creative roots. Writing, taking photographs, teaching. As I approach phase one these goals start to seem like folly. I can certainly do them, but will they have any meaning if no one connects with them? I don’t think that this is grandiosity on my part. Rather, my practical mind sees little point in expending energy that doesn’t have a purpose.

Problems that I thought that I solved years ago present new. Should I travel for inspiration? How do I connect with strangers and convert them into friends? What should I write about? Should I pick commercially viable topics, or should I write from my soul? How much should I reveal about myself? How vulnerable can I be?

At the moment I am trying the “blunt instrument” approach. I take photographs, I write, I make videos, I do podcasts. I hope that one of these outlets will catch fire with me. That somehow the act of doing will show me the course to follow. That my actions will have meaning.

At 64 I still want to change the world. There is an urgency to this idea, combined with the reality of my life. If I haven’t changed it during the majority of my life how can I change it with the minority remaining?

To be honest with you dear reader, I’m not even sure what that change would be. The themes that flow through me today include: tolerance towards others, understanding others, the common core of humanity, our planet… the list goes on. I chuckle as I read my list. Still altruistic. Still a little boy trying to do something big. Still holding on to what the nuns said, “Michael, God has plans for you.”

My time is running out. I should have acted sooner. I should have been braver. I should have been stronger.

Dear reader, if you have read this entire piece, I thank you. My writings aren’t three sentences of inspiration. They don’t have the funny punch line of a meme. The don’t polarize you and force you on one side of the fence or the other.

When you read my writings you enter the mind of a common man who thinks and wonders, “Why am I here? Is success based on how many marbles that I have at the end of the game? How many friends have I acquired? How many papers that I have published? Sadly, this common man doesn’t know the answer to these questions, even after 64 years of thinking about them.

For now, I’ll keep hacking away with my blunt instruments, if only because I have no other tools at my disposal.

Growing Pains

This morning I feel like I am moving into the unknown, change is afoot. Many aspects of my life are in motion. The kind of random motion where it is impossible for me to determine the eventual destination.

Being a creature of habit this unknown is difficult for me. Clearly, I am the agent of some of my change. Clearly, some of my change is happening without direction or effort on my part. Overall, the process feels uncomfortable.

Front and center is my work life. It has now been two and a half months since my private practice retirement letter went out. Every day I am saying goodbye to patients, some who I have worked with since 1989. I am still at the point where most of the people that I see are first-time goodbyes. It is difficult.

We live in a world of depersonalized services. We buy things off the internet. We deal with unintelligible customer service reps thousands of miles away. We connect with people using apps on our phones. Plug in a few statistics and hook up with a stranger. Even intimacy has become a commodity.

Doctors practice a production model. The more patients that you see, the more money you make. I want a good life, but if money was my only goal I would have gone into a more lucrative field, like business. It is clear that a major part of me wants to help others, and be a positive influence of change in their lives. Some of that desire is altruistic, some to justify my carbon footprint.

I have established connections with my patients, and now those connections are about to be broken.

Trained in the psychodynamic milieu of my residency at Northwestern University, I am acutely aware of my role as doctor and caregiver. Aware of the necessity of a professional connection with my patients that includes boundaries. Aware that my position gives me power, and that it is my responsibility to treat that power with respect.

Despite this artificial barrier, I have developed connections with my patients. Now it is my responsibility is to help them transition to a new doctor. Now, I have to say goodbye, over and over.

The vast majority of them congratulate me and thank me. Some are tearful, which makes me tearful. A few are angry. Some have just moved on, heralded by a “release of information” from a new doctor requesting their medical records.

The latter group has surprised me the most. Some of whom I have known for decades. Their way of coping has been to simply change to the new provider. I guess the word “provider” says it all; an interchangeable thing that provides a service. It isn’t their actions that surprise me, it is my reaction to their actions. I find myself hurt and discounted. A part of me quickly buries these emotions, another part acknowledges them. Another chunk of self-awareness to add to my self-awareness vault. This piece has sharp burrs that bump up against me and cuts me. I would like to discard this piece, but I know that I can’t because it is part of me.

As my life moves in a new direction, so does my wife, Julie’s life. As she stretches her professional wings, I close mine in. More change in my recent sea of change, but that is the topic of another post.

Every experience in life helps me grow, a process that never ends. Unfortunately, sometimes growth involves growing pains.

Vietnam

Tuesday morning 5:51 AM finds me sitting at a small metal table on a narrow cement sidewalk in front of Starbucks, sipping coffee. Sipping coffee and thinking.

I have been watching the PBS Vietnam special for the last week. It has been riveting, and disturbing. I feel compelled to view it like I am compelled to stare at an accident on the side of the road. The emotions when I watch the screen trump any rational reason why I should, or should not, view the series.

It surprises me how fresh the half-century-old photographs are to me. I saw many of them in real-time when I was a child and adolescent. When I view them now I am instantly transported back to those days. In many ways, I traveled the same journey that the storytellers did.

As a child, I believed that the government’s only purpose was to protect us. That they always told the truth, and that they were transparent in their actions. As an adolescent, I became progressively more jaded by the reality that I saw on the nightly news. The body counts based on political currency, rather than necessity. The dehumanization of an entire nation of people. The devaluation of American lives. Winning the war became the goal in Vietnam, the reasons why lost in political rhetoric and catchphrases.

The stories of the soldiers, many children, brought back memories of me sitting in the kitchen of the house on Francisco Avenue listening to WGN as my year’s draft lottery numbers were being announced. My number was 108. My best friend John’s number was in the high 200s. Predictions were that they needed to draft up to 160 or 180 that year. I was relieved for John but terrified for me.

I remember the sick feeling in my stomach when I became aware of my number. A feeling of being completely out-of-control. By that point, I had lost faith in God, the government, all authority. I was too afraid to separate myself from my family. Too afraid to escape to Canada.

It felt like my life was over that day. One more trauma in a series of traumas, but one that would likely be my demise. I had survived others in my young life, some formidable. However, the US government and my perceived expectations of my family appeared to be insurmountable. A barrier that I did not have the strength to breach.

During my draft year, the war deescalated and they never reached draft number 108. It was still a year of hellish waiting.

I’m not sure what was more painful. The thought that I could be sent off to war and most certainly die, or the realization that those who pledged to protect me had clay feet. It was a time of transition for me. A time where I decided that the only way that I could move forward in life was by taking control of my own life. A time of abandonment of naive, but comforting beliefs. A time of doubting everything. When you doubt everything you are alone, and so it was a time of great loneliness.

It was one more step in me becoming ever more independent. A blessing and a curse. It was one more step in me becoming expert in areas that I found necessary or interesting. A blessing and a curse. It was one more step in me becoming skeptical of other’s motivations in their interactions with me. A blessing and a curse. It was mostly a terrible time.

I have softened over the years. tempered by life experience and maturity. I view authority with a reality that is more nuanced, less absolute. I have more trust with people in my life, and I realize that most individuals, agencies, and authorities have many facets… some good, some bad.

I tend to focus on the positive of people and things, not the negative. I tend to see the good in others, more than I see the bad. But I still have a wary eye.

I am aware of the damage caused to real people who were exposed to horrific atrocities at an age where they should have been focused on weekend parties and fast cars. I lost a cousin because of the trauma of Vietnam. I have worked with countless vets at the VA who lost functional lives because of their experience. I currently work with successful men who seemed to beat the odds, only to crumble when the structure of their work lives ended. That vacuum filled with memories and nightmares from a time better forgotten. It saddens me. It sickens me.

I am aware that knowledge without action means little. We can learn from the past, or we can repeat the past. This rule applies to big-picture stories, like the Vietnam war. It also applies to small-picture stories, like our personal lives. So many times we repeat cycles of futility, hoping for a different outcome. I want to move forward. I want to learn and move on. I don’t want to be cynical or paranoid, but I also know that I can’t be all trusting either.

My wife Julie sometimes criticizes me as I can come off as being an expert in many things. It is true that my obsessive nature drives me deep into topics. It is true that my professional life places me in a position where I am expected to be knowledgeable, an expert. I wonder if my intrinsic nature fueled this quality, or if it was formed by the traumatic realities of my young life?

I move on, forever growing, forever questioning. I want to believe, I want to trust… one step in front of the next, moving forward.

Walk

My senses are confused this evening.
I walk the path from my house to the river.
The air is hot and moist. The air of July.
The fragrance is of fallen leaves. The fragrance of October.
The DuPage is shallow and slow-moving. The river of August.
The dusk is early. The light of September.
The memory is of schooldays. The memory of childhood.
I walk aware. Aware that all moments are unique.
Transient, never to be repeated.
I walk and I celebrate the gift of today

The mighty DuPage river. Slow and pondering.

Change

Walking in the dark, I think. First random scattered thoughts, without theme or form. Then ideas more focused, still loose not gelled. Slowly, a greater theme emerges as I silently plod forward. The environment around me synchronizes with the milieu inside of me.

Today’s theme started to consolidate as I passed a truck stopped in the middle of Jefferson Avenue. It was out of place in the pre-dawn morning. I spied another truck out of place, then another.

As I approached the Starbucks on Chicago Avenue their reason, and my theme appeared. The last truck was stringing holiday lights in the trees, preparing for Christmas season ahead. The season was changing, change happens.

My life is not static. I am not fixed in time like the photographs that I take. The world around me is changing. I am changing. Often I have little control over either.

The lights are being strung in the trees. In a few months they will be removed. I celebrate their appearance, and I will mourn their removal. My life moves forward and I celebrate and mourn my changes simultaneously. Change like so many things is neither good nor bad, it just is.

What will change bring me today? How will I view it? Will I accept it or fight it? The only certainty is that it will occur.

On Retirement

Dear reader, please note that I wrote the following post in late July, as I was flying from Seattle to Chicago.  My retirement letter was just sent out, and I was returning back to my practice (from vacation) in a few days.


I have to admit that I find it uncomfortable. Probably more so than others. I dislike the uncertainty of the unknown. I bask in the comfort of routine. It has always been that way for me, but I feel that this tendency has increased with the increase in my years.

I am a creature of habit, not one to seek adventure unless the benefits were great. Like most stances that are reasonably reasonable, my position has both served and hindered me.
My conservative ways have given me security, comfort, and a degree of financial independence. My conservative ways have prevented me from new experiences and new growth. In some ways, it has been a toss up. Like most, I am a product of my personality. I accept this truth much of the time.

My life has been changing, my years have made me ever more conservative. My spirit has made me ever more adventuresome. I view this phase of life as both exciting and confusing.

I realize that I have to push myself if I hope to move forward. I have had the comfort of a professional persona. A role that allowed me to be instantly identified. A title that gave me immediate status. That is now about to change as I redefine the fundamental essence of who I am. I look forward to this change, but I am also fearful of it. It is easy to quote, “With power comes responsibility.” This is very true, but it is equally true that with power comes power. Soon I will lose that power and once again I will become the working class kid from the Southwest side of Chicago who wonders if he can make it in the big world.

I made my decision to leave private practice over 10 years ago. A lifetime ago. A decision made out of desperation. Overweight and physically sick I saw no other option.

My subconscious aware of my spouse’s financial insecurity combined with my own ambition to be successful, I worked ever harder. The more that I worked, the sicker I became. Finally, I realized that my only solution would come from moving outside my established norm and to a new equilibrium.

I told Julie that I would leave private practice 10 years ago. I’m sure she took my distant prediction with a grain of salt. Ten years sounds like a lifetime. For me, it allowed a window of hope off on the horizon. A window where I could work less and explore those things that I felt I was intended to do.

Then things started to change. I have chronicled many of them in previous posts, so I won’t belabor their details again. I reduced stress, faced traumas, worked through traumas, moved towards health. Slowly, my overweight and sick body became thinner and healthier. Slowly my energy increased and my mind cleared.

Now my fear of becoming ever sicker has been countered by the reality of what I am leaving, and what I am moving towards. My distant goal served an abstract purpose. My current reality not only comforts me, but it also challenges me. What if I can’t do what I have set out to do? What if I lose myself as I lose my professional self? What if….?

Such fears serve no purpose, and so I make effort to place them in their proper perspective. However, more challenges continue to emerge.

My retirement letter has been sent to my patients; patients will react. For some of them, I am just a commodity that can easily be changed out for a newer shinier model. For others, I will have to absorb their anger. I have been a “provider of services” for them and my leaving will be an inconvenience. For others, both patient and doctor will have to deal with the pain of the ending of our relationship.

I have worked hard to maintain professional boundaries with my patients, but that hasn’t
prevented me from forming bonds with them and having them forming bonds with me. I will miss them, and I suspect that some of them will also miss me. This part of my transition saddens me deeply. For every action, there is an equal and opposite reaction. The positives of moving forward are countered by the negatives of what I am leaving behind. A life lesson that is ever repeated.

I have some general plans for my future. Now more physically fit I can see some of them moving from theory to reality. Yet, I am still hindered by myself. My shyness. My fear of intruding on others. My desire to succeed and to be recognized.

I know that I need to conquer these hindrances, or at least quiet them. I have to move past my shyness, I have to move past my childhood based fear that I offer little, and therefore I am a waste of time to others. I have to recognize that success comes from achieving my goal rather than how many accolades that are sent my way. These changes sound simple, but they are not for me. They are my new Mount Everest. I have claimed mountains before, I will climb this one too. Climbing mountains is what I have done all of my life.

My immediate plans are simple. To continue to hone my basic creative skills and pray. Pray that one of the 100 amorphous ideas that I have floating in my brain solidifies so I can focus with greater purpose and energy.

I have to accept that I will need to grieve many losses. The loss of my professional life. The loss of patients who I have been able to connect with. The loss of power that my profession has afforded me.

I will also have to accept the uncertainty of a new life and direction. One in which my efforts may be met with rejection or ridicule.

I move ever forward, grateful that I have been given another chance to rediscover myself. A chance to grow. A chance to think new thoughts.

Today my goals are to realize that change happens and that I am at the exact place that I should be at this very moment.