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.