Pedestrian

I've experienced much loss in my life, both personal and professional. It's no secret that as a physician people come and go often without warning. And I worry about my patients. Not just about diseases and diagnoses, but I think about their well being. Are they happy? Do they have enough support? Are they in pain?

The doctor-patient relationship is a bidirectional investment. Over years of visits, I have become intimately familiar with the people who inhabit my exam room. I ask about their families and hobbies, not to be a more avid physician, but to be a better human being. I am not just pedestrian. Making the right diagnosis is a joy but doesn't sustain, becoming part of the intricate stitching of the quilt of another's life is ultimately what pulls me out of bed every morning. When a patient dies, or moves, or leaves to see another physician, the effect can be devastating.

I accept the inevitability of my career choice. I hear the sound of the door closing most every time a new patient enters my office. I will journey with them, maybe for days, maybe years. I will give of myself freely and try to take sparingly. It is a familiar cycle. Seasons change.

People come and go.

When I decided to convert to a concierge practice, I hoped to retain ten percent of my patients. I fully realized that, in a sense, I was closing the door on the other ninety percent. I planned carefully. I sent my letters six months early to help people land on their feet. As the months have passed, jubilation has given way to harsh reality.

I now have to help plan for the mass exodus of many people I have spent the last ten years worrying about. I stressed over their heart attacks and strokes as well as their colds and gout attacks. I have held hands, mourned losses, and celebrated triumphant victories.

I knew intellectually what I was in for when I made this decision.

But right here, right now, in the midst of it I can't help but pause.

This humongous, cataclysmic, overwhelming loss

is nothing less then suffocating.