The Start of the End

The last few weeks of clinic, I've found myself doing something different.

I've begun saying my goodbyes to my patients.

I see my patients at least once a year. The stable pituitary, adrenal adenomas. The thyroid cancers. I tend to see my diabetes patients more frequently, perhaps every 3 or 6 months. Having been here for 6 years now, I've accumulated quite a patient list. And in fellowship, I must say I've had a greater sense of ownership of my patients.

They're MY patients. I'm THEIR doctor.

I know their history, often I remember their faces and recall their medical history by the mere mention of their names. We've shared life stories- I'd seen them go through weddings, jobs, divorces, deaths, surgery. They knew of my plans to propose, the engagement ring, the upcoming wedding plans. Just last Monday, I saw Mr. C again for follow up of his diabetes. The first thing he says, '6/7/08, right?' (Our wedding date). He asks me if I'm pissing in my pants yet. And reminds me that if I change my mind, he's got a very cute single grand-daughter my age (I don't think he realizes I'm 32 and not 25).

Now that I'm less than 5 months from graduation, I'm likely seeing my patients from now on for the very last time. And so, I've gently been preparing them, telling them I'll make sure the doctor who inherits them 'will be smarter and better looking than me'.

Some have been nonchalant (perhaps even relieved?) that I'll be leaving. Many, though, have told me they'll miss me. As I will miss them. It's funny, but it's true. Many patients have asked if they could continue to see me when I move down to Iowa and begin my new practice. And though I tell them I'd love to see them again, I do often remind them that their patient records do not come with me, and the care they receive here, really, is second to none. After all, it would be inappropriate for me to recruit my patients from here for my new practice.

Though in a way this is a business relationship, I've felt like we've gone a long way with many of them. Like the 40 or so thyroid cancer patients I have who are disease-free. Or the diabetes patients who have been able to keep their hemoglobin A1c below 7%. It's like, we've come so far together, that I'm proud of their achievements.

This year, the program decided to do something different. Instead of new fellows randomly picking up the patients of graduating fellows, they've decided to have one fellow 'inherit' all the patients of a graduating trainee. So, I basically know who will be taking over my practice come July. And so, I reassure my patients that they'll be in the good hands of Dr. MN. And hope that they get the care they so deserve.

I begin every patient interaction with a handshake. I've done so for the last 6 years. Now, I'm ending many visits with a warm hug. I really shall miss my patients.