The last day in the office has come and gone. After three years as a general practitioner and 17 years as a general consulting paediatrician, I am no longer in the office practice of medicine. I am on my way to becoming a full time medical bureaucrat. It's a big change, and it makes me nervous.
One of the nicest things about this past 17 years has been working with my wife in the office. She's a nurse; her insight and common sense have had an impact on almost every aspect of what we've done. We built two practices - first in Kamloops where we spent 11 years, then in Comox.
For the most part, it has been a happy practice. I think of my patients and how they've become a part of my life. The baby boy I resuscitated in 2004 gave my grand-daughter her first (non-family) kiss two years later. Then there's the mother of a baby with congenital chylothorax. I resuscitated her infant in the delivery room with high pressure ventilation and then with bilateral chest tubes. We sent the baby off to a tertiary center within hours of delivery. But she recognized me two years later in a donut shop and came over to say thank you.
I think of all the kids I saw with learning and behaviour problems. Some did well, others not so well. I remember attending the high school graduation of one of my cancer patients. Then there were the children who didn't do well. Kids with inoperable heart disease and metastatic cancer plus one lovely girl with polyarteritis. Their funerals taught me some humility. But they also taught me that medicine is rarely about curing and is always about caring. How we care, and how we show we care will be fodder for another post, but caring will always be the most important medical value for me.
It was a real mixed up day today. I felt as if I was abandoning my patients. One boy was in tears. So was another child's Mom. And then there were the good moments, with gifts received (chocolate, drawings) and memories exchanged. A girl who I had looked after with bronchiolitis as an infant presented today with psoriasis. A girl referred for ADHD looked as if she were more depressed than inattentive. Our receptionist left to get home before darkness fell - and that was a pretty choked up feeling.
Finally, the last patient went out the door - a lovely kid with CP. My wife and I were alone in the office with our thoughts and memories. We will miss this work. I know I will miss it a lot. I know that I will want to continue seeing babies, children and youth as part of my professional life. I've been doing it for so long that it's a part of my fabric. I'm Jon, and I'm a recovering paediatrician. I look forward to a few relapses.
