I didn’t know you were so stressed out…

Even then, I knew. I knew it would hunt me down some day.  I knew the name before the police office laid the subpoena down on the table, stepping away quickly so we could maintain 6 feet for social distancing while I reluctantly picked the heavy envelope up. The prosecutor was grateful for my meticulous level of detail - courteous, deferential even. It wasn't me on trial, after all.

What Do You Do For a Living?

When I first started this journey, I thought medicine would be everything.  And for a long time, it was. Over the last 16 years I geared my entire life around it - the classes I took, volunteering opportunities, people I networked with, places I've lived.  I'd squeeze in "life" during allowed breaks – sleep, exercise, celebrations, time with my husband, friends and family – all the while patting myself on the back for finding such a great "balance". But as the scales tipped more and more toward medicine the longer I headed down this path, the realization hit me:  I'm no longer working to earn a living, I'm living to work. I watch so many of us continuing down the road we were set on, unsure if we can take another step but pushing forward because that's the only way we know. What if we stop?

Reflections at Lake Marian, New Zealand

This Doctor’s Secret Shame: A Patient Suicide

Sitting at my new hospital cubicle workstation, O's hoarse voice rang out in my ear as her obituary on my screen sucker punched me in the gut.   Squeezing my eyes shut to stop the onslaught of burning tears only brought visions of O down on the ground, clasping the pill bottle with my name on it.  Of course they were prescriptions that I wrote... she wouldn't have had the time to find a new PCP 2 weeks after I had left the clinic.

Rainbow over Cook's Chasm, Oregon Coast

Are You Sure You Know What You’re Doing?

Returning to the picture on the page of an angry, pink baby with a T-piece resuscitator hovering over its face to supply oxygen, I was immediately transported to another place, three and a half years ago.

Except that baby was limp and gray.  Slippery in the warmed blankets that didn't seem to be able to contain her.  Listless despite the efforts to stimulate her to breathe, turning bluer by the second.

"Why isn't she breathing??  What are you doing to my baby?!?"

Mom's wails rang out in my right ear as if it were yesterday.

Sunset over Heceta Beach, OR

To The Doctor Struggling with Burnout: I See You

My friend, I remember being where you are, feeling like there wasn't anyone who could possibly understand the darkness I found myself in. The isolation. The inability to explain the full weight of what I dealt with as a primary care physician every day to my very well-intentioned non-medical tribe. The difficulty reconciling the knowledge that I was "living the dream" but in reality was merely existing in a living nightmare, my own personal hell I had spent my entire adult life trying to achieve. I resisted for a long time to share my story - it's not an easy thing to do... it took me 2 years to even admit to my husband that I was struggling, and that in and of itself felt like a failure. Because we should be stronger than this, right?  We knew what we were getting into, we logically understood that we would see and endure a lot of suffering. But to know this is different than to live this reality.

When My Best Isn’t Good Enough, I Can Still Do This

"So I heard you're leaving..."

"I am."

"When?"

"My last day is February 1st."

C shrunk into himself as he centered his gaze on his worn hands.  After 10 seconds of silence, he finally sighed and looked back at me with eyes that hadn't known true rest for the last 6 months.

"It's hard to start over, you know?  I don't know if I can tell someone our story again."

Nodding my head, I looked over at his wedding ring and felt a familiar pang of regret.

M walking along the Columbia River Gorge

Death of a Primary Care Physician’s Career: Act Three

"So when should we see each other again?"

She's young and healthy, M.  No reason to have her come back sooner than her yearly physical.  Are you OK with her just getting a letter in the mail notifying her that you're gone?

The thought of her discovering I was leaving via an impersonal letter on clinic letterhead filled me with dread.  She deserved better than that.  To hell with my promise of keeping my mouth shut.

Columbia River Gorge View atop of Wind Mountain

Doc, Are You Giving Up On Me? When Is Enough Enough?

"Doc, I'm tired of this."

I looked at V's wan face.  The vibrance that I adored had been sucked out of her over the last 9 months by chemotherapy and radiation.  I remembered the moment she cried in my office, angry I hadn't been the one to tell her that her breast cancer had returned everywhere.

Now she couldn't muster up any emotion - no tears, no anger, no frustration.

Just tired.