a sad goodbye

This coming Monday, sometime around midday, I will leave my practice for the very last time. And whilst the last few months, back at my desk after sabbatical, seeing ‘my’ patients, has tested my resolve, I remain convinced that, for my family at least, taking a break from GP partnership is still the right thing to do. My children know what I look like again, and frequently tell me to go away and to stop bothering them. A once very anxious son is now coping well with life. An often very grumpy husband still has his moments but does not carry the strain of family life on his own and sometimes (almost miraculously) smiles a little.

I have taken time for a few, mostly introspective and teary, reflections as I have silently said goodbye to patients, many of whom I have cared for, often very deeply, and some of whom I genuinely love. And  it is with this sadness in my heart that I share these thoughts about the privilege that being a GP is, and still remains, despite everything that can overwhelm us and make our job near impossible at times.

I have been a partner in a deprived, urban area for 12 years (7/10th of my working life). And whilst I cannot now ever say that I have devoted my whole working life to one practice, and we doctors are competitive souls, I have given the best that I could to my patients throughout this time. And, in a way, part of my reason for leaving at this time in my life, when my family need me too, is because I have sometimes given too much, leaving nothing left for anyone else, especially me.

I found my niche as a GP and have not wanted to be anything else since I realised the power of listening, truly hearing and talking as theraputic tools. Many of my patients have been able to find what they needed in my consulting room and have been able to move on in their lives because of time we have spent together. I have so much knowledge stored in my head about so many of my patients, vital miscillanea that have no place in medical records. I am a respectful custodian  of deep and traumatic secrets that I have been asked to take to my grave, but I have also shared in many tales of life’s joys, successes and triumphs too. And, as I step out of the front door for the last time on Monday, these secrets and tales will leave alongside me.

I haven’t been able to say ‘goodbye’ in any formal sense to either my colleagues or my patients. This change of career path has left me without words for, as I once said, “I cannot tell you how sad it makes me feel to tell you of a decision that has made me so happy”. Today, however, I suddenly felt that some expression of what I have been experiencing, as I’ve treasured my last days and weeks with my patients, was necessary, for me at least.

I went on a home visit this lunchtime to see a dearly loved, long know patient of mine. We hugged, we chatted, we caught up on each others’ family news and then, almost as an after thought, we sorted out ‘the medicine’. And I wanted to distil this feeling, of sitting with a terminally ill patient, who remains generous in spirit despite their pain, whose face lit up when they saw me and whose journey I have been able to share. It is this welcoming that we receive into people’s lives that I will miss, this welcoming that is the privilege of General Practice. It is this that I will miss the most. Being in the same moment with a patient who might just be helped by something that I know or say or hear from what they want to tell me. It is this privilege that, in time, I will seek to find and establish somewhere else.

And so this is my thank-you to my patients. My thank-you that I cannot say out loud because the emotion is too overwhelming to share in any other place than here. It will only ever be these particular patients who formed me as a GP and whose stories have fuelled my passion for my career so far. I may never be able to tell them individually how much they have meant to me, how they have empowered me, how they have enriched my life and made me determined to fight against inequality and deprivation as my career takes a new turn. Perhaps they will never know how much their wanting to see me, instead of another GP, has strengthened my identity and self-worth and how proud I have been to serve them for a dozen years.

As I step out of the practice door for the last time on Monday, I will carry my patients in my heart and I will endeavour to remember the lessons that they have taught me as I continue on my slightly uncertain way.

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