Thursday, March 10, 2011

Missing Mondays and the People Who Live There

Well, today was my last day of rural medicine and if I didn't have to be someplace else, I could easily show up for work on Monday without a second thought. You see, I've gotten rather comfortable dodging the potholes and frost heaves on the road paralleling the Kennebec River on the way into town, and encountering patients in the grocery and hearing them say, "Goodnight, Doc," even though they know I'm a student, has warmed my heart. Being treated as though I was expected to stick around has been wonderful and it's made leaving far more difficult than I could have imagined six weeks ago. I'm going to miss those Mondays.

Working in a private practice in a small town has been the fulfillment of a fantasy I've entertained since the 1990s when I first saw the film, Doc Hollywood. Although I've mentioned this on numerous occasions, I'm bringing it up now because the idea of having experiences similar to those depicted on screen was an important one at a time when the dream of going to medical school was very far away. So far, in fact, that I hadn't begun giving it serious consideration. You could say, I was still in the "wouldn't it be nice" stage, back then.

Fifteen or so years later, I'm a student who's only used his stethoscope on other students or model patients, pretending I have more than a vague notion of what I'm doing. I thanked God for all the times I'd taken blood pressure readings as an inpatient psychiatric clinician because at least I could do that with a modicum of confidence. I'd taken illness histories while performing psychiatric intakes, so I had that down, too, but there was much that was "new" in every sense of the word. I owe a word of thanks to every patient who smiled and let me fumble my way through our initial interview, trying my dead level best to do no harm in the process.
And especially to those who said it didn't hurt each time I stuck them with a needle administering a TB test or allergy shot, whether it did or not. They were braver than I would have been, had it been me.

I'm grateful because each morning and each afternoon brought me closer to walking into the examination room feeling it was my business to sit down and ask, "What brings you here today?" And, upon hearing what each person had to say, knowing how to lead us on a fact-finding mission together, discovering what name we ought to give their problem and what we might do about it. At first I was wrong as often as I was right, but neither my patients nor my preceptor were eager to find fault and things gradually got easier and I got better. Another reason why I'm going to miss Mondays.

Most of all, I'm going to miss talking over the day's census in those precious minutes before all hell breaks loose, working through lunch and sharing an orange if there's time, greeting patients in the waiting room and chatting about the snow or road conditions like we've known each other all our lives. I'm even going to miss the blasted wall-mounted blood pressure unit that always sent me running for my portable cuff because I never could get the knack of dealing with its idiosyncrasies. The past six Mondays have been good ones, and despite being someplace new, seeing new patients and learning new things, I'm still going to miss Mondays in that tiny little town on the Kennebec River and most of all, the people who live there.

(Photo copyright 2011 by the author)
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