Sunday, 9 January 2011

On Saying Goodbye

This was written in reflective mood in October 2006, in the weeks preceding my resignation from the practice where I had been a GP for over 30 years.

In just a few weeks I will resign from my partnership and leave the practice where I have been a full time GP for over thirty years.

Perhaps several times a day I find myself telling patients whom I have come to know so well that this is likely to be the last time they will be seeing me. Some I have known for decades. Some I delivered of their babies in my early years of practice. These young parents were of my own generation and have gone on to be blessed by the arrival of grandchildren as I myself have done.

If not too pressed for time, we do a little reminiscing. Sometimes they will remind me of instances I had quite forgotten. Sometimes we talk together of parents and grandparents of theirs whom I had known and helped to care for, and who are now long dead. Recently I saw a man whom I had first met when I was a very new GP in August 1976. He had asked me to check the scattering of nodes in the back of his neck - firm, persistent and “rubbery”. A more experienced partner agreed that he should be referred to hospital. Hodgkin’s lymphoma was diagnosed and treated early. Successfully too - there has never been a recurrence.

By far the most of them wish me well and say how much they think I deserve my retirement. A few are clearly distressed and wonder how they will ever cope without me. I don't hold much with that. Of course they will cope - and I think it will be good for them. They may even be surprised at how quickly the memory of me fades as they establish themselves with my successor (God help her).

I find myself wondering why I am not sad. Well, perhaps I am, but only a very little. Being a GP in a busy urban practice has been an amazing experience - professionally about as rewarding as it can get, and I have achieved things that I would have never dreamed possible when I started out. But in all my 30 years here I have been kept going by one thought - that is, of leaving it. Not general practice, but London. Noise, no horizons, gloom, pollution and an ever pervading sense of threat (I was on the receiving end of my first really nasty assault just a few weeks ago - from a drug addict whose request for drugs I had, for good reason, refused). Now I want more of my own company, more time alone, peace, and to pick up my paint brush once more and shake the dust off my studio easel.

There is a sense of unreality about all this. I am already stepping back and no longer feel wholly a part of it all. In our regular practice meetings I listen more, talk much less, and contribute only when asked my view on one matter or another - and such views as I express are always qualified by something along the lines of "but you must decide as you think best". For I am no longer entirely there, and certainly no part of the future that lies ahead for my colleagues who will carry on after I am gone.

Day by day I box up my files, clear the drawers in my desk , and pack away the books in my personal library that have accumulated over the years. I was going to bequeath the last to my colleagues, but my wife, for some reason, has begged me not to. "They belong in your study at home" said she. I am not so sure - for who on earth will read them? Not I, surely, who so badly wants to set out on a journey to explore great literature - literature that I have had to neglect over the years, not having been a "good" reader and having like all of us to make professional reading a priority.

I have given little thought as to how I will feel on the evening of Wednesday 29th November, when I will close my consulting room door behind me for the last time and say goodbye to the few staff who stay on until the surgery shuts. No tears, I think. Not from me, anyway. It is my unexpressed intention to leave and not ever to return. In one sense it has to represent a major loss. But life, particularly as a doctor, inures one to loss and I guess I have only survived it this long by allowing those protective barriers insidiously to build up. And then I remember my own father whose last function as a consultant rheumatologist was to deliver his customary lecture to the second year clinical students at The London Hospital. This was on his 62nd birthday in the summer of 1968. I should remember it - for I was among the audience. He put down the chalk and the duster and said quietly and without emotion after almost 40 years in that remarkable foundation "Well, I think that is all, ladies and gentlemen” (yes, some of the consultants of the old school did address their students so) And perhaps the only sense of foreboding that I really feel now has to do with the fact that he survived only three years into his retirement. But it is tempered by my conviction that while I may have inherited his head, I have not, thankfully, inherited his heart. It is my hope that fortune will determine that mine will sustain me for the years that his own denied him. For I have much to discover, much to learn, many friends to enjoy, and an adored family to love.

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