In 2014 I wrote a piece titled “Recapturing Abundance”. I was working hard and often feeling stretched, but this particular day I did a couple of house calls that brightened my day and lifted my spirits.
One visit was not at all an uplifting one, because my Alzheimer’s patient had moved closer to the end of his disease progression. But it was an important visit, best conducted in his home.
The other was quick, reassuring for me that my diagnosis was correct, and for him in that it showed how much I cared.
Both those housecalls energized me and I breezed through the rest of my day, even though it was busy and demanding.
That night, I reflected on the idea of abundance as a state of mind as I sat in the barn with the animals. My wife, in the house, left me a note with words of wisdom from the ancients. We are not together anymore, but even during years of drifting apart we often shared our readings from varied sources.
Now, nine years later, I experience the sense of abundance less and less often. Primary care is hard work, increasingly dominated by the computer at the expense of patients and providers both. Healing is hard to bring about without the time and human connection doctors of my generation have known through the earlier years of our careers. Those new in their profession don’t know the difference, because they never had the experience of uninterrupted eye and emotional contact during an entire patient visit.
I have now started to work part time in the housecall practice I mentioned a short while ago. Because it is a new practice, it is naturally slower. But the way it is set up, it isn’t necessary to keep a hectic pace just to stay in business. And it puts me on the road, where I can see the early fall foliage, and in patients houses and apartments, where I can see their pets and their families, where I see how they move around and what interests them. This is something I feel will help me recapture my sense of abundance more than just once in a great while. I love taking care of patients, but not always the way we have to do it these days.
This is what this post category, “Progress Notes”, will document – in a roundabout sort of way.
As usual when I describe clinical encounters in my writings (it’s been 15 years since I started “A Country Doctor Writes”), I draw from my 44 years of practice in Sweden and in several different clinics in Maine. Everything is heavily fictionalized. Many changed details can still bring about the same emotion (and there will likely be a range of them), conclusion or realization that made me want to write each story in the first place