Update

My last OR day is 7/30. My last day in this office is 8/15. My first day in Santa Rosa is 9/2.

I get annoyed when patients assume I’m retiring. Either (A) they think I’m old enough to retire, or (B) they think I’m rich enough to retire. Neither is true, although (B) would be nice. Sadly, I chose the wrong field for early retirement. I wish I had been one of those lucky sods who hit it big during the internet boom, one of the ones who got out at the right time. If I had, I wonder what I would be doing with my riches and leisure time right now? Because I’m a working boy, after all; no Long Island Ice Tea on the 40-foot sloop for me.

So: what early retirement really means is the freedom to do the work I love and not have to worry about making a living. I suppose I could write part time, maybe keep up some sort of boutique medical practice on the side. I like medicine, but the 9 to 5 (or more often, 8 to 5 or worse) five-day-a-week grind is tiring.

I’ve often thought it would be fun and challenging to establish a medical consultancy practice catering to folks who feel that everyone else has given up on them. I wouldn’t be able to fix most of these people, but I could promise them that I would research their situation and come up with a plan of action that would have the best chance of producing results. I would run a cash operation and bill by the hour like a lawyer.

Yeah, that’s the dream. It’s sort of the opposite end of the spectrum from my present reality. Fact is, from medical school onward, a large fraction of my time has been devoted to indigent care. While I don’t mind this, at some point I have to step back and take a look at what it’s costing my family.

Even in this idealized practice, I could, of course, donate a portion of my practice to charity cases. Ten percent is the figure most often quoted as the amount necessary to facilitate an untroubled night’s sleep. I’m doing a LOT more than that at present.

Meanwhile, I’m doing the 8 to 5, and that’s not going to change any time soon. I’m afraid 8/15 can’t come fast enough, though. (Sorry, patients!) The steady rain of guilt has turned into a torrent. The guilt has matured, in fact. Used to be, I felt guilty for leaving my patients. Now I’m burnt out, guilt-fatigued, unable to feel much genuine guilt when patients insist, “Noooooooo, you caaaaaan’t leeeeeave!” And that makes me feel guilty in a different way, since I don’t seem to be capable of acknowledging their feelings with any true empathy. My honest reaction is, “Yeah, yeah, life’s a bitch. Next!”

Isn’t that awful? And yesterday, the daughter of one of my patients brought in a “crazy quilt” she made to thank me for the care I’d given her mom. It took her six months to make this. Six months. She started it even before she heard I was leaving, and she didn’t stop it when she did find out.

Nope, no guilt. No no no.

D.