It’s 8:00 pm. You check your work inbox and prepare for the following day: reply to emails, fill prescriptions, prep your notes.

You wake at 5:00 am. You exercise, eat, rush your daughter to school. You arrive to work at 7:30 and review the schedule with your team. You see a man with shortness of breath and a new arrhythmia, a walk-in patient with a severe headache, a teenager there for a sports physical who admits she’s binging and purging. You’re already running behind.

In between visits, you squeeze in work on the three inboxes you’re assigned, fill prescriptions, and order tests. One woman’s mammogram shows a mass;  she’ll need a biopsy. A runner has a hairline fracture. A newborn’s bilirubin is elevated. A patient needs preauthorization for her asthma inhaler, so you call the pharmacy. Paperwork from outside records and nursing home faxes piles up.

You eat lunch at your desk (heated-up leftovers), make two scheduled phone calls—to a woman to review her warfarin anticoagulation and to an elderly dementia patient’s son to discuss his nighttime agitation. You hurry to a meeting to discuss the influx of patients, the need to somehow open up more visits.

You start seeing patients again at 1:00 pm. You place an IUD in a nervous millennial and biopsy an atypical mole on the back of a middle-aged man. A nurse pulls you aside to review the insulin regimen for a patient with uncontrolled diabetes. You call a social worker and a psychiatrist when a patient there for dizziness confesses she’s been severely depressed and has thoughts of suicide. You sit with her and cry. 

You see your last patient and make more phone calls. You discuss FMLA paperwork for debilitating panic attacks and review the chronic opioid therapy plan for a patient with back pain. You finish your charting and tackle the inbox again. Your pace slows as time goes by; your brain is tired. You finally finish at 7:00 pm.

It’s Friday night. You drive to a retirement party for a colleague who has worked at your clinic for several decades. He’s surrounded by friends and family who regale the crowd with stories of grateful patients. You think about how the constant outpouring of self, the push day in and day out, threaten to overwhelm you. You know you should only do this for as long as you can give it your very best.

And you wonder: How long will that be?

Mary Pan
Seattle, Washington


1 thought on “Timeline”

  1. Thank you for sharing the diversity and challenges of practice- and the fatigue that too much of even the most fulfilling work can bring.

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