Covid Vaccine Clinics – a surprising joy.
Covid Vaccine Clinics – a surprising joy.
Every Wednesday morning for about six months now I see patients for Covid vaccination some of whom I have seen since the beginning of the practice in 1968. Some I have looked after since early childhood. For others I have delivered their children, walked with them through the process of parenthood, been with them through those common and sometimes uncommon trials, even the death of a child.
Sometimes I have walked with them through depression, threats to their marriage, and ultimately to death of a spouse – most commonly at home where I have also had the privilege of their care.
So far, they are all pleased to see me and react with pleasant surprise.
I need to explain that I have now turned 80 and am only practicing around 7 hrs/week. Some of these patients I have not seen in a consulting capacity for many years and have handed over their care to younger doctors in the clinic. But I know them and know their circumstances and history.
It is unusual for me to see a patient for vaccination that I have not ever seen – less than one in ten. Even when I have not at any stage been their regular attending doctor I have seen most attendees to the clinic in semi-urgent situations when the attending doctor has not been available.
Prior to seeing them for their vaccine I review their history and so am reminded of their ongoing treatment for diseases including cancer diagnosis and progress and that of their spouse who might have deceased and it might be the first time I have seen them since that or other particular event.
I review their medical history with respect to the vaccine and give opportunity for questions and then express my sadness in hearing about “John”. I express my appreciations of John acknowledging how difficult the pathway might have been while also expressing appreciation to the person in front of me for their care.
Tears and smiles get mixed together in the response.
I am humbled by their gratitude.
One of the great privileges of General Practice is to help the patient walk out of the consulting room feeling better then when they walked in. Hopefully – and mostly – about who they are with an increased confidence and gladness they can face the future. In the instance of a confronting diagnosis to be given the information necessary for that point in the pathway together with the confidence of a follow-up appointment given at the time and to know that I am available on the telephone – which, just by the way, has been used inappropriately maybe five or ten times in my five decades of practice.
I am very much aware of the privilege of the long-term GP in “giving” strength to patients in difficulty or crisis. We lived on the premises for 6 years before converting the whole building to consulting rooms, now seven plus a laboratory collection room. I think the image of the “village GP” – even in this metropolitan setting – has facilitated this relationship in a way that may now only be possible in a country practice.
I am acutely aware of the dangers of this “privileged” relationship and of the careful need for boundary setting. Wonderfully – maybe because I have set the pattern early – patients including neighbours have responded in respecting these boundaries while being our friends.
I am aware that I digress from the Covid vaccine clinics.
But when to bow out? I consider at this stage with my continued reading of journals and articles in print and online that I am still aware of what I don’t know and make good use of referrals within the clinic and with appropriate specialists using what I consider good judgment of these choices. For how long is this appropriate? And how long and in what way is the role of “respected and knowledgeable elder and teacher” to be retained?
I finish a triennium of professional development points at end of 2022. Maybe that’s when but maybe before.
Maybe this very special reconnection with patients known for many decades has facilitated my saying goodbye.