Letting Go Again and Again

Letting go is getting easier with each passing day. With only ten work days remaining (not that I'm counting!), the approaching new reality is quickly becoming less of a distant idea and more of a concrete certainty. Change seems to truly be the only constant in the universe in which we can have complete faith and trust.

Patients' reactions are still varied. "But why?" is a common refrain, followed by worries about the future.

Yesterday, I was traipsing through the health center waiting room, hoping not to be noticed by any patients lurking in the corners. Suddenly, I heard my name being called and I turned. There sat a patient whom I have not seen for some time, and as I informed her of my imminent departure, her face fell, although she quickly smiled and wished me the best. "You'll continue to be in my prayers every day," she said, reaching out to give me a hug and a kiss. A sweet goodbye.

So far, I have chosen to give my home telephone number to only one patient who I trust implicitly not to abuse that information. She is an educated and self-sufficient woman who understands that our therapeutic relationship is coming to an end and any subsequent contact will be solely as friends. Additionally, I have told a few of my favorite patients that I may call them from time to time, but not to have any specific expectations. For the majority, it is a final goodbye, with the caveat that I will be working per diem shifts in the clinic and they may run into me now and then.

There are still three patients I have not told for whom I fear my departure will be difficult at best. Taking my fears into account, I am attempting to arrange joint visits with their therapists or case managers so that the news can be broken in a safe and supportive environment with another trusted professional on hand. These are the most tender goodbyes that could actually have clinical repercussions.

Overall, this process is going smoothly, and I am somewhat impatient to begin my new work lifestyle. Still, there is much work to be done---a plethora of t's to be crossed and i's to be dotted---before I can truly close that door behind me. I am processing my guilt at leaving my colleagues in the lurch, and I am also processing the fact that my professional identity---of working with the poorest and sickest of the poor and the sick---will need to change in the coming weeks and months. This does not diminish my self-chosen position as an advocate for the disenfranchised and vulnerable, but it does underscore the fact that I will not be slogging away in the trenches forty hours a week after the 18th of January. Can one leave the trenches and still be a fierce advocate for those in need of advocacy? I believe so, and I plan to figure out how to do just that.

Now for a weekend of R & R, and psychic preparation for the continued process of letting go.