Everywhere I looked I was reminded of what I was losing. As I walked through the waiting room, I could feel dozens of pairs of eyes staring at me in disbelief – the leaving letter I’d written to patients was pinned to the notice board.
I crossed the tree-lined street to the coffee shop opposite the surgery, but the atmosphere in there wasn’t much better. Sandra, the pharmacist from the chemist next door, was in front of me in the queue. She’d been dispensing medication as long as I’d been a GP in the area. I thought she was going to mention the article, but she had other news for me.
‘It’s as if the village is in mourning,’ she blurted.
Sandra had become a close friend over the years. She had the kindest face, which was framed by her masses of chestnut hair. She wasn’t much over five foot tall, and looked up at me with her dark eyes.
I couldn’t respond. I had no idea what to say. She carried on, every word tugging at my heart.
‘Your patients are so sad. They don’t know what they’re going to do without you. Amanda, do you really have to go . . .?’
I gently squeezed Sandra’s arm. Really I wanted to throw my arms around her and give her a bear hug.
‘I’ve made my decision, and I’m just going to have to see it through now. I feel terrible though,’ I admitted. The urge to cry rose up in me. That was the last thing I needed: to burst into tears in the middle of a coffee shop queue.
Then came the big question. ‘But what will you do now?’
Well, yes, what indeed?
‘I guess with your experience you could easily get a job in another practice,’ she continued.
That was the last thing I wanted. I’d be faced with the same problems, just in a different location. But what was I going to do? I felt like I was going through a bereavement. I felt sad, lonely, lost, unable to see a way forward, a thick dark fog of self-doubt and guilt obscuring my vision of the future.
Suddenly, the roasted aroma of coffee beans smelt acidic, nauseating and unbearable. The sounds of the café, the white noise of chatter, the hiss of the milk steamer . . . It all felt more than I could bear. I felt waves of heat rush up my neck and I was desperate to return to the chill of the winter air outside.
It was torture. What had I done?
‘I’m going to have to get back to work,’ I said to Sandra.
‘But you haven’t even had your coffee. We have to do drinks before you leave . . .’ Her voice trailed off as I gave her the thumbs up and dashed for the door.
Outside, I took a few deep gulps of air, drinking up the freshness in place of my coffee. I felt like crying. It was all too much. Seeing my outburst in the magazine, hearing how my patients were feeling and then, of course, the final panic: the realisation that I didn’t have the faintest idea what I was going to do with the rest of my life.
Back inside my consultation room, things went from bad to worse when Mr Collins knocked on my door.
If only I could have hidden behind my desk for the afternoon, but there was no getting away.
‘Come in,’ I said, hiding behind a cheerful voice.
Brian Collins was one of my long-standing patients. He was 56 years of age, tall, with grey receding hair, and was always clean shaven. He had long spindly fingers that always made me think he should play the piano.
Brian poked his head around the door and gingerly made his way across the mottled carpet towards my desk. His steps were uncertain; a man whose confidence had taken several knocks.
He’d been on and off antidepressants for as long as I could remember. They eased his depression, but then he would stop taking them, convinced he was feeling better, only to fall back into a depressive slump.
Brian was typical of so many of the patients I saw at my practice. Wealthy, successful, middle class, well-spoken. The stereotypical pinstripe-suited man who travelled into the city every day. When I’d first started working in the area, he was the type of man I must admit that I felt a bit intimidated by, as I thought they might not trust a young female doctor. But, to my surprise, I managed to win him and many other patients over. I think as much as anything else it was by showing them that I really cared about them. I’ve always believed that the root cause of many illnesses can be found in the emotional problems that lie bubbling underneath. The problem then became that many of my patients seemed to depend on me as a counsellor, more than as a doctor . . . Mr Collins was no exception.
‘What can I do for you, Brian?’ I asked, my voice gentle, warm, doing my best to set him at ease.
His eyes were downcast as he slumped into the chair opposite.
‘Is it really true you’re going?’ he said, his eyes filled with worry.
It was the first time I’d come face to face with the effect my departure was having, and it was unbearable. The tension in my little consultation room was palpable.
‘Yes, I’m afraid so.’
He fell completely silent for a moment, staring, intently, at one spot on the carpet before finally looking me in the eye. I could see the tears. It was heartbreaking to watch.
He tugged free a tissue from the box on my desk and dabbed the corners of his eyes.
His voice trembled. ‘But what will I do without you? You’re the only person who understands what I’m going through, and I find it so hard to open up to people.’
His fears were completely natural, and were shared by many people who might feel anxious about changing their doctor.
‘Will you be moving to a surgery nearby?’
I opened my mouth to speak, but nothing came out. I was going to tell him no, but the question had thrown me – all the way back into that pit of uncertainty. I swallowed hard and whispered. ‘I don’t think so.’
His eyes dropped again, crestfallen, and then he suddenly lurched onto his feet.
He shot out his hand, as I imagined he had done hundreds of times in his board meetings, disguising his distress with formality.
‘Well, I wish you all the best for the future, Doctor Brown.’
I felt a lump rise in my throat as I shook his hand.
‘You’ve been wonderful and I really appreciate everything you’ve done for me over the years,’ he carried on in his rigid, staccato voice. ‘And anyone who has you as their doctor next is blessed.’
I bit my lip – hanging on by a thread to stop myself breaking down in tears. Hiding behind my medicine, I told Mr Collins to continue with the same dose of antidepressants, and to review how he felt in three months.
I walked him to the door and we had a moment’s silence, both aware of each other’s grief. ‘Things will get better,’ I encouraged.
With that, he slipped out of the door and I broke down, the avalanche of the day’s emotions crashing in on me.
It was no good; a doctor’s life is a constant flow of difficult situations, of emotional patients, of pain and sadness and death. I needed to be stronger than that – I was stronger than that, always had been – but I just couldn’t see how I was going to get through the next few weeks.
My phone rang.
I wanted to leave it ringing, and I almost did, but I needed something – anything – to pull me out of the low mood I was descending into.
‘Is that Doctor Brown?’ asked a voice on the line.
‘Yes, who’s speaking?’
‘It’s Doctor Phil Burn here. I saw your