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Chào: (Vietnamese: Goodbye/Hello)

One of the first words I was taught by my parents was “chào”. In Vietnamese, you say chào and bow when you greet someone or when you leave as a sign of respect.

In my first blog about self-discovery, I detailed the burnout and why I left clinical practice. In this second blog of the trilogy, I wanted to share encounters with patients as I told them goodbye. After 20 years of being in clinical practice, I developed long relationships with patients; some viewed me not just as their doctor, but as their mentor, their friend, and their confidant.

I assumed the envious role most hairdressers do with their clients; they tell me about their families, inform me of their worries, and reveal their innermost thoughts. These patients have followed me as I moved to 3 different practices during my career. I saw patients graduate college, shared in their joy of getting married and buying their first home, helped them through pregnancies, held their hands when they lost their spouses, and ushered them through their end of lives. 

Some patients were subjects of my blogs: Online Reviews, Lipstick Rheumatology, The Purse Exam, Freeze Tag, and The Sacred Bond.  I advocated for their health by calling other specialists to see them sooner, arguing with insurance to approve their medicines, and writing letters to Congress to improve access to medications.

Hence, when I informed them I was leaving and hanging up my stethoscope, their reactions varied. Most of them understood, thanked me for my service, and wished me the best. Still there were comments that made me chuckle. I will share with you a few of my favorites:

“OMG! You are having a mid-life crisis!” My understanding of a midlife crisis was that one would run a marathon, buy a new sports car, or get Botox as means to tenuously cling to one’s youth. I don’t think leaving practice falls into this category; I was in survival mode.

It’s almost better if you were dead than knowing you are around and I cannot access you.”  There is a reason why we were told in medical school the patient should never be between you and the door. 

I can’t believe I outlasted you!” stated my nonagenarian. I patted myself on the back for doing a great job keeping him healthy all these years.

“Now that you’re not my doctor, let’s hang out!” There are patients I would love to see again socially but others I am selflessly letting other rheumatologist share in their joy.

Marry me and take care of me!” I told this 78 year old gentleman that I appreciate his proposal, but I do not believe his wife nor my husband would permit that. Additionally, I am looking for more in a marriage.     

While I received great advice when I started practice, no one ever talks about how hard it is to leave. I experienced guilt, shame, and disappointment in myself for giving up—my own perception, never expressed by patients. With each goodbye, I was witnessing a prelude to my funeral. I consider myself humbled to be alive and to have the opportunity to hear the eulogies extolling my virtues. 

Patients brought flowers, cards, sweet treats, and prayed over me. One patient gave me a hand-carved cane from a fallen Aspen tree; he taught me the dead roots are what make the best canes, not the trunk. I have learned much from my patients; they made me a better doctor and a better person.

To my patients, I say, “Chào, it has been an honor to take care of you.”




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The author has no conflicts of interest to disclose related to this subject

Kathryn Dao, MD, FACP, FACR, is a rheumatologist and Senior Medical Director, Aurinia Pharmaceuticals, passionate about advocating for patients and furthering the field of rheumatology. She is founder and president of Rheum101. Viewpoints and opinions are her own. Follow her on twitter @KDAO2011