no good at goodbye

it was the first of july- and my last day of work.  i'm not good at last.  i'm not good at goodbye.  i'm good at first- i'm better at hello.  lately my life feels like a lot of lasts- and lately,  it's been creeping up on me.

friday, i had clinic, my last clinic. and friday, mr r. was waiting for me when i got up to clinic.  he is also a writer.  he had written two poems and that was pretty much why he was there- to share them.
so i'll share one too.

'the world changes every day
this i know is true.
it doesn't matter what you may say,
it's all about what you do.

if you only go around to criticize
the things others try to do-
your life will be built of only lies
because you have to contribute too,

it's not what this person or that has done,
when everything's finished and through
if you can't greet the morning sun
having done all that you can do'

love it.

the next guy was someone i hadn't seen in 18 months- one of my first patients at the VA.  a relatively young guy with parkinsons disease- who comes to clinic with his ex-wife. another one of those women who give and give and care- and take care- of these guys- just because it's the right thing to do- just because no one else will.  i love this- it teaches me.  it reminds. it is right.

then i got a message from my next patient apologizing for missing his appointment- because he is in the hospital- because he's in the icu with an arterial clot.  badness.  but he thought to call, and cancel, and to say goodbye.

then a new patient with pancreatic cancer.  a vietnam combat vet who grew up with 10 brothers and sisters barefoot in the countryside of the deep south.  a man who'd made wise choices to overcome things.  a man who knew his character and chose to be true to himself even when that was the harder thing to do.  a guy who chooses peace- a guy who lets go.  i had to say both hello and goodbye, and thank you- because he reminded me of things that needed reminding.

then mr. w.  my dear old mr. w.  mr. w who i wanted to say goodbye to.  mr. w who i'd been looking forward to seeing all week.
he didn't show up for his appointment.  so i called him.  he is not getting out of bed.  he is full of fluid. he'd missed his appointment 3 days ago to get the fluid tapped- there were transportation issues- even though he lives with someone- even though he is on hospice.  and it just made me so sad.  it just pushed my buttons.  for some reason- all the sad of my leaving and all the sad of letting go- of this job, with these vets, in this place, and all the sad of everything became all wrapped up in mr. w.  and while talking about his case with a colleague- i began to cry- just a little- just teary-not the ugly cry.

and then she said that thing that you never want to hear when you're teary and hoping not to really loose it- she said "i know you have so much on your plate right now- and that you're so tired..."
no! don't do it!! don't acknowledge my overwhelm! don't call out all the junk i'm bringing to the table!
doh.
so i got a little more teary- but then i pulled it together and set up an ambulance to go get mr. w and bring him in so we could tap the fluid and get him home to louisiana.  i had to call his son and tell him the plan- and that i was leaving- and that i wouldn't be around for the family meeting that needed to happen- because i'm moving to africa and this was my last day.  and it just sounded absurd coming out of my mouth.  he thanked me for all i'd done- 'i 'preciate you- we all do'. 

i got called from oncology to go see the patient who has eyes like my dad- he wanted to say goodbye- but i didn't.

and then to torture myself even more- i called mrs. b- to check on her and her husband.  but i couldn't do it- i couldn't say good bye.  i will call again next week- from boston- maybe from africa- i just can't say goodbye.

friday afternoon i got a card from my 'fellow'.  a woman i've trained for the year- a woman that i've coached in how to talk to people that are really sick, people that are dying.  she has watched me talk to patients- prescribe medications- and has run her plan by me for each of her patients all year.  it was a beautiful card.  a keeper.  it was thankful and praising- and it made me feel worthwhile. she is good at goodbye.

saturday morning we got up early and cleaned and packed and left.
we drove 18 hours to boston- the five of us.  18 hours away from what was 'home'.

and while driving somewhere in pennsylvania, i found out that mr. w never made it to the hospital that night.  he called to tell me the ambulance didn't come, and that he was hungry- and could i get him something to eat that wasn't too spicy.  and i was so mad.  at the system.  at the negligence.  that after a lifetime of neglect as a homeless veteran, he wasn't now treated with ultimate respect. that what i'd set up for him, hadn't happened.  i made calls, i made it happen again, i told him to go to the hospital- his son would bring him, the team would be waiting. 

i still didn't say goodbye.

today we arrived. new england.  mikes parents home.  the house i've come to for the past 22 years- my closest home.  sitting outside, not on a porch, but a patio.  the night is growing around me and the neighbors are playing basketball- otherwise it's quiet- no tree frogs.

it smells different than georgia- more earthy and less sweet.  my kids are watching a movie with their cousins. we've drunk some wine and had lasagna.  it is good.

but i'm here in new england to say more good byes.  and i'm no good at good bye.

i'm just not good at goodbyes.