7:00 am

I start the day with an emergency department follow-up for a patient diagnosed with disseminated coccidioidomycosis meningitis. I confirmed that she had valley fever 3 months ago, but she declined treatment. Today, she expresses gratitude that I had tested her, which enabled the ICU team to identify her condition quickly when she arrived unconscious. Now on lifelong treatment, she regrets not starting earlier but is thankful to be alive.

9:00 am

I see my 26-year-old patient who is recovering from a left parietal embolic stroke. Her initial echocardiogram at the hospital did not reveal a patent foramen ovale (PFO), but repeat echocardiography with bubble study after her discharge confirmed its presence. She is relieved to finally have an explanation and is optimistic about her upcoming PFO closure.

1:00 pm

I perform an IUD insertion for a 30-year-old patient with a history of seizures and a complex medication regimen. She is thankful that her family doctor could perform the procedure.

2:30 pm

I follow up with a 45-year-old patient under gynecologic oncology care for endometrial cancer that we diagnosed last year. She shares that she is feeling anxious, so I facilitate a warm handoff to integrative behavioral health.

3:00 pm

I meet with a patient who has type 2 diabetes and is a World Trade Center attack survivor with a complex oncologic history. As I review his care plan, I reflect on his resilience and courage.

4:00 pm

I end the day with my 67-year-old patient who was diagnosed with a lower extremity thrombosis. She feels grateful to have a primary care physician in her corner to help navigate her care.

10:45 am

I see a woman in her 40s with severe nausea who comes in with her husband. I order an HCG urine dipstick pregnancy test, and the results are positive. The pregnancy is a surprise, but they are thrilled. Their joy is contagious and a pleasant diversion from the colds and flu that dominate this time of year.

11:10 am

A woman arrives using borrowed crutches after she fell while bouldering. She has broken her ankle and is anxious about whether she will “ever walk again.” I tell her that not only will she walk again, but she may even master bouldering…but not for at least 4 to 6 weeks.

2:25 pm

A 45-year-old man presents with an inflamed sebaceous cyst on his neck. While I do my best to channel Dr. Pimple Popper, we talk about his son who is going to maritime school on the GI Bill. Sometimes, doing procedures is a nice way of getting to know my patients.

4:00 pm

A couple who are in their 80s are ushered into the room because the husband has been feeling dizzy for days. I am shocked at how young they look; I say to them that I must be in the wrong room because I was expecting a couple of old people. That breaks the ice. They relax and smile. The dizziness turns out to be due to positional vertigo. They thank me for saving them a trip to the emergency department.

7:10 pm

I check my inbox and see that a 99-year-old patient has passed away. At a recent visit, she was just as spry as ever and still had that delightful twinkle in her eye. I send a handwritten condolence card to her daughter. Sending condolence cards is a practice that I have done since residency, and I will continue to do this until I hang up my stethoscope.