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The Art of Medicine

Something old, something new

Maurer, Brian T. PA-C

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Journal of the American Academy of Physician Assistants: June 2014 - Volume 27 - Issue 6 - p 66
doi: 10.1097/01.JAA.0000446985.64434.77
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I pull into the empty parking lot, swing my vehicle around, and back into the space just outside the front door of the brick office building. It's a single-story ranch-style structure with a wide veranda that runs the entire length of the building. I slip the gearshift into park and pop open the trunk. One by one, I carry the blue cardboard boxes to the porch and stack them outside the door. Afterward, I secure the vehicle, unlock the front door, and carry the boxes inside, dead-bolting the door behind me.

The spacious room smells of fresh paint; the carpet has been cleaned. Several new office chairs stand stacked by the front window. The colorful mural on the wall depicting a large apple tree with birds and butterflies is just as I remembered.

Meticulously, I cart the blue boxes through the far door and down the hallway past the line of empty examination rooms to the back corner office. A new desk sits facing the entrance; a small bookcase rests up against the sidewall. I set a box down on the carpet and open the hanging blinds to let the morning sunlight in. I look out over the grassy knoll to the stands of trees in the wetland beyond. Come spring, there will be peepers in the swamp.

I return to the large room with the mural on the wall and lug the remaining boxes to the back office. One by one, I stack them in a corner. I stand up and stretch and feel a small twinge of pain in my lower back. At 60 years old, carting boxes isn't as easy as it used to be.

I take a break and walk through the rest of the building. In addition to the waiting room, three clinician offices are tucked into each of the three corners. Adjacent to each of these are three examination rooms; each one has a window, a bank of cabinets with a small sink, and a telephone jack on the wall. The old linoleum tile floor in the large central area that functioned as a laboratory has been replaced. A new refrigerator stands in place of the old. I open the door and count several doses of Tdap and DTaP vaccines. Some of the overhead wall cabinets have been stocked with medical supplies. In one I find a box of finger splints, rolls of paper tape, several slings and Colles splints, as well as a box of tubular gauze with a plastic cylindrical applicator. I recognize the V-shaped crack on one end. It must have been inadvertently left behind when the former practice moved out.

Finally, I enter the central business suite. A new flat screen monitor rests on the front desk; the computer is tucked away beneath the Formica top. The room looks huge without the banks of file cabinets that once held paper charts for the 5,000 patients in a pediatric practice I had helped to grow from the ground up. All of them now rested in another location, another office half a mile away, where they had been transported when my boss vacated this office 3 years ago.

I take a deep breath and exhale slowly, scarcely believing that after a 3-year hiatus I'm standing in the midst of office space I had designed and then occupied over 16 years of practice.

I walk back to where the blue boxes sit in the corner office and lift the lids. They're all there: my medical textbooks, medical articles I collected over the course of my 35-year career in practice, mementos from past patients; my framed prints. I set myself to the task of arranging the books on the shelves of the new bookcase and consider where I might hang the old framed prints. My goal is to have everything set up by the end of the weekend. On Monday we open our doors: the premier pediatric walk-in care center in the community where I've practiced general pediatrics for 26 years.

It isn't easy shifting gears at age 60. I always thought I would finish out my last few years in the pediatric practice I had helped to grow 20 years ago. But fate dealt me a different hand.

Something old, something new. Forced out of an old practice, offered a chance in a brand new enterprise: a new pediatric care facility in an old office. This time round the management is different; the future course uncertain—as uncertain as it had been 20 years ago.

When the going gets tough, the tough get going, I tell myself, lifting a well-thumbed copy of Oski's Pediatrics from the blue pasteboard box and placing it lovingly on the new shelf.

© 2014 American Academy of Physician Assistants.