Progress Report

I wasn't kidding about my career change being an adjustment. Here's where I am so far:

I have started working as a contract employee for a group that does psychological evaluations for disability services. I am doing a day a week now, and will add in a second day next month. I've stopped taking new patients in private practice and am condensing my schedule to three days. It's not been exactly a smooth transition. Turns out, right now I am the only person in the office on the day I do testing. Which is just a little weird. The first day, I had NO idea about how it was all supposed to work and found myself trying to figure out how to use the fax machine and how to structure the evaluations. Also, I'd been given the wrong code to the building and someone had to let me in. Fortunately, I was only scheduled with clinical interviews my very first day, which I could do in my sleep. The other glitch has been that I keep getting scheduled to do tests that I'm not familiar with (yet) and have to get people rescheduled. I asked which tests they needed most so I know what order to tackle learning them. First up, the Wechsler Adult Intelligence Scale. I used to do those in grad school and earlier in my career but a much older version. But it's coming back to me. And I will also learn tests I've never encountered in due time. I remind myself that if I could do neuropsych evals, I can sure do these. And I got very positive feedback on my first set of reports, so I know I'm on track.  I don't even care that the office is ugly. I like just handing in my reports and not having to think about it again, and I am also very excited about being able to walk away from dealing with loathsome insurance companies.

The bigger question, I suppose, is the why of this change. Well, I'll tell you. I've been doing therapy now for 30 years. I'm a little tired. I was planning to just continue in private practice, gradually reducing my days when I got older, until I retired. And then, you know, cancer. I have to say, it just changed me. At first, I was so focused on just getting though the surgeries and chemo that I didn't really acknowledge to myself how much it changed me. And I thought that there was even a positive effect of it deepening my understanding of how it feels to have something truly frightening and difficult thrown into your life. And then... the long-term-ness of it set in. For one, the constant fatigue caused by the endocrine therapy I'll be on for a decade (assuming all goes well). And the ongoing awareness that there's a good chance it will come back. It's just an ever-present thing. Like a couple of weeks ago when I found a lump and ended up with an ultrasound to rule out a local recurrence or lymphoma related to the reconstruction. They decided it's a watch and wait sort of thing, and that's a relief. But it reminded me that life is just too short to keep doing something that I don't want to do anymore.

It has been gradually dawning on me over the past year that I'm not enjoying what I'm doing and I no longer have much patience for minor complaints. When someone walks in and says, "I have been up since 5:30," I think, "Wah." Hell, I can't even remember the last time I slept through the night and being awake for hours in the middle of the night has become commonplace for me. Headache? Cold? Sprained ankle? Need for a tonsillectomy? Big deal. And not just physical problems, but all the minor little glitches that make up life. The guys putting in your new HVAC knocked over a vase? Your car needs new tires? Your friend gets annoyed when you offer unsolicited advice? Well, suck it up. All those sorts of things fall solidly under the category of "it's not cancer" for me. My partner laughed and said, "You've lost your EFA." Which, it turns out, means "empathy for assholes." Clearly, it is time for me to pass the torch.

Our office lease gets renewed the beginning of every July, so that's my outside end date. It's too soon to tell patients just yet, although I know that's not too far away. And I'm anticipating some reaction. But I know it's the right move for me and for my health. It's increasingly clear that practice is taking a toll on me.

At this stage in the game, therapy is easy for me. Maybe too easy. And although it's a little nerve-wracking to do something pretty unfamiliar to me and walk away from a practice and referral base I spent years building, I am confidant that it will be a good change. I've got this.