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A Fifth Act

Kim Duir, MD


Within a few months, I will be retiring after 37 years as a family doctor, and it seems natural to look back for a bit before moving into whatever this next phase will be. Leaving family medicine feels more than a little bit like pulling teeth, as it requires a wrenching separation that hurts like hell. Saying goodbye to patients all day long over the last few months has been both tearful and full of surprises. One of my patients had to say, “I know you are uncomfortable, but you are going to sit still and hear my gratitude.” After that, I really tried not to squirm and deflect whatever people felt they needed to say to me.


One of the families that I had to say goodbye to was the daughter, granddaughter, and new great grandchildren of a woman who was my patient for many years before she died 25 years ago. I will never forget her funeral, when the members of her amazing choir blew the roof off that packed church. I remember her attentive 5-year-old granddaughter, who came to all granny’s doctor visits and “helped” me put on granny’s wound dressings with all the seriousness she could muster. And I remember the day that same granddaughter walked into my office for a newborn visit with her first child and, most recently, her second child. The richness of these connections is powerfully addictive and it is hard to imagine what “cold turkey” will feel like in the months to come.


I have been privileged to attend Pakistani weddings and Vietnamese naming ceremonies, I have received red eggs from Mien patients for New Year, and chicken curry with handmade chapatis kept warm in kitchen towels for a surprise lunch. Scattered across these decades, there are little girls in every color of the human rainbow who carry my first name. There are names and dates in pencil on a piece of cardboard that was kept hidden in my drawer during the early days of the AIDS epidemic. We were not sure what would happen to people if word of their diagnosis got out, and the dates beside those names is testimony to the only thing we did know then; that they would all die.


It is the intensity and the longevity of our connections, and the improbable intimacy with people we might otherwise never have met, that makes the work of the family doctor so delectable and so exquisitely difficult to walk away from.


There is one thing that can ease my quite painful thoughts as I face retiring from all these irreplaceable treasures. I have seen an astonishing number of talented young people who have stepped into primary care at our clinic and they have brought their grit and their passion to this remarkable and remarkably challenging work. There is a scene in Kurosawa’s classic film “Redbeard” where a new doctor arrives from the city to replace the older doctor at a rural clinic. The older doctor simply says, “Good, you are here. Now I can go.”


As much as I will miss caring for my patients, I know that they will be well cared for by this next generation of family doctors, who astonish me every day with their wisdom, their commitment and their compassion. I honestly tell my patients that I would send my own mother to any of them in full confidence.
Good. They are here. Now I can go…



Dr. Duir with one of the babies she delivered during residency.