Reciprocity. It happens in clinic sometimes, genuinely and lovingly. Someone says something in a way that gives me far more than I can dish out in a 20 minute clinic visit. It’s things like this, on top of genuinely getting to know my patients and their families, that keep me going back in each week. To steal a phrase from a friend, I’m really “happy to help & thrilled to be here.”

Really and truly. I’m not a PollyAnna; there certainly are bad days when I want to go home and snuggle with my boys, turn off the computer, and slow down. But really the general pulse of my life is that I’m thrilled to be here working, sharing, learning, and giving.

Primary care is fraught with difficulties. There is paperwork (read: piles), tedious e-mails, phone messages to return, lab values to review, refills to sign, new protocols to incorporate. This all sandwiched in between clinic visits with sick children and worried families. Emails and Twitter feed wedged between heart disease and plantar warts. It is complicated to manage this and busier that I ever imagined it would be. But it is still really good.

My week was overstuffed. Like a chicken with far too many lemons inside or some grotesque burger you see on TV with condiments piled obnoxiously high. I said, “Yes!” one too many times. So I’ve been spinning all over the Puget Sound this week. Between meetings and interviews, clinic visits and bedtime stories with the boys, I’ve been trying to make sense of my commitments and over-extentions.

But something happened last night in clinic that made it all okay and helped me remember how privileged I am to be a pediatrician.

Real reciprocity.

I read a commentary earlier this week about why a pediatrician quit her job. The logistics of primary care ate away at her at just the wrong time, I bet. She left practice for other work. Reading it left me feeling a little vacated. I didn’t really relate to much of it. I, too, like so many of my colleagues, am overwhelmed with the reduced reimbursements, lessening time with patients, ya-da-ya-da-ya-da. But really, being a pediatrician doesn’t have to be about any of those tedious details. What I remember from my days at work are the children I see and care for, not the WIC paperwork I filled out.

So the reciprocity. Last night a parent stopped me just as I’d opened the door to leave. He said, “How are you, Dr Swanson. How is your family?”

Lots of people ask me that. Many of my patients inquire about my life and seem to really care about me and my children. But this was different. I closed the door and stepped back into the room. I gave a real, solid, non-canned answer about how I was. This father went on to explain that he’d recently lost his grandfather. He was re-examining things in his life. He realized he’d worked himself into a corner of stress and didn’t like it. Loss had redefined what was meaningful. He worried that I might be the type to over-commit and do too much work. He wanted to make sure that I knew he was thinking about it. He reminded me, in just the right way, that maybe I needed to step back.

So I will. I’m going to take a few days off. As are hopefully all of you. Happy Memorial Day weekend. Safe travels if you have them.