Lon Setnik, MD MHPE 2024-12-24 %% #note/sharing %% I sit down with a groan. So many mixed feelings running through me, most of all, *Why am I here today?* Seventeen patients are already waiting on this holiday Monday, and I’ve been asked to come in early. It’s an Urgent Care shift - one of my last at the hospital I've cried for and about, and has given me so much to over the last two decades. I just want to turn the page on this chapter. This month has been relentless. We've been working short, and I've already started at the new place. With this schedule plus my side hustle, I've worked more than I have since residency. And, I'm not good at staying while simultaneously moving on. It's been brutal to keep showing up with a smile during the contractual 120 days since my notice. Now the end of the trail is in sight - just a couple more shifts. I just need to get through today. I click on the person waiting the longest. They've been bedded for almost an hour, it's an 8-year-old boy with a cough and fever. Ugh. I brace myself for the first of dozens of conversations with the same themes I've had so many times before. "What do you want to make sure I do for you today?" I ask. They respond, "I want to make sure I'm not going to get my sister (or mother, grandmother, nephew, etc.) sick." "I need antibiotics when I get sinusitis." "I just want to feel better!" Deep breath. I can do it. All shifts come to an end. I open the first chart. It's an 8-year-old boy: panhypopituitarism, steroid dependent, absent corpus callosum, congenitally blind. Further red flags include his meds: hydrocortisone, fludricortisone, levothyroxine, and more. Oh gosh, and he was in the ER last night. He's a medically complex child at an Urgent Care with a possibly dangerous condition, on a Monday, over the holidays. *These patients don't belong in urgent care.* I think as I approach the door. I will need to send him back to the ER. They aren't going to want to go. What a mess. I take a deep breath. I think I can cover my overwhelming dread with a surgical mask. I can do it. I can be kind. It's not their fault. I spray alcohol on my hands, knock on the door, and open the door to find ... An elf's toothy grin lights the room, as warm as a sunrise cresting a mountain ridge. I recognize him immediately - he's a fun spirited kid, and his mom is on top of everything. And today, he's dressed like an elf in a full pajama onesie. They're almost as happy to see me as I am to them. And in that moment, I know why I came to work, to have them remind me why I am here.