So this week I need to decide whether to close my clinic.

That is, it looks like I will have to.

I went home sick on May 30th, 2014. My blood tests were positive for strep A a second time. I coughed horribly. I went to the emergency room twice.

I tried to go back to work in August. My doctors allowed me to see five patients total the first week. Then four patients a day for three weeks. I would cough through each visit and fall into an exhausted sleep afterwards. The doctors took me back off work.

Pulmonary saw me. Abnormal pulmonary function tests in October, the 5th month after getting sick. An abnormal CT scan "probably not cancer". Bronchoscopy showed inflammation and the infection was gone from my lungs. Home. Rest, rest, rest, write, do not talk or I coughed.

I stopped coughing by Thanksgiving. I saw neurology, because my muscles still were weak and I was so tired. He sent me to otolaryngology, who sent me to immunology, who sent me to infectious disease. I am on a low dose of penicillin twice daily. No one knows if that will keep me from getting strep A systemically again. Mortality for sepsis, a systemic infection, is 28-50%. Sepsis is on the rise. Once you get it, you are more likely to get it again. I've had it twice. Once after my sister died and a year after my father died.

My repeat chest CT was clear on December 28th. I was like a cat on a hot tin roof that day: I was more nervous about cancer than I realized, since both my mother and my sister died of it, young and younger. I finally started wanting breakfast in mid-January. I still go to bed at 7 or 8 if it was a tiring day. My sleep has been great all along. I felt like I really got my brain back in January when I could eat breakfast. My weight finally returned to pre-sickness level. Strength and muscles are lagging.

I managed to hire a physician assistant in December. But the patients want me back. I had to ask another doctor to supervise the physicians assistant, I am not allowed to do that. But I am still the CEO of my small clinic.

And the CEO says that the low budget model works. In spite of seeing an average of 7 patients a day for only six months last year, we broke even. But now the patients are steadily moving away, we are at 9 months, and the doctor is still not released to work and is not well. The CEO (me) said to the financial adviser that the model works, we just need a doctor (currently me) who bloody well doesn't get sick all the time.

So, we will have been open five years on April 30th. It looks like we will close at the five year anniversary.

Farewell, little clinic.
A friend sent this: loser

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