"Freud, you have some of the lowest treatment numbers but some of the highest improvement and outcome rates. Your patients and their parents seem quite happy with you. I'd like to see your clinical numbers up, though," Dr Phillips said.
"I like to take my time with my patients," I said. "They're mostly young and scared. They need understanding, compassion, empathy. They're not like kids with broken bones or a cut that needs stitches.
"Be that as it may, there are always more patients. You taking that extra five, ten minutes is putting more pressure on your colleagues."
"I'm sorry that they feel extra pressure. I won't compromise my personal ethics and standards or the safety and security of my patients," I said. "Or their trust."
"You can take all the time you want with your patients when you're running your own practice. We have expectations and you're not meeting them. Well, not all of them."
"So, my patients have the best outcomes but you complain that I take too long with my patients?" I asked.
"It's not a complaint, really. It's an observation. You're seeing maybe three-quarters of the patients your colleagues are. So, your patient outcomes are better, but your time per patient is longer."
"So I'm not really understanding what exactly the issue is. You're happy with my patient outcomes, you've already told me my notes are succinct but detailed and of the whole group, I have the best patient outcomes."
Dr. Phillips looked at me for a long time. He had a slight smile on his face.
"Off the record, you're a fantastic physician and psychologist. The feedback I'm getting from your supervisors and your patients is phenomenal and I hope it's something you will carry on to private practice if you go that route," he smiled.
"But...?" I asked, my eyebrow raised.
"But, you do need to step it up clinically here. That's on the record. Now, if, for some reason, one of your patients requires some extra time, I may be able to look the other way. When you're on call for the ER, though, I have to stress speed. It's an emergency room. You need to make a quick assessment. Inpatient, outpatient, which service. We need the beds and we need to deal with the patients as quickly as possible. You might have to make a few small compromises. But yes. You need to maintain your compassion and empathy, but it can't be at the sacrifice of patient care."
"So, what you're saying, if I'm to understand is 'keep doing what you're doing but be faster in the ER?'" I asked.
Dr. Phillips winked at me.
"Remember what I said off the record," he smiled.
"You're going to be a great doctor, David. I think you're going to be one hell of a youth psychologist. Just remember, right now, you're under constant evaluation. Now is the time to toe the line. Don't make waves. Head down, get 'er done. You're near the finish line."
I nodded in understanding.
"Now, get out of here and have a good Thanksgiving," Dr. Phillips said, smiling and offering me his hand to shake. I smiled, shook his hand and wished him a good Thanksgiving.
I went into the locker room and changed into my street clothes and out of my scrubs, gathered up a few things and headed home.
There was an unfamiliar car in the driveway as I came home. Frowning I went into the house. It wasn't terribly late and the holiday wasn't until tomorrow. Mom was still awake. The light was on in the kitchen and glowing down the hallway to the door. I smiled. Living back at home had worked out really well the past few years. I had one year left of my psychology internship and then I could either start my own practice or practice in a hospital. I hadn't decided yet.
I unlocked the front door and was immediately accosted by a bushy haired ... mountain.
"Big brother!" The mountain with my dad's voice said.
Toby. I hugged my little brother who was home from Yale.
"Welcome home!" I said to him as I hugged him again.
"Look at you, mister doctor man," Toby smiled, pulling away and holding me at arm's length.
"Me? Look at you!" I said, looking at Toby. "You're a monster!"
He shrugged.
"I joined the rowing team," he said.
"You did not!"
Suddenly, we were interrupted by a high pitched scream and again I was suddenly accosted by a ton of hair.
"You're home!" My sister said. "Hi."
I laughed looking at my little sister who was now a Freshman at Michigan.
"Hi," I looked at her. "Sorry, who are you? I was expecting my little sister but not some grown woman!" I said.
She hit me in the shoulder.
"Hey! Watch it. That's my bad shoulder!" I said.
"Oh," Erin said. "I'm sorry. Did I hurt you?"
I grinned.
"Gotcha!"
"You jerk!" She punched me again. Harder this time.
"Kids!" Mom yelled from the kitchen. "Can you let David actually come in the house?"
"Aww Mom!" Toby whined. "Why do we haft let him in?"
Mom came out of the kitchen and I handed her a bouquet of flowers I'd picked up for her for the Thanksgiving table.
"These are beautiful. Thank you, David. They'll look perfect tomorrow night. Is Angela coming?"
"No," I said. "She's in California with her parents."
I hadn't told my mom that Angela and I had broken up. She had a job offer in Texas and I was not willing to leave Ohio right now. It was amicable. We were still friends and texted all the time. After Thanksgiving she was moving to Dallas. I was excited for her. She was going to do good things.
"That's a shame. Okay. So it'll be the four of us, your grandparents and a surprise guest."
"Who's the surprise guest?" Toby asked.
"A surprise," Mom said, going back into the kitchen. "David, are you hungry? I made you a plate not knowing what time you'd be home."
Mom called out from the kitchen.
"I could eat," I said. Mom smiled as she put the plate in the microwave to warm up.
"Sit, sit," she said while I tried to get cutlery.
"I can get my own cutlery," I argued.
"You've been at work all day, and it's late. Just sit down," Mom said.
So I did.
Toby and Erin both sat at the table with me and Mom sat down once she had my plate and cutlery.
"So, Erin, how's school?" I asked, digging into the meatloaf Mom had made.
"It's alright. A lot harder than I expected," she said.
"But you're crushing it, right?" I asked.
"Into a fine powder," she grinned.
Toby cracked open a beer and handed one to me.
"I am still not used to you being old enough to drink," I said, clinking cans with him.
I finished my dinner and hung out with my siblings for a little before heading to bed.
In the morning, well, early afternoon, I woke up to the smells of Thanksgiving. Mom's turkey was roasting in the oven, I could smell pies baking.
I got up, got dressed and went downstairs to see if I could help.
"Nope. Everything is under control. Your grandmother is bringing green bean casserole and mashed potatoes. Our guest is bringing salad and fruit for dessert. Everything is cooking. Go watch the game with your brother. Erin has the table to set.
Toby was watching football on TV I flopped down on the sofa beside him.
"Who do you think Mom invited to dinner? Does she have a new boyfriend?" He asked.
"How would I know?" I asked.
"You live here, don't you?"
"I sleep here. I live at the hospital," I joked. Toby laughed.
We watched the game for a while and then Erin joined us and changed the channel on us.
"Hey! I have money on that game!" Toby said. Erin and I looked at him incredulously.
"I'm kidding. I wanted to see what you two would do or say."
I rolled my eyes.
"Brat," I mumbled.
Mom had called dinner for four o'clock, and the doorbell rang at three thirty. It was Grandma and Grandpa Foster who'd picked up Mom's parents.
"Well," Grandpa Foster said jokingly. "If this doctor thing doesn't work out, you'll make a hell of a doorman."
"Arthur!" Grandma Foster slapped him lightly on the arm.
"Kidding, obviously," Grandpa frowned.
I ushered the four of them in.
They all went into the kitchen to say hi to Mom and then said hi to Erin and Toby in the living room.
The doorbell rang again so I went to answer it.
I was not expecting the people on the other side of the door.