Barrett L. Dorko, P.T.

Journal Entry, Nov. 15, '96:

Last night a vivid dream of being in a restaurant, watching Dad seating people, and Mom behind a large grill, having walked over there from the oven where she was baking pies.

Dad is watchful, making sure Mom's okay.

I feel contentment, safety, and at home.

I really would like to lead a simple, quiet and uncomplicated life.

It's hard though. As it turns out, I didn't choose a profession that lends itself to simplicity or complacency.

In private practice for eighteen years now, I've watched the expansion of our services and growth of income common in the 80's become the half-empty schedule and spare payment of the 90's. I feel today that almost nothing I ever did as a clinician, or said to any referral source had much affect on all of that. I controlled it about as much as I did last night's dream.

I get those flyers in the mail from corporations offering to teach me how to grow again, how to prosper in a time when the entire healthcare system seems to have conspired to gut the profession. I don't know, maybe I should take their advice. But just now I'm thinking about all the chores at home this weekend, the writing I've promised to others, something leaking from beneath my car, my bald spot. I don't feel like focusing on a major career move right now.

There's a new patient due at my office in a couple of hours. I have no idea what she expects or if I can help her. I probably will, but I'm way past predicting such things. Maybe I'll learn something more in her presence, maybe I'll say exactly the wrong thing. I've begun to feel that the future of my practice, and the future of my profession, is about as easily predicted.

A good friend and wonderful therapist from a neighboring state called this morning. He tells me that he has a total of eight patients scheduled next week. He wants me to help him write something to give to the docs, something that may convince them that his practice is special. This has never worked for me, but I'll try. I know he loves his work, and feels it slipping away.

My father called. He had a dream recently of standing in a riverbed, picking his way forward among beautiful rocks that support and delight him. The water is flowing fast and loud.

He says, "I'm trying to make my way up the embankment. There's a road above that I can see. It's like Detroit Road up the driveway from the nursing home as I leave each night. I don't know how I'm going to get there, but I hear someone tell me not to worry, that I'll make it. You should have seen the rocks Barry, they were gorgeous."

These days my father seats and serves just one customer each day. He remains watchful for Mom's well-being, and he knows that one day he'll make that trip up the embankment to Detroit Road for the last time.

Some days my schedule doesn't reflect the many years of effective care I've provided, or my hoped-for confidence from the medical community.

Often I have the time to sit and dream, to write in my journal, and feel the stream of my practice rush past or suddenly become a trickle.

I need to remember that the rocks beneath me really are quite beautiful, and that somehow I'll make it.

I want so much to feel the contentment and safety I had in last night's dream. I want to feel at home again.