I Was Done Before I Said It Out Loud

I knew I was done on June 1.

Nothing particularly dramatic happened that day. No one stormed out of the office. There was no catastrophic financial event or giant neon sign flashing, KIRSTEN, IT IS TIME TO GET THE HELL OUT.

One of my coworkers had just left on vacation, but before they left, I received a long list of messages about everything that was wrong. This patient was being difficult. That patient wasn’t following the plan. Someone had done something incorrectly. This needed to be fixed. That needed to be handled.

Basically a pretty standard Monday in my world.

Normally, I would have started working my way through the list because that is what I do. I solve things. I smooth things over. I figure out who needs what, what needs to happen next and how to keep everything moving without anyone seeing the twelve small fires burning behind me.

Except this time I looked at the messages and thought, I don’t want to do this anymore.

And then I had an even more surprising thought.

I don’t have to.

That was it. After eleven years, I was done.

Of course, no one becomes done in a single day. June 1 was just the day I finally stopped arguing with myself about it.

Our clinic began with Susan and me. It was small, personal and honestly pretty special. Susan was one of those physicians people immediately trusted. She was kind and empathetic and genuinely interested in the person sitting in front of her. She made people feel hopeful without selling them a fantasy, and she had a way of seeing someone as a whole human being instead of a collection of symptoms attached to a billing code.

People loved her.

They also loved us together. Susan was the healer, and I figured out how to make everything around the healing happen. We were a duo. It worked because we trusted each other, we had fun together and we cared deeply about the people who walked through our door.

It was also affordable enough that we could help more than a very small group of extraordinarily wealthy people, which mattered to both of us.

Then we added IV therapy, so we needed a nurse. We bought a larger space, which meant more rooms, more equipment, more staff, more services and bills that continued arriving with impressive reliability whether we had a good month or not.

We added injections, acupuncture, peptides, ozone therapy, and other cutting-edge treatments we believed could help people. There was always something new to learn and another way we thought we might be able to serve our patients better.

But every new thing made the business more expensive to run, which meant we had to charge more, which meant fewer people could afford us.

That became harder for me to reconcile.

We were sitting in the middle of a community full of people who needed help, while increasingly serving the people who could afford to spend thousands of dollars outside of insurance. Many had second homes in our town. Lovely people, many of them, and just as deserving of good care as anyone else. But I couldn’t ignore the fact that there were people living a few miles away who needed the same care and would never be able to walk through our door. People just like me.

I understood the economics. We were a business, not a charity, and apparently banks, vendors, and insurance companies remain oddly uninterested in being paid with good intentions.

Still, it bothered me.

Then we adopted a new business system designed to make the practice more profitable. It required a significant investment of money, time and energy, including hours of training on how to turn educational presentations into consultations and consultations into programs that were not inexpensive.

I hated it.

I understood why we were doing it. We needed patients, we needed revenue and we needed the business to remain solvent. But the whole thing felt more like a sales process than healthcare, and no amount of training was going to make that feel normal to me.

I didn’t want to “overcome objections.” I wanted to listen to people. I wanted to help them understand what was happening in their bodies and make thoughtful decisions about what to do next. I wanted the work to feel individual and compassionate and genuine.

Instead, I was sitting in a conference room learning how to convert more leads.

Nothing says healing quite like a carefully optimized sales funnel.

Around the same time, Susan stopped seeing patients to focus on new ways to manage her own declining health. We searched for another physician who could step in without needing years of training. We had tried hiring younger practitioners, paying for functional medicine education and teaching them what we knew, but that came with its own set of challenges. Susan and I are Gen X women. We were raised on some combination of figuring it out, sucking it up and understanding that the reward for doing your job well was usually more work. This occasionally created what I’ll politely call a generational disconnect.

Eventually, we found an experienced physician who seemed like the answer to everything. She was our age, had practiced functional medicine for years and came with an impressive background. We truly thought we had won the jackpot.

It didn’t work out the way I hoped.

The warmth and partnership I had shared with Susan weren’t there. The energy in the office changed. There was more tension, more negativity and a steady stream of problems for me to manage. Everyone could feel it. Susan was traveling for treatment and was no longer involved in the daily business, so everything landed with me.

And while all of that was happening, my personal life blew apart.

I moved my parents from California to Santa Fe because that was where my mother wanted to live. One chilly day, my dad fell on some ice and no one told me. A few months later, we knew something was terribly wrong and discovered he had a slow brain bleed.

He had surgery. At first, it looked like he might recover, but afterward, things became increasingly complicated and then increasingly awful until my mom and I had to make the decision to let him go.

I watched my father leave this earth. There is no eloquent way to say that because there was nothing eloquent about it. It was horrific and heartbreaking, and afterward there was still an entire life to deal with.

My parents had bought a house that needed to be completely remodeled. The day my dad went into the hospital, they had to move into a small Airbnb studio so construction could begin. After he died, the remodel continued because grief apparently does not stop contractors from needing decisions about tile, paint colors and plumbing fixtures.

My mother was grieving. I was grieving. We spent seven months finishing the house. The house my father would never get to see.

Then my mother was diagnosed with breast cancer and had to have a double mastectomy. She needed me more than ever, and my heart hurt for her in a way I can’t really explain. She had just lost the love of her life, and now she had to deal with this bullshit too. It felt cruel.

Through all of this, I was still running my clinic, or trying to. I couldn’t give the business the attention it needed, but I also couldn’t give my family anything less than what they needed. There was no correct balance. There was just me moving back and forth between two parts of my life, feeling like I was failing whichever one I wasn’t physically standing in at the time.

For a long time, I kept thinking I could fix it. If I worked harder, found the right person, solved the next financial problem or got everyone pulling in the same direction, maybe the business would feel good again.

I think what I was actually trying to do was get back to the beginning. Back to the days when it was just Susan and me, when the work felt intimate and hopeful and we knew exactly why we were doing it.

But that version of what we had built together was gone.

That doesn’t mean what replaced it was entirely bad. We still helped a lot of people. I worked with some extraordinary women, and I’m deeply proud of what we created and the care we gave. There were beautiful moments right up until the very end.

There were also very real expenses, complicated relationships, impossible decisions and a business model that required more and more of me while giving me less and less of what had made me love it.

I had become very good at keeping it all going.

Maybe too good, because when you are competent, people assume you’re fine. If the bills get paid, the problems get solved and everyone receives a response, it looks like things are working. No one necessarily sees what it takes to make them work.

Sometimes even you stop seeing it.

That is the trap of being capable. Because you can carry something, you begin to believe you are supposed to. Other people believe it too, which is extremely convenient for them.

By June 1st, I had run out of ways to convince myself that being able to keep going was a good enough reason to keep going.

I didn’t want to spend the next several years managing negativity, chasing revenue and carrying the responsibility for a business that no longer felt like mine. I didn’t want to keep giving my best energy to something simply because I had once loved it.

I wanted to write. I wanted to help people in the way that had always felt most natural to me, sitting with them, listening, helping them make sense of complicated information and making sure they didn’t feel alone between appointments.

I wanted control over the cadence of my own day.

Mostly, I wanted my life back.

Closing my clinic doesn’t mean those eleven years were a mistake. I don’t regret what Susan and I built, and I will never stop being grateful for the patients who trusted us or the people who stood beside me through all the different versions of the business.

But loving what something once was is not a reason to stay inside what it has become.

I’m taking the best parts with me. The relationships. The experience. The ability to sit with someone in the middle of a health crisis and help them find the next step when everything feels confusing and terrifying.

I’m leaving behind the overhead, the sales pressure, the constant responsibility and the idea that my value is somehow measured by how much I can carry without dropping it.

I don’t know exactly what this next part will look like. For someone who has spent most of her life making plans, solving problems and knowing what comes next, that is both wildly uncomfortable and kind of exciting.

What I do know is that being good at something does not obligate me to do it forever.

Sometimes you do everything a chapter asks of you. You learn from it, love parts of it, survive the parts that nearly flatten you and eventually realize you have reached the end.

Then you close the damn book and start writing another one. That’s where I’m at now. I don’t know exactly what comes next but it finally feels like mine.