"Follow up in two weeks? No, I can't, I'm moving to Siberia."

Spent over an hour with a patient today. Went through the list of her problems, came up with a medication plan, set out a list of tests she needs to come back for, specialists for her to visit, a comprehensive plan to address her issues... felt like a successful visit... until the very end, when I handed her the prescriptions for the medications, and the slips to take to get the tests she needs... "So you'll do all of this and I'll see you back here in two weeks?"

"Oh, no, I can't come back in two weeks."

"Okay... when can you come back?"

"Never. I'm moving to Siberia [not Siberia, but may as well be] next Monday."

"So you're not even going to be able to get these tests done by then..."

"No, no time."

"And the refills on the prescriptions... you're going to have to go to another doctor, in Siberia, because these won't work halfway across the world..."

"Sure, yeah. I mean, not right away, but I'll try to find someone."

"So this whole visit was just sort of an exercise, in a way, because you can't actually follow this plan we just put together..."

"Yes."

"Why didn't you tell me you were moving to Siberia?"

"I didn't think it mattered."

"Well, bring a medication list, and try and see a doctor there. Good luck."

"Thanks."