It is Monday morning, the first appointment of the day.
She walks into your operatory, a little slower than she would like. You notice it in the furrow of her brow, her frustration with her aging body, the joints that ache more than last year. The furrow is tiny, gone before most can even perceive it is there. She has a natural inclination to smile. Being kind is important to her. She was raised in an era where being polite was more important than being right. Her kindness walks into the room before she does, lighting up her way. As she sits in your chair, she picks a piece of lint off of your shoulder, instantly endearing you to her.
You are not a doctor. You are her doctor and she makes sure you know it.
Being maternal comes as easy as breathing to her. Why shouldn’t it? She has raised four children and has helped raise seven grandkids. The entire family lives within 5 miles from the home she and her late husband have owned for 32 years. Every Sunday the family gathers around her well-worn dinner table to share stories of the week. Last night she made her famous lasagna. Her eighth grandchild is on the way and she beams when she tells you. Her smile is impressive. The novelty has not worn off. She loves being a grandmother and she wants to share her joy. She slowly takes out her pocketbook, overflowing with pictures of birthdays and graduations. She is so proud. She tells you about how the arthritis is getting worse and the cortisol shots do not work anymore. She tells you about battling cancer for the past year, how it’s harder to hold the kids after the chemo. She tells you about how its been exactly one year since the anniversary of her husband’s death, about how life still feels hollow without him and about how its been harder to shake the heavy feeling of sadness that sits on her heart.
She is your patient. It is Monday morning.
When you see her waiting in the reception, a full 15 minutes early just like always, do you know her name? Are you in that room waiting patiently as she walks in or do you spend the extra five minutes it will take her to get settled to finish a quick note? Do you notice the furrow of her brow, the frustration she may not even know is there? Do you ignore what it may mean that her frustration with herself grows? Are you kind in return, knowing that kind is her currency, that being kind is helping to show her how much she means to you? What does she mean to you? Is she another name on the schedule? Something more? Do you tap your foot impatiently as she tells you about the secret to the sauce in the lasagna? Do you look at the overflowing pocketbook of pictures and think about how the next patient is inevitably going to be late?
The arthritis, the cancer diagnosis, the depression… that is a clinical picture of her. But there is more, much more. There is impact on life. There is recovery and deterioration. There is hope and expectation and understanding. Behind every clinical diagnosis you make, there is a person. A life you can impact. A world you can help change for the better. There is a line that is drawn between being a diagnostician and being a doctor- another world you can cross into to expand your scope and your reach. And that world is how to be a good clinician.