When I began the practice of medicine, I used to think of the entranceway to the exam room in mystical terms. How else could I explain my patient’s willingness to suspend all social rules and norms upon passing through those magical doors? They would sit down in front of their baby faced-doctor and talk about things. Private things. Scary things.
Conversations occurred that would be unthinkable if two strangers were to meet in the outside world. I learned of abuse and infidelity, pain and yearning, secret joys and countless regrets. I bore witness to the inner pain and struggles that often were hidden from one’s closest friends and family.
People undressed. They replaced their clothes with unflattering gowns. They demonstrated their body parts unabashedly. Pointing to that which looked out of place. Wincing from pain induced by my clumsy touch.
The exam room became a safe zone. A place where judgment was replaced by support and understanding. A place where one’s darkest secrets could be revealed but not allowed to consume them.
When I abandoned my traditional practice for home visits, I feared that something important would be lost. I often wondered if there was a certain element of depersonalization that came with such sterile environs. Maybe my patients revealed their inner needs and fears because the institutional setting of the exam room was a sufficient departure from normal life.
Then there was the question of my lab coat. The wizard’s frock symbolized a certain otherness that separated me from the rest of society. Again I conjured up visions of a magnificent veil that allowed me special access of a most personal nature.
It’s been almost two years now, and I have visited countless homes without the comfort of the exam room nor the lab coat to hide behind. My fears, of course, were completely unfounded.
My patients still tell me their triumphs and tragedies. They still pull their shirts up unashamedly to show me a rash or lump or bump.
And I have come to realize that it was never the sanctity of the exam room nor the long gray coat that droops from my shoulders.
With both great awe and humility,
I have come to the conclusion that it is me.
I am the safe zone.
Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion. Watch his talk at dotMED 2013, Caring 2.0: Social Media and the Rise Of The Empathic Physician. He is the author of I Am Your Doctor: and This Is My Humble Opinion.