Sometimes what patients really need can be surprising


“I give up! I can’t help these people.” Emily was completing the final month of her emergency medicine residency and flopped into her chair with exasperation.

“What’s up?” I asked. We were on the final two hours of our shift together. And I, as her attending, was already feeling apprehensive about the patient encounter that awaited me.

“They want so much from me, and I can’t fix them!” She began to tell me about the patient in room 24 she had just met: a young woman with a benign-appearing neck mass that was diagnosed last week. We had found it two weeks ago on CT in our emergency department, and she had since seen her primary care doctor and a head and neck surgeon, received a fiberoptic evaluation, and was scheduled to have an operation to remove it the next day.

“What’s she doing here?” I could feel my own irritation brewing.

“She thinks her airway’s closing because of this thing. I mean look at her CT! It’s nowhere near her airway. She’s ridiculously anxious. She told me she wants it out today. She thinks she’s dying.”

“What did you tell her?”

“That she’s not dying.”

“Great. Is she good to go?”

“Probably not. Work your magic, she probably just needs a hug.”

I got up and took a deep breath. The door to room 24 was closed, so I could only imagine what was behind it. Should I bring in the box of Kleenex in preparation? Deep breath. Do I have my phone on me in case I need rescuing? Deep breath. Twist the door handle. One last deep breath.

“Hello!” Said a smiling face as I entered. She sat upright in her bed and seemed genuinely happy to see me. Maybe this was a ploy.

“Hi, I’m Dr. Sanjay. How are you?”

“I’m great!”

“That’s wonderful. I understand you are pretty concerned about this thing in your neck.”

“I was. I’ve seen three specialists this week, and nobody’s really talked to me about what it means. I thought this thing was collapsing my airway and every time I’ve laid down to sleep for the last week I thought it was going to choke me and I would die.”

“And now?”

“Emily was the first person to actually show me my images. She showed me where it was. I have nothing to be worried about. I feel silly being here.”


“Emily, you and I need to talk.” I deadpanned as I sat down next to her. A mortified look fell upon her face.

“Oh god, what did she tell you?”

“That you fixed her.” I beamed proudly. Her face quickly mimicked my own.

Sanjay Shewakramani is an emergency physician.

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