There’s a good reason why we don’t see patients’ joy in the office

I like to think of myself as a relatively optimistic person.  If you have ever met me in person, you might think that I have a pretty sunny disposition on life.  And for the most part, I do.  Since I write every day, however, there are times when my posts may start going negative.  Not for an extended period, but long enough for my readers to wonder if am just a touch depressed.

I am not.  I use this blog as a playground for my thoughts.  Unsurprisingly, those thoughts reflect my passing moods.  Good and bad.


When I start going negative for a few posts in a row, I like to remind people of an old patient of mine named Ruth.

Ruth was problematic.  Well into her seventies, her body may have dulled but her tongue was sharper than ever.  And she used it to lash me with complaint after complaint.  If it wasn’t her knees, it was her ankles.  If it wasn’t her ankles, it was her hips.  I battled the impossible month after month, year after year.  Our interactions left a bitter taste in my mouth.  Nothing makes a physician feel more impotent than the stubborn problems that refuse to bend under our practiced hands.

I am fairly experienced with complex medical issues.  I have never shied away from diagnostic challenges.  But I have to admit that Ruth seemed to push my buttons just so.  I started to dread our visits, and winced every time her name came up on my schedule.

I am not proud of this.  The covenant between doctor and patient is sacred.   Neither a patient’s attitude nor my inability to solve her problems is an adequate excuse for such feelings.

A different view

It all changed instantaneously.  I was walking lazily through the Botanic Gardens with my family one weekend when I spied Ruth a few hundred yards away in the Rose Garden.  She was surrounded by children and grandchildren.  The young ones teased and coaxed as Ruth hopped back and forth with her walker.  Her laughter wafted effortlessly through the air.  She was alive and animated.  Her gait straightened, her limbs moved, and her face was alight with joy.  This was not the same crotchety woman whose visits I had grown to loathe.  I stared awestruck for a few moments before moving on.

A week later, Ruth hobbled into my office with none of the aforementioned spring in her step.  After making small talk, I mentioned that I had seen her from a distance at the gardens.  I talked of how alive she was among her children and grandchildren.  How her laughter caressed each brow, patted each back approvingly.  I saw no evidence of a body impaired by arthritis.

I could see Ruth appraising as I spoke.  She was waiting for me to get to the point.  Eventually, I stumbled through my thoughts out loud.  I wondered why I had never seen such joy in the office.  Although I am only familiar with a fraction of my patient’s lives, I usually have a distinct feeling for who they are.

As Ruth replied, I could see the amusement in her countenance at being asked such an absurd question.

Joy?  Meh.  You expect me to be joyful at the doctor’s office?  This is where I go to complain about my knees?

Her eyes sparkled, and I nodded with a more profound understanding of our relationship.

And so it is with my writing.

Final thoughts

I sometimes start going negative on the blog because it is a safe place for me to do so.  It is a safe place for me to voice my worries and concerns as well as my joys and triumphs.  I feel that is part of the intimacy we share.

Don’t let it concern you one bit.  I am surrounded by tons of love and support in real life as well as online.

I’ll be just fine.

“DocG” is a physician who blogs at DiverseFI.

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