A new patient was on my schedule the other today. She was coming in at 4 pm for a CPE — “complete physical exam.” I had never met her before.
A handful of patients each day are brand new to me. It’s always a crap shoot if they are going to be nice or mean, rocket-science or simple, or somewhere in between any of that. Either way, I always try try to put my best foot forward.
The brief description next to her appointment slot on the computer screen told me she was 52 years-old. As four o’ clock approached, I perused the chart to prepare for the visit. Usually I look for things such as outstanding issues that came up with the previous doctor — perhaps a bad knee or poor sleep. Also, what medications is she on? Does she have an any unfinished labs or imaging that were ordered, and still need to be followed up on?
In her case, it appeared there wasn’t much going on. No meds. On computer, she seemed pretty healthy. The only thing I came up with, is that she might need a mamogram.
My MA (medical assistant) let me know she was ready to be seen. I read what the MA wrote as her “chief complaint:”
“Patients has no particular issues, she just wants an annual exam.”
Okay. We’ll see if that’s true. A lot of times people will say this to my MA, but it seems like they usually save a little something up their sleeve for me. For instance, the 17 year-old I saw earlier that day for a CPE, who reportedly had no complaints, presented me with “a bubble on the bottom of my toe, and I don’t know what it is.” These kinds of seemingly-simple issues are usually the ones that stump me, as opposed to, “I have a splitting headache and my back is out.”
I figured his bubble was a wart, even though it didn’t look exactly like a wart. Whatever it was, he didn’t need it, and so we froze it off.
Just as I am about to head down the hall to meet this lady, a pathologist calls me regarding another patient. I had left a message with the pathologist earlier, and since I don’t know when we’ll connect again, I take the call. Turns out, it takes longer than I would have thought. It’s a complex case.
20 minutes later, and 34 minutes after 4 pm, I enter the 52 year-old lady’s room. I hate to keep people waiting, and I carry this guilt with me. Some people are nice about a doctor running late. Others are less forgiving.
I step into the room, and she greets me with a big smile. She is sitting in a chair, and standing next to her is a young boy, three or four years old. He greets me with a shy smile, and then looks down.
I ask who the little one is, and she says, “This is Ian, my grandson. I adopted him one year ago.”
Ian looks back up at me, smiling. I can see he is curious. He says something I can’t quite hear. His voice is sweet. She tells me he is wondering what we are going to do.
I tell him I am going to visit with his grandma, and make sure she is healthy.
I open our conversation by apologizing for being late. She say’s no problem. I don’t immediately ask what the story is about the adoption, but I wonder.
She is a nice lady. She smiles often. She has shoulder-length blonde/graying hair, and is wearing a white summer blouse with blue flowers on it.
I ask her if anything is on her mind. No. I ask her about her general health. It’s good. I ask her if she has any requests. She doesn’t.
I ask, “Are you eating, sleeping, exercising okay?”
She brightens up. She is! As far as exercise goes, at least. She announces that she walks about 10,000 steps per day, and points proudly to the tan-line on her wrist where her fit-bit usually sits. She’s not wearing it right now, but this is what really keeps her on track.
I listen to her heart and lungs. I do the rest of my exam.
After that, we begin to wrap things up. This is when she mentions that the last year has been pretty tough.
Her husband left her a year ago. They got divorced after 25 years of marriage. He started doing drugs.
Her daughter is also doing drugs! That’s why she adopted Ian.
I listen. I ask her how she is doing, through all this. Would she like to see a therapist? I say that sometimes it helps to talk to someone when you are going through a tough time. Heck, sometimes it helps to talk to someone, period!
“A tough time” — isn’t that what life often is, I think to myself?
Hearing people’s struggles helps me put my own in perspective. My boyfriend and I up and down, lately. I don’t know if we’ll last. It’s weighing on me, heavily.
I feel this lady’s energy. I know I’ll be okay, either way.
She tells me she’s not interested in counseling — she’s choosing to stick with positive people, and that really makes a difference. Also, she is going to church, and that helps.
I believe her. I can see that she doesn’t really need to see a counselor, at least not now. Her eyes communicate strength, pain, and joy.
This lady is strong.
I think about walking. I think about how I can walk, no matter what happens to me. Walking is a good way to get through things and to remind you that you are strong. It’s a good way to gain perspective.
I also think about choices. You can decide you are going to stay positive, even if you are going through a tough time.
I am going through a tough time. I admit this to myself. But, it’s probably not as tough as this grandma has been through in the last year!
Her resilience has worn off on me. I leave the room, joyful. Schooled.