Wednesday, February 28, 2007

Listening

Sometimes, what a patient needs is not medications.
Case in mind, I saw a 62 year old patient for follow-up of his diabetes and hyperlipidemia. I’ll call him Jake. Someone I had been following soon after I began fellowship, someone familiar enough to me that I call him by his first name, and whose face I could picture if you told me his name.
He came in for his 1.30 pm appointment a few hours early. And because the lab was unusually slow that morning, I decided to see him in the morning.
His medical problems were well-controlled with what he was taking currently. Hemoglobin A1c 5.9%, LDL well below the 70 mg/dL goal we all strive for. As far as meetings go, that should not have taken more than 15 minutes. But it was clear Jake had more issues in his mind.
Because my calendar was wide open for another few hours, I just let him say what he needed to say.
His wife of 39 years was having an affair. With a mutual acquaintance. He spoke of how he hurt, first finding out, and then secretly recording their phone conversations. Of the pain he felt when they were being affectionate, or when they talked about sex. Especially when she denied everything to his face, until confronted with evidence. And how he felt trapped, because at their age, a divorce would bankrupt them.
And so, for 50 minutes, I just listened, nodded and shooked my head. Held his hand at times. While the tears freely ran down his cheeks, face contorted with pain.
When he stood up to leave, he did something he had never done before. He gave me a bear hug. And walked out, shoulders a bit less stooped, head a bit higher.
I’d like to think that listening helped Jake much more than the metformin and simvastatin and lisinopril and aspirin that I have him on.
It’s a reminder to me that doctors, despite our license to examine, poke, prod, treat, cut open, stitch, prescribe medications, are still fellow human beings. Nothing more, nothing less.