A wish for my patient

Lai, Joshua

Liz was a true frequent flier. At least, I was never surprised to see her sitting on the exam table, her bleached blonde hair hanging over her pink iPhone, fingers madly texting someone. When I'd enter the room, she would always be swinging her legs back and forth like a little girl, and when I'd say "Hi", she would look up, and then back down again at her phone. Then the scent would hit me. Always the same pungent, flowery perfume to match the pink lacquered nails and the thick layers of makeup hiding her naturally pretty face.

The very first time I saw her, she had come in because of recurrent epigastric pain. As most medical students are, I was eager to practice my history-taking skills. She'd had this pain for a few weeks, and the antacids my preceptor, Dr. T, had prescribed were "garbage". She was 23, a smoker, a heavy drinker, and an illicit drug abuser. All throughout the interview, she alternated between glancing at me, looking off into space, rolling her eyes, and reflexively checking her phone. I heard my voice hardening and deepening into the same stern tone my father used to discipline me. I suggested pointedly that if she drank less, her pain might lessen too. She ignored me, and asked when Dr. T was going to show up.

When he finally arrived, she barely looked up. Seemingly unconcerned, he asked how she was doing and counseled her to cut back on her drinking as well. "Really Dr. T?" she whined, "I don't think it's the alcohol, it's those pills you gave me. They made it worse, so it's your fault, not mine!" With a calm smile, Dr. T suggested that perhaps both were to blame, and prescribed a stronger antacid. I stood by, scandalized and amazed at the same time.

I saw Liz twice again the next week, each time blocked from view by her phone. Curiously, she never refused to see me, but seemed to relish giving me one word answers to all my questions. Deeply frustrated, I resigned to accepting that her phone was her first priority, and, following Dr. T's example, just asked her how she was doing lately. Surprisingly, she began to warm up to me. She told me she wanted to learn to dance, but couldn’t afford classes because she had dropped out of high school and couldn't get a job. She was really stressed too, because her older, live-in boyfriend was being a "prick". I also learned that she and her brother were on their own — her mother had died when she was a teenager, and her father had left them to fend for themselves. As a teenager she had lived with her aunt, but now, all she had was a small inheritance from her mother. As she went on, I felt a dullness growing in the pit of my stomach, a mixture of pity and guilt. There was something so fragile hidden beneath the tough, fierce exterior she presented to the world, something I found myself wanting to protect. Over the next few weeks, I simultaneously looked forward to and dreaded seeing her, happy to get an update but afraid of finding out what new problem had arisen.

On the last day of my rotation, I came out of one exam room startled to hear someone sobbing in the next. Dr. T emerged from his office, "That's Liz, and it sounds like something bad has happened, because her aunt brought her in. Why don't you see her aunt in room two, and I'll see her alone this time.” I thought I'd walked into the wrong room because Liz's aunt wore the exact same pungent perfume. She was also blonde, but heavier set, heavy lidded, and looked older than her age. "Liz has had a breakthrough,” she said as soon as I sat down. "She's upset because her boyfriend broke up with her, but it's good because this is the first time in her life she's wanted to go to rehab.” My eyes widened in pleasant surprise. "That poor girl has been through so much," the aunt sighed, "She took it so hard when my sister died. I did my best, but as she got older she became too much to handle. We came to screams and blows almost every day, so I had to kick her out. I mean, I've got my own problem too y’know?” Later that day I heard from Dr. T that he was going to help Liz check into rehab. My heart gave a silent cheer. Then, abruptly, my rotation ended, and I never found out if Liz went to rehab, quit drinking and partying hard, or found a better boyfriend who didn't take her for granted. After my rotation, I wrote a letter, in her voice, imagining what she would say to Dr. T, years out of what I pray was a successful rehab: Hi Dr. T, Out of rehab, clean for three years. Three years! I bet you thought I wouldn't be able to do it. Thanks for talking me into it. It was TERRIBLE. But now I’m glad I did it -- I don't drink or do drugs anymore, and I save a lot of cash. Who knew Travis leaving me was doing me such a favor? That bastard. I haven't thought about him in years.

Anyways, you'll be happy to hear I’m working now as a waitress, and I’m planning to go back to school.

No idea whatsoever what I want to do after that. But guess what? I met a guy, and we've been dating for a year now! His name is Brian, and you're going to meet him because I'm going to make him become your patient. You'll have to tell me (secretly) what you think of him.

I've never told you this before, but you're a really great doctor. You always listened to my problems and you didn't yell at me if I did something stupid. I really felt like I could tell you anything. And you were always available for me. I can't count how many times I thought to myself, "I have no idea what to do" and just came to your office to see you. Actually, the truth is, I had no one else to turn to. I hope you didn't find me too annoying. But that's why they pay you so much right?! I know we don't see each other that often anymore, but that's because I don't need to see you that often! Don't worry, I still think you're the best doctor in town. Who knows, if things get really serious with Brian I may be seeing you soon about having kids...

Hope you and that medical student are doing well, Liz

Theme: Patients | Patients
Theme: Physicians | Médecins
Theme: Relationships | Relations

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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