Patient: Sarah*
I stand in front of a closed beige door, pushing hand sanitizer through my fingers, and taking in deep slow breaths. I say to myself, Only this moment matters. This patient. This person.
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I open the door, smile, and enter.
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“Hi, Sarah Johnson? I’m Jill Monteiro. What do you like to be called?”
“Sarah is fine, thanks.”
I push down the floating computer attached to the wall, log in with my badge, and take a seat on the rolling stool.
“Great, please call me anything you like – Jill, Dr. Monteiro, whatever makes you most comfortable. How can I help you today?”
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Deftly I position the keyboard and screen to achieve that magical angle which allows me to type and maintain eye contact with my patient. With Sarah.
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“Well, I’ve been having stomach and digestion problems. I feel bloated all the time, no matter what I eat…”
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She looks nervous, anxious. I try to put her at her ease, express concern, and ask more questions. My fingers are capturing her words, trying to complete as much documentation as possible during the visit, which we doctors are repeatedly advised to do. An image of my husband’s disappointed face as he watches me yet again working after dinner flashes across my mind. Sarah beings to cry.
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I want to comfort her. Be present in this moment. Only she matters now. I stop typing, swivel my stool towards her, and lean in.
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“I’m also having chest pains and my heart is racing. I went to the emergency room recently and they did a bunch of tests. I don’t really know what they did,” she says, her voice breaking.
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I suggest we review the evaluation she had done. I turn back to the computer and click on her emergency department visit note.
The computer freezes. I wait. Sarah continues to talk.
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“I’m having such a hard time focusing, concentrating. I took a friend’s Adderall and I felt so much better.”
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I click the computer mouse again. Nothing happens. My eyes automatically glance at the computer clock. My heart quickens. Deep breath. Stay calm for her. I apologize and laugh, a bit awkwardly.
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“Computer problems, you know how that goes.” I restart the program. The minutes pass.
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We begin reviewing her studies together. Her phone buzzes. She pulls it from her lap to her face and starts texting. “Do you need a minute to take that call?” I offer.
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“No no, it’s fine. Sorry. I’m all done.” She lets the phone fall to her lap.
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I suggest we do a physical exam. As I wash my hands, I look back over my shoulder. Sarah is now sitting on the exam table, legs dangling over the edge, eyes fixated on her phone, and fingers texting at lightning speed.
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As our time together draws to an end, I make my recommendations and apologize for staring at the computer screen while I order the tests she needs.
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She smiles politely and says, “No problem. But there is one other thing I’m worried about…”
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I click the refresh button on my schedule as she continues to talk. I see my next patient is already in an exam room, waiting for me. I’m late.
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More minutes pass until I am able to kindly take my leave. I shake her hand, thank her for coming in today, and start moving towards the door.
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She blushes a bit and says, “Thanks so much for listening. No one really does that. It means a lot.”
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Everything comes to a standstill. I breathe this moment in and offer a sincere, “You’re welcome.”
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Back in the hallway, my medical assistant catches me. Mr. Matsen does not feel well and wants to be seen today. Nancy Walker’s insurance changed and she needs new prescriptions. And Brent needs his leave of absence paperwork filled out as soon as possible.
I quickly give instructions for each, turn to the next closed door, push the hand sanitizer dispenser down, and feel the cool foam between my fingers. Deep breath in…. and out…. Only this moment matters. This patient. This person.
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I open the door, smile, and enter.
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Written by Jill A. Monteiro, MD, MBA
Published May 2020
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*This is a true story and all names have been changed for privacy reasons.