A new patient calls for an appointment. I ask, “What would you like to come in for?”
“Depression. Two weeks ago my doctor put me on antidepressants.”
“Why don’t you see your current doctor?” I ask.
“I feel weird discussing my emotions with someone who doesn’t have any.”
When doctors are fully present, vulnerable—even emotional, patients are more likely to be honest, transparent, and open. Sexual intimacy is, of course, inappropriate between patients and physicians, but emotional intimacy is essential in any healing relationship.
What patients really need is a human being who is being human, a whole person who sees the patient as a whole person. On her way out, a new patient says, “I feel like I just got a physical, met with a marriage counselor, and had a spiritual awakening.” We could all have comprehensive, personalized care, but here’s the paradox: We resist what we most desire: Intimacy. Intimacy means “in-to-me-see.” It’s when we see so deeply into another, that we find our own reflections and discover ourselves.
Beatrice, an elderly woman calls for a Prozac refill. I remind her of my office policy: no refills between appointments. She screams, “None of my other doctors made me come in. What’s wrong with you?” Upon arrival for her appointment, she’s fuming. After thirty minutes, Beatrice breaks down and shares how difficult it has been since her husband died last month. She feels isolated and scared. With tears in her eyes, she hugs me and then thanks me for getting her out of the house.
It’s Friday night when Christie calls for an antidepressant. I pick up on the second ring. “Hello, how can I help you?”
“This is the doctor? It’s almost midnight and you answered the phone!” Frazzled, Christie tries to explain herself. “Things are kind of tough right now, Pamela. I was just calling so you could prescribe me some antidepressants.”
We talk about her mother’s death and the challenges of raising her autistic child.
“Christie, I’m happy to see you Saturday morning.”
“I just can’t believe you answered the phone. I’m so excited, I don’t feel depressed anymore.”
Being emotionally available and accessible is healing. Sometimes I think maybe I am the antidepressant.
Pamela Wible, M.D. is a family physician in Eugene, Oregon. She is author of Pet Goats & Pap Smears: 101 Medical Adventures to Open Your Heart & Mind. Photo credit: GeVe
As everyone knows, it’s not how you feel. It’s how you look that counts! And you probably know the rest Dr. Wible. Thanks for a great post, lovely pic, and your delightful approach to medicine!
I’ve had a wonderful relationship with my ARNP up here in WA State. We try to hug before she slips off to her next patient. — Recently I’ve been looking for a Dr of Osteopathy because this old body’s taken some heavy use. There are none within 50 miles who are accepting new patients, so I wrote her a note saying, ”Let’s grow old together.” I knew she was as delighted with my ‘failure’ as I was. — She’s not an MD or a DO, and every time I presented over the last ten years with a complaint she prescribed another med for me… making me ”polypharmacy”. Fortunately, she _listens_ to me. It took us about 4 (15 minute) visits and I’m down to ”normie” Rx totals. I still have confidence in her abilities though, being a former pharmacy tech, I check every Rx out, and recently quit my statin with a life-stye work-around. It was a totally one-sided decision. — I think we have as close a match to your ideal as we can find up here in a totally hospital-owned clinic. ds
LOVE, love, love your pickup line: “Let’s grow old together.”
Where are you in WA?
My oldest daughter went to high school in Hawaii for two years at Punahou. She did not like it and sought out a Psychiatrist. This old Japanese man and his wife were so kind to befriend my daughter. The academic mind in me says this is totally inappropriate. A psychiatrist is not suppose to become friends with a client. The mom in me from which is coming from a place of the heart cannot express enough gratitude to this man who not only helped my child but will forever be available to her. To this day, she can call him from wherever she lives and he will be there for her. I met him at her High School graduation. He gave her a gift and I was able to meet him. I respect him for not being so called appropriate. I also respect you for creating a change that our society needs.
If you were my doctor I would be intamate with you all the time!!!!! Im naked and ready to be examined and after that… my turn to examine you!!!!!!!! 😉
I believe I was a participant in patient profiling. I do not use the word victim as I do not feel like a victim. At age 20 I had a 5year old and 2 year old child when my last child was born. I finished school, worked as an LPN while I was working on my bachelors degree. A month prior to my due date I spoke in depth with my obstetrician about a tubal ligation. He checked, double checked and left time in case I changed my mind. We signed the consent and it was as good as done. Baby delivery time comes around and my doctor isn’t on call. He happens to be out of town for the weekend. The obstetrician on call decides I am too young to make that decision and she refuses to perform the procedure. 4 weeks later my original doctor tied my tubes, another hospital trip and recovery that was unnecessary. Its not up to the doctor to decide what I do with my family and body. I had 3 children at age 20, which was plenty for me. So while I wouldn’t call myself a victim, I do believe I was profiled as “young and dumb”.
Hi Michelle Lopez ~ I approved this comment though I think you meant to submit it on the patient profiling blog. I am familiar with your situation. A family medicine resident I trained with did not want any kids and she had a really difficult time finding another roc to do her tubal because, of course, she was too young to know what she wanted in life. Even though she was mid-20s and a doctor.
Somehow I bloghopped (is that a word)? and found your wonderful bits of wisdom!
Besides the fact that you resemble Stevie Nicks, I love the way you write! I wish I could pick you for our primary 🙂 You are one in a million!
Dear Dr. Pamela,
You have truly defined a new dimension in Doctor-Patient relationship. You have reinforced my strong belief that female doctors are far more caring and empathetic than their male counterparts.
As a teen male patient, I have always enjoyed a very affectionate and caring treatment from one of my neighborhood lady doctor aunt. Sometimes it was very shameful and embarrassing for myself, getting my private parts exposed to her for her examination.But she developed such frank and loving relationship with me, we could look at each others eyes immediately, even after a very intimate exam. I naturally developed an emotional attraction towards her and never hesitated to visit her even during my college days.
Today, as a matured man, I have remained attracted and respectful to female doctors and always visit them for any of my medical treatment including my annual physical. It is definitely not a sexual obsession or a fetish but truly immense love and emotional attachment for these caring and highly talented female medical professionals.
Dr. Pam, today I am truly feeling lucky to meet a female doctor like you who is so free to express your love for your patients. I wish I could be you male patient forever.