The Woman on the Exam Table
She sat on the exam table waiting for me to enter the room. She looked no different than the dozen patients I had already seen with cold and flu symptoms. We were well into the frantic weeks between Thanksgiving and Christmas and viruses were the gift of the season.
I stood in front of her and listened to her list of cold and flu symptoms. Headache, sore throat, cough, congestion, low grade fever….same as everyone else. She was busy shopping for her children and grandchildren and they would all be in town the following week. She still had to grocery shop and clean her house and cook. She simply did not have time to be sick…same as everyone else who was busy traveling and shopping and generally too busy to be sick.
My mind quickly ran through her complaints as I told her I would order a flu swab and that treatment would depend on results. Everyone wanted an antibiotic for a quicker recovery even though antibiotics wouldn’t treat a virus. I spent a lot of time explaining this and I was weary of it.
She continued to tell me about her holiday plans and all the reasons she did not have time to be sick as I started my exam. She talked through me peeking in her ears with my otoscope but had to be still when I shined the light on the back of her throat.
Peace. At. Last.
I held the light there a few seconds longer than needed just to soak up the brief silence. I realized it was a little too long when her eyes met mine and she anxiously asked if her throat looked ok. Rattled out of my reverie I knew it was time to move the exam along. I replaced the otoscope to it’s home on the wall and grabbed my stethoscope from around my neck.
When I placed the stethoscope on her chest to listen to her heart and lungs I was mainly going through the motions. I moved from the front of chest to her back and said the same thing I had been saying all morning. “Take a deep breath.” As expected her lungs sounded clear but something in my mind forced me to stop. I realized that when I was listening to her chest I didn’t even recall hearing her heart beat.
Was the rhythm of her heart regular? The rate normal? Any murmurs? Any extra heart sounds? I had no idea. I was appalled at myself. She deserved better than this. She deserved to be heard. She trusted me to provide her with good medical care so that she could see her loved ones for the holidays.
While she was there for simple upper respiratory symptoms and had no red flags, she still she deserved for me to be present. During the time spent in that exam room with her I needed to be focused and give her my best care. I moved my stethoscope back to the front of her chest and listened.
Her heart beat was steady, regular, no murmurs and her rate was a perfect 70.
Our eyes met again. “Does my heart sound ok?” I could honestly answer with a resounding yes. “Yes it does sound ok, very normal.”
As I left the room to ask the nurse to do a flu swab I made the conscious decision that no matter how tired I was, every patient deserved to be heard. Whether it was their words or their chest I was listening to, I needed to truly listen. I could be efficient yet still be present. I could review flu swab results quickly but knew I needed to be present as I did so.
Her flu swab was negative as expected. She was relieved as expected. We talked about symptom management and I advised her to return if she worsened rather than improved. As I reviewed this with her, I didn’t see just another woman on the exam table. I saw a wife, mother, grandmother, daughter, sister, and friend.
That small gift of presence in the exam room made all the difference for her I believe. She thanked me for taking the time to listen and take care of her. Her thankfulness was a reminder to me that my career is a gift and not to be taken for granted.
To be trusted with someone’s life is a sacred trust. A trust I never want to break because of busyness. A trust I will continue to earn…one patient at a time.