What You Say to Your Patients Could Be Vital
A primary care physician ponders the quality of advice given and forgotten.
Loitering in the hallway of my son's school awaiting a parent/teacher conference, I completely forgot that the woman introducing herself and shaking my hand was an alcoholic. I forgot that she had visited me in my office, a decade prior, for a consultation. I forgot all of that.
What I remembered was that we had gone to high school together. We had grown up in the same city, in the same neighborhood, and on the same block. We were never compatible socially.
She was gregarious and popular, and I was quiet and introspective. We may have nodded familiarly or said hello if we passed each other on the street, but nothing more. We were acquaintances by proximity.
Back to the present: We exchanged pleasantries in the school hallway for a few minutes. Our kids were similar in age. She looked happy and healthy. I glanced at my watch and prepared to enter my son's classroom when she stopped me, and asked the question that I assume had been in her mind the whole time.
“You don't remember, do you?”
She had come to my office nearly 10 years earlier for a routine physical. It was a mid-morning appointment, and as I listened to her heart, I recognized the faint odor of alcohol on her breath poorly covered by breath mints. I waited patiently until the end of the appointment, and then gently discussed my suspicions with her.
She told me she was drowning in new motherhood; her job was taxing; she was fighting with her husband. The alcohol was originally meant to help her unwind at night, but over time she was consuming more and more. She was hiding her drinking from her family and friends.
She was an alcoholic.
Her words cleared the cobwebs out of the vaults of my distant memory. I remembered telling her that she wanted to face her alcoholism now for her children's sake; that she wanted to be healthy when they grew up and they needed her. I handed her a few brochures, gave her a few phone numbers, and scheduled a follow-up appointment.
I made her promise me that she would get help.
As it turns out, she never came back to my office for that follow-up. But that morning, she began a long successful journey toward sobriety.
Now, a decade later, she was thanking me for saying the words that launched that journey.
Years into the practice of medicine, I have spoken millions of words in the exam room and forgotten the majority of them.
I humbly hope that some of my other words have similarly hit the mark.