When I first began practicing medicine, I used to think of the door to the exam room in mystical terms.
How else could I explain my patient’s willingness to suspend all social rules and norms when they passed through that “magical” entrance way? Sitting in front of their “baby-faced” doctor, they would tell me things. Private things. Scary things.
Conversations occurred that would be unthinkable if we had met as strangers in the outside world. I learned of abuse and infidelity, pain and yearning, secret joys and countless regrets.
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I bore witness to inner pain and struggles that were often hidden from their closest friends and family.
People took off their clothes and replaced them with unflattering gowns. They uncovered private body parts unabashedly, pointing to parts that looked out of place, wincing if my clumsy touch caused pain.
The exam room became a safe zone, a place where judgment was replaced by support and understanding, where patients could reveal their darkest secrets without being consumed by them.
When I traded my traditional practice for home visits, I was afraid that something important would be lost. I had often wondered if the sterile environs of a doctor’s exam room were depersonalizing. Perhaps my patients revealed their inner needs and fears because the institutional setting of the exam room was such a departure from everyday experience.
Then, there was the question of my lab coat. The “wizard’s frock” is a visual symbol that separates me from the rest of society. Again, I conjured up visions of a magnificent veil that allowed me special access of a most personal nature.
It’s been almost two years now, and I have visited countless homes without the comfort of an exam room or the lab coat to hide behind. My fears, of course, were completely unfounded. My patients still tell me their triumphs and tragedies. They still pull up their shirts unashamedly to show me a rash, lump or bump.
I have come to realize is that it was never the sanctity of the exam room, nor the long white coat that droops from my shoulders.
With both great awe and humility, I now understand that it has always been me.
I am the safe zone.
