She looked familiar; you have to give me that. And my receptionist nodded and smiled as I picked up the chart from the rack by the waiting room; I knew that nod -obviously I’d seen her before. I’ve seen so many patients over the years, and I don’t remember them all, so I appreciate these little cues from my staff. After all, many of the patients have come back because I’m familiar to them; they comfort themselves in the feeling that we both share something, if only memories… I had a quick peek at the chart to refresh mine.
As luck would have it, the chart was empty, however:no history, no impressions scribbled in the margins -no memories. But after a few years, charts get lost I suppose: misfiled; they even get shredded after whatever the ever-changing legal limit happens to be so I wasn’t concerned. Stuff happens. And I’m pretty good at pretending.
I glanced at the first name: Candace. Nothing rushed into my mind, except that it always seems more intimate and friendly to call a patient from her seat as if we were on a first-name basis. It implies a shared trust, a history.
I once addressed a similarly seated woman in a busy waiting room as Mrs. Rangapurampti -I was afraid to attempt her even more difficult first name- and she scowled at me. “You’re so formal, doctor,” she added once we were walking alone down the corridor to my office and she’d recovered her composure. “I remember you as much more approachable than that…” I begged her forgiveness but felt shamed at being caught out; I hadn’t remembered her either.
“Candace?” I said rather louder than necessary, and in an unneeded question format: she was the only person in the room. A strikingly beautiful woman with long blond hair and a powder blue dress, the name fit her like stockings.
She smiled, looked up from the magazine she was reading, and stood up slowly and deliberately in an almost practiced way. I noticed this, but mentally shook my head at the thought: nobody needs to practice standing up. And yet I felt like applauding her style. I was sure I couldn’t rise from my chair like that…
We shook hands and I introduced myself as if it was actually unnecessary because, of course, she already knew me. And I knew her… I do this just in case. She accompanied me down the corridor at a safe distance -not too close, not to far: a just-right distance, it seemed to me when I noticed it. The strange thing is, I couldn’t remember ever thinking to notice this before.
When we had seated ourselves in my office, I opened her empty, blank chart and realized I’d have to fake the memory-thing, or play my old-age-forgetfulness card. Lately, the latter has been the more successful strategy and as long as I don’t seem too doddery or forgetful, it seems to call forth a bit of the parent in the patient. I think it helps them to realize that we’re both in this together…
I sat forward, in my chair, pen hovering over her chart: a picture of anticipation. “So what can I do for you Candace?” I said, smiling and looking for all the world, I suspect, like a lens focussing. When her face took on a curious expression, I pointed to the empty chart. “The referral from your doctor doesn’t seem to have arrived yet.” And it hadn’t -yet another obstacle to gaining her trust.
Her eyes twinkled and her forehead raised just enough to show some little lines that I hadn’t noticed before. “Oh, I think that’s because my GP sent it to another gynaecologist. But I realized that I’m travelling at the end of the week and she couldn’t see me before then.” An absolutely disarming expression crept onto her face. “And you had a cancellation, so…”
I almost blushed at the thought of my otherwise empty waiting room. “It happens,” I said, hoping she hadn’t noticed.
“I only need a Pap smear,” she continued, “But with my busy schedule, I’ve been putting it off. And because it was abnormal last time, my GP didn’t want to do it.”
I nodded and wrote something in the chart. “Well, I’m going to need to take a more complete history again, so I hope you don’t mind me getting a bit of background.” She didn’t mind a bit, she said, and as she spoke her hair bounced almost playfully on her shoulders. I proceeded to go through a complete medical, surgical and gynaecologic history, duly noting it in the chart.
When I was finished, she sat back in her chair and looked at me. “You certainly are thorough, doctor. I don’t think anybody has ever asked me some of those questions.” She blinked slowly and sat up straight. “I’m impressed.”
I did blush that time, but I wasn’t sure why; I always ask those questions. They’re the way a doctor finds out if there are other factors that need to be considered in treating the patient. Pretty standard stuff, I thought.
After I’d done my usual complete physical exam and subsequent Pap smear in the adjacent examination room, she joined me at my desk. I was still writing in her chart when she sat down, but I glanced up briefly to ask her if she had any questions.
A soft expression settled on her face and she smiled at me. “You’ve answered all my questions…” She hesitated as if she was searching for some words. “You know, I just have to say, I’ve never felt so normal as in this office. It’s the first time in many years that I’ve felt that I was actually being seen and treated as who I actually am, not who I’ve become.” She almost looked embarrassed and for a moment I thought she was going to lean over and hug me from across the desk. “Thank you, doctor. You don’t know how much I appreciate this!”
I smiled lamely in return. I had no idea what she was talking about, although I did wonder if I’d missed something in the history I’d just taken. I nodded my head in polite acknowledgement of the compliment and walked down the corridor with her.
When she’d left the waiting room and the door had shut behind her, my receptionist and her assistant jumped to their feet. “What was she like?” the younger one said excitedly and grabbed her phone to post something on her Facebook page. My receptionist, an older woman, rolled her eyes and then looked at me. “Well..? What was she like?”
I stared first at the younger assistant and then at her. “Excuse me?”
“Candace!” the younger one said with what seemed like reverence.
When I didn’t answer -couldn’t answer- my receptionist sighed. “Didn’t you see those signals I was giving you before you picked up the chart?”
“You mean the not-so-subtle nod to remind me that I’d seen her sometime in the past and to pretend I remembered her? That signal..?” I shook my head. “Because, I really didn’t remember, you know. Not even after taking her history.”
Two pairs of eyes rolled in unison. “It was the TV star nod…” My receptionist glanced at the younger one. “And she’s done a few movies, too, hasn’t she?”
Another maudlin eye rolling session from the assistant. “Wait till my friends see this on Facebook!” She began to type frantically on the phone with her thumbs again.
“You’re not going to tell me you didn’t recognize Candace?“ the older one said shaking her head in disbelief.
“She was probably so stunned you didn’t recognize her that she’ll never come back,” the assistant mumbled, obviously disappointed.
I smiled and then shrugged indifferently. “Actually, I’m not so sure about that,” I said and walked slowly back to my office, still wondering who I’d seen.