9x9 Room

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My exam rooms in my office are pretty typical for a physician's office.  They are small, 9 x 9 rooms.  They have an exam table, two chairs, a rolling stool, a sink, some shelves, a literature holder, otoscope and ophthalmoscope, cabinets, few pictures of my family. They are pretty plain.

 

 I have always wondered what the walls would say if they could speak. So much happens within these rooms; so much of life is examined and changed within these 9 x 9 rooms.  Over the past 12 years, 1000s of conversations have occurred within those rooms. Some of them have been light-hearted and some of them have been some of the most serious discussions in a person's life.

 

Within this 9 x 9 room, I have sat and I have told people about their newly diagnosed cancer, talked about the fact that I believe that the patient with cancer now has recurrence by something that I found on physical exam.  I have examined the patients and found abnormalities that, I know, mean their disease is progressing and no longer curable.  This week a young lung cancer patient came in for a routine visit. While doing a physical exam I was able to feel a small lymph node in his arm pit. This turned out to be the “tip of the ice berg”. CT scans quickly confirmed wide spread disease. Hope for a cure and a long life evaporated in that room.

 

Within this 9 x 9 room, I have talked about patient's hopes, dreams, and their faith. Patients have taught me so much about faith and God. I have seen patients’ faith awaken as they have faced the challenges of their diagnosis. I have heard stories about their triumphs, tragedies, and their disappointments. I have talked about their children and families. Counseled young 20 year old women about positive genetic test and how these genes will dramatically change their health and threaten their future. How they now must consider removing both their breast and ovaries. These are some of the most difficult discussions I have ever had.

 

Within this 9 x 9 room, I have heard about love and hate, divorce and marriage, sex and inability to have sex. I have seen couples grieve over the lost of ever being able to have a child. I have reassured mothers that their unborn child will be safe as they receive chemotherapy for breast cancer and lymphoma.

 

In this 9 x 9 room, I have had discussions that would be appropriate at a kitchen table; I have had discussions that would likely be more appropriate in a confessional. Some discussions have made me blush and some have made me cry.  I think that one of the most important things that a practicing physician can earn is the confidence that his patients are able to talk to him, talk to them about pretty much anything.  In some ways, I suspect that I know some of my patients better than some of the people that I call my friends.  In our day-today lives, our friendships are so guarded, what we relate to people who are close to us are so guarded, but a good physician makes sure that the patient understands that they can really talk and tell him anything.  It is amazing what happens in the 9 x 9 room.

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