I suppose I could do it for free,
Diagnose whatever I see.
And sometimes elusive
Advice I’d give without fee.
Thirty-two years ago, in the winter of 1978, I walked into the Chinese restaurant in Saginaw, Michigan with another medical student. As we sat down, my classmate observed, “It’s funny, you know, as soon as you start doing clinical work, people start talking to you about their medical problems. Whether they know you’re in med school or not.”
“Maybe,” I said, “We just got more attuned to listening for it.”
As we munched our mini-egg roll and spooned our egg drop soup, we overheard the couple in the next booth talking about a parent’s recent surgery. We looked at each other and we ate, two not-quite doctors, listening to public conversations about very confidential matters. After a while I said, “Coincidence?”
My classmate shook her head. “Karma,” she said.
I expressed my doubts, but while we stood in line at the cash register a man was talking to his friend about a recent doctor’s visit. We could tell there was a great deal he hadn’t understood, and we two students made eye contact and, without saying anything, decided to let the moment pass. When we layered our clothes up and stepped out into the shocking cold of a Michigan winter evening, I said, “Maybe it is Karma.”
Such events riddled my days and nights ever since. Whether I admit I’m a doctor or not, the drama and irony of medicine’s interface with the human condition accompanies me wherever I go.
“My husband’s doing better,” I heard the woman say this afternoon, “With that new drug, I don’t know what you call it, it grows new veins and such, well his stumps have healed up real good and he’s started to grow hair there ‘n’ the doctor says that’s a sign of healing, like he’s getting his circulation back. And it’s hard on me. Beer ‘n’ cigarettes, beer ‘n’ cigarettes I tell him, that’s my therapy.” I didn’t point out the irony.
“So I went to the dentist,” the man said in a public venue, “And he did x-rays and everything, well, come to find out there’s nothing wrong with my teeth, no abscess or nothin’. And he put me on penicillin like I asked and I’ve been taking it for a week, a week, and I’m better, the pain is gone but there’s still swelling.” I nodded.
In an airport on the slidewalk I diagnosed the person ahead of me with scoliosis, osteoporosis, and neuropathy; I wondered about deficiencies of B12, folate, vitamin D, and thyroid.
On the airplane I saw the lion-like facial features of acromegaly, the consequence of a pituitary tumor in adulthood. I wondered how it affected the person and the family. Again, I didn’t say anything.
I don’t give unsolicited advice to people who aren’t my patients.
It’s none of my business