Behind Closed Doors

My heart rate increases, and I feel color coming into my neck and cheeks. I’m not a clinician: I say this phrase inside my head as I take a deep breath, trying to slow my heart, which feels like it might beat out of my chest. 

Then I say—this time out loud, to the person sitting across the exam table from me—“I’m not a clinician,” before continuing with, “… but on your physical exam I noticed something out of the ordinary, and I’d like to have one of our physicians take a look at you.” I wait and smile my

“If we are in an end-of-life situation, can I be with him?” I asked Lisa, the veterinary technician. She’d brought Alex, my springer spaniel, to my car after his oncology re-check.

COVID protocols had upended vet appointments. I’d park in a numbered space and text the receptionist. A tech wearing PPE fetched Alex. I’d wait in my car for the oncologist’s call, praying for continued remission.

“He looks good; I don’t find anything of concern,” I’d hear, and breathe relief. But as the months since chemo went by, the possibility of recurrence grew. The prospect of not being present to say

One of the most interesting aspects of being an ophthalmologist is the daily need to interpret what patients say they see.

Is it a flash or a floater? A gray spot or a fuzzy, broken line? Perhaps a shining area in the upper corner of your vision? Or maybe two images side by side? And what does “blurred vision” mean to any given person? 

Walking to the clinic, I pass a school where children gather in their crisp school uniforms. I admire their superhero lunchboxes, beaded purses, and colorful barrettes; I notice how tightly the younger children hold their older siblings’ hands. Next I pass an abandoned church, with stained-glass windows that shine on a sunny day, with wildflowers and weeds covering its front yard, with its earth-colored stone walls.

Arriving at the clinic, I admire my patients’ homes, standing out boldly among the drug houses. They are painted bright colors, and many have yards full of flowers and vegetables. One of my patients,

“Estoy cansada,” my client says as she drops onto my couch, settling herself inside the dip that holds her body every week.

I close the door to my therapy office and sit across from her. “I’m sorry you are tired, Anita. Tell me about your week,” I say. Then I sit quietly until she is able to focus.

She tells me that she sleeps all day, that her body hurts everywhere, and that her adult son never visits her despite the sacrifices she made to keep him fed and clothed growing up.

“You are a good mother,” I say. I

With a crisp gesture, sharp as the crack of a whip, the nurse sends the curtain rings skittering along the track, separating the bed on one side of the room from the other. The doctor does it more sedately, pulling the curtain along as if walking an aging dog, chatting to calm an anxious patient as she does. Either way, the object seems to be patient privacy.

Even when the curtains are drawn tightly enough to prevent a sliver of a glimpse of the person within, the task inevitably fails. There can be no real privacy when a few squares

I treat a lot of patients with multiple disabilities, like cerebral palsy and epilepsy, so things get complicated when they are admitted to the hospital. The parents have to deal with multiple rounding teams who come into the room at unpredictable times.

One such parent told me how she had solved the problem of dealing with surgeons who would not answer her questions. Her child’s surgeons often rounded at an ungodly hour in the early morning when no one was awake, spent a few minutes in the room and then moved on. By the time the mother was awake, the

My patient walked into the exam room, expressionless, her shoulders hunched. Her last blood pressure reading had been high.  

I gently closed the door. “Good morning,” I said. “My name is Esther, and I am an RN. How are you today?”

“I am OK, I guess.” 

“You are here for a BP check. May I check it?” 

“Sure, why not.” 

When the ambulance doors shut, a fertile silence is wrought as patient and paramedic situate into the tight, mobile quarters. The patient, strapped backwards on the gurney like a carnival ride, stares upward at bright lights and cabinetry chock-full of colorful medication boxes. As the ambulance takes off toward the hospital, the paramedic begins an ataxic dance, hopping and twisting over blood pressure cords, pulse oximetry, heart monitor leads and IV tubing.

Patients may not be as forthcoming around large numbers of family, bystanders or medical personnel, but the atmosphere in the back of the ambulance is made for intimacy

During my fifteen years as a health educator and project manager for a large HMO, I met frequently with the physicians, managers and medical staff in their offices. Sometimes these were formal meetings, and sometimes I just dropped by to run through an idea or check out a procedure. Perhaps we met to work on a new outreach program. Or perhaps I gave an in-service about the databases we used to track patients with chronic conditions. Even though the doors between the waiting areas and the offices and exam rooms were locked, many of the receptionists recognized me and buzzed

Something doesn’t feel quite right these days. I’m in-between, hanging in the wind, waiting for the next set of closed doors to open, for what lies behind those doors to emerge. The earth moved from winter through solstice into spring, yet temperatures still dip. Which jacket and shoes to wear? How many blankets are needed at night? We just sprang the clock ahead, but I haven’t yet adjusted and my sleep is off. A big birthday lies ahead and I want to get into celebratory mode, but I still dwell in this decade, which was capped off by a trying