Twenty minutes behind as I knocked on the exam room door and entered. No need for introductions. We knew each other well. We skipped the “asking the patient her goals for the visit.” I already knew them. Twenty years of caring for and being trusted by a patient and a friend allows that. Her goals were the same as mine. We were there to tell the truth.
A knock on the exam room door. Unlike usual, this time I ignored it.
She and I did the “how are you’s,” the labs, the imaging studies – all the preliminaries. Then we started to get to the truth part. “Yes, it is cancer, a difficult one.”
We talked options, risks, benefits. I told as much of that kind of truth as I knew.
She didn’t say much. She didn’t have to. Her eyes spoke volumes. Fear. Deflation. Sadness. Then moist. Then a tear. And another.
I reached over to the counter, grabbed the tissue box, scooted my stool over to her and offered her a Kleenex. She took a tissue.
Then the real conversation started. More tissues. The truth was told.
Bill Toms
Keene, New Hampshire

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