fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

Search
Close this search box.

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

Search
Close this search box.
  1. Home
  2. /
  3. Stories
  4. /
  5. Command Performance

Command Performance

The reasons not to go to Mary’s wedding seemed overwhelming.

She was neither a family member nor even a close friend: She had, in fact, been my psychotherapy patient several years back. The very notion of attending her wedding raised the issue of professional boundaries: Wasn’t it inappropriate for me to see a patient outside of the office setting?

My professors had made a big deal of this during my clinical training, admonishing my class to maintain strict divisions between our personal and our professional lives. Even then, I’d wondered, Whom are you protecting? The client or yourselves?

Then there was the question that other wedding guests were sure to ask: “How do you know Mary?” I’ve blurred a boundary or two in my time, but how could I answer that without violating the HIPAA regulations about patient confidentiality?

On the other hand, I knew it meant a lot to Mary to have me at her wedding. As her therapist, I’d sat with her for many hours, trying to help her undo the damage of a traumatic childhood and her difficult relationships with the men in her prior marriages.

I’d witnessed her emotional journey—an internal trial by jury in which, at first, she’d accepted the prosecution’s charge: “There’s something wrong with you.”

With my encouragement, she’d engaged in a retrial, this time with a defense attorney (myself) at her side, and we’d carefully examined the evidence. Over time she’d reached her own verdict—Not guilty—and had gradually freed herself from her psychological prison.

My own inner dialogue about attending the wedding went like this:

My inner child (a whine, rising to a scream): “I don’t want to go! It’s my day off! I want to go to the beach!”

My Catholicized superego: “You should go. It’s only one day! Stop complaining! Think about what it would mean to her!”

This went on and on—until suddenly, out of the blue, came a thought I didn’t expect:

I need to be there.

When the wedding day arrived, it was the best summer day ever—the one of you dream about, the one you grieve for after the sun disappears into Lake Michigan. I’d lost the wedding invitation, but I felt confident of the time and place: Mary’s farmette on a short thoroughfare just outside of town.

I turned my aging Subaru down that road, and sure enough, there it was—a modest older home set before a red barn, with a bouquet of gaily colored balloons by the dirt driveway. I parked my car with others in a roped-off area and ambled toward the barn, where people sat around tables, eating and talking loudly.

Darn it! Did I miss the ceremony?

I squelched that thought. You’re here. Sit down and grab yourself some lunch. All you need to do is say hi to Mary, meet her new beau and skedaddle!

The banquet table groaned under classic Midwestern fare: high-carb, high-fat offerings, punctuated at the end by an enormous cake. I scooped up a hot dog and baked beans, added a side of heavy potato salad, grabbed a beer and asked some people if I could join their table.

They gave me a hearty welcome and introduced themselves. There was Amy and her husband from Detroit, Sam and Ginny from town, and Paul and his wife all the way from Cincinnati. Then came the moment I’d been dreading.

It was Paul’s wife from Cincy who spoke: “And how do you know Grandpa?”

“Grandpa?” I murmured—then plunged into a flurry of apologies: “I’m so sorry! I thought this was a wedding that I’m supposed to be at!”

To their credit, no one laughed—at least, not out loud. I even heard someone say, “Everyone makes mistakes.” (As I tell my patients all the time.)

Still apologizing, I got up, dumped my remaining food in a trash can and fled. Instead of a big piece of cake for dessert, I ate a huge slice of humble pie.

I knew it! I fumed, sitting in my car. Why did I ever decide to come?

After a bit, though, that strange feeling came over me again:

I need to be at Mary’s wedding.

I felt certain that her house was nearby; how many more celebrations could there be on this small road today? My self-instructions resumed: Just show up, say hi and skedaddle.

I started the car and drove on. Sure enough, Mary’s farmette was less than a half-mile along. The scene looked like a wedding should, with a makeshift stage and a big tent over a sea of folding chairs that were beginning to fill with people. I let out a huge sigh of relief.

Approaching the crowd of people, though, I could tell something was wrong. It hung so heavily in the air, I could almost smell it.

I heard snippets of muttered comments: “Mary’s in her house!” “Mary’s crying!”

I rushed into the house—Professional boundaries be damned!—and made my way through a maze of relatives to Mary and her husband-to-be, Bob.

“What’s wrong?” I asked.

Mary burst into tears.

“The minister was supposed to be here an hour ago,” she sobbed, distraught and shaking. “We can’t reach her….How can I tell my family and friends?”

Suddenly I realized why I needed to be here. To comfort Mary, of course—and something else.

“Mary, everyone is here but the minister,” I said calmly. “I’ll be happy to get onstage with you and Bob and officiate at your wedding ceremony. It won’t be street-legal, but you can easily take care of that another day with a justice of the peace.”

Mary wiped away her tears. To her credit, she summoned up the courage to walk out to the assembled family and friends and tell them the new plan.

In ten minutes everyone was seated, and the three of us were arranged onstage. As I looked out on the crowd of radiant, expectant faces, HIPAA was the last thing on my mind.

The show did go on—made all the more glorious by Mary’s and Bob’s mutual declarations of love. In addition to the usual marriage stuff, I made note of the couple’s courage in committing to something greater than themselves. I threw in a favorite Rumi poem: “Out beyond ideas of wrongdoing and rightdoing, there is a field. I’ll meet you there.” If they could meet there, I told them, they would experience the happiness they were seeking in their marriage.

Finally, I proclaimed: “And now, under the authority bestowed upon me by absolutely no one, I pronounce you husband and wife!”

The audience laughed, cried and applauded. No one asked the inevitable question about how I knew Mary.

In my own mind, though, another question took its place:

How did I know that I needed to be here?

Greg Holmes is a clinical psychologist in Traverse City, MI. His career has included teaching positions in psychiatry and family-medicine residencies. With his wife, physician Katherine Roth, he coauthored The Good Fight: A Story of Cancer, Love and Triumph, which chronicled his battle with a rare and deadly cancer. The book was a featured presentation at the National Writer’s Series. “I began to write in an effort to share stories that would touch and inspire others.”

Comments

9 thoughts on “Command Performance”

  1. I loved this story! When I started reading it, it reminded me of a similar decision I agonized over in terms of attending a client’s wedding. I too heard that voice saying I needed to be there despite risks of boundary confusion, and it turned out to be the right decision. But, in your case, there were a couple of major twists and turns that I did NOT experience. One was hilarious, the other was near-tragic. I so admire the way you pivoted and offered to officiate. You saved your client from a lifelong guilty plea, then you saved her wedding day!

  2. I love this story as it has such a happy ending the way it should be when so many people help each other to make it right
    thank you for sharing

  3. Thanks for sharing this great story which brought a tear to my eyes.

    A Higher Authority took you there; your Inner Authority allowed you to be open to that Higher authority.

  4. Yes, as a retired psychologist, I also was taught the lines that needed to be drawn, and most of the time with good reason. There are always exceptions and the wisdom is knowing what those are. You were indeed needed there. I’m glad you went.

    1. I’m so glad you listened to that persistent voice that told you that you needed to be at Mary’s wedding. I was always glad when I listened to those voices, and always felt regret when I ignored the voices.

  5. Dr. Louis Verardo

    Dr. Holmes, what a great story, and how wonderfully it illustrates the therapeutic relationship you had forged with your patient. And frankly, I am in admiration of the skill you displayed in thinking on your feet so quickly; I could only hope to be that adept. And for the record, what a nice wedding gift you gave to your patient…

Leave a Comment

Your email address will not be published. Required fields are marked *

Related Stories

Popular Tags
Scroll to Top