“How Long Have You Had These Symptoms, Doctor?”

“How long have you had these symptoms?”

Dr. Quantrell’s tone was kind and inquisitive, but with the CT scan on the computer between us displaying a two-centimeter kidney stone, I couldn’t help hearing: How long have you been ignoring this problem?

Much has been written about the experience of doctor as patient. Like many of my colleagues before me, I’d fallen into the trap of trying to diagnose myself before calling my family physician.

For months, I’d felt some vague right upper abdominal pain off and on, gradually increasing in intensity, duration and frequency. Over that time, I’d paid attention to see if there was any pattern to when I felt the ache, or if anything made it better, or if I had any other symptoms.

Before calling my primary-care doctor, I wanted to be able to present a clear history to help him formulate a diagnosis. I wanted to appear as a Good Doctor with good diagnostic skills, not as another patient with an unclear source of pain and all the diagnostic challenges that this represents.

Meanwhile, I vacillated between fretting that something serious was wrong and, on good days, convincing myself that I’d imagined the ache, or that it would eventually disappear.

Finally, some blood in my urine forced me to seek care, which led to the CT scan—and the diagnosis of a large kidney stone.

Upon hearing this, I felt a mix of relief and bewilderment. Relief that it wasn’t any of the ominous diagnoses I’d feared, and bewilderment that I’d entirely missed the diagnosis. I had not been a Good Doctor.

I learned that a stone of this size needs to be surgically removed—a fairly complex, higher-risk procedure—and was referred to Dr. Quantrell, an expert at the recommended surgery.

In the days before our consultation, I named my stone “Seymour,” to help foster the illusion that my pain and bodily dysfunction were somehow separate from me as a person.

When Dr. Quantrell posed his question about the duration of my symptoms, my reply was a sheepish “Oh, I don’t know, maybe a couple months?”

I felt ashamed that my response was not a neatly synopsized and organized history. I wasn’t sure if managing to ignore the stone meant that I was stupid, stoic or both.

As Dr. Quantrell outlined the procedure, I felt myself bouncing between fascination and fear. I worried about having to be admitted to the big university hospital; I worried about being able to tolerate the post-op pain; I worried about any number of unlikely complications. I also felt concerned about taking time away from work. Although I knew that my colleagues would cover for me, I still wanted to be a Good Doctor—one who didn’t ask too much of others, even if it meant ignoring the increasing pain from my right kidney.

Fortunately, my surgery and recovery went smoothly. Since that time, though, I’ve reflected on how much pressure I’d put on myself to be a Good Doctor, instead of allowing myself to be a human being. I regretted that the time I’d spent trying to ignore my discomfort had ultimately led to a more complicated treatment—which in turn had meant enduring more weeks of increasing pain as I awaited surgery.

Had I let myself acknowledge my pain and my fear earlier, the stone could have been diagnosed sooner, when removing it might have been simpler. That would have been a wiser course of action, as any doctor would agree.

And yet stories abound of physicians heroically—and recklessly—ignoring their own physical safety and well-being in order to keep on working: doctors returning to round on patients right after they themselves had been discharged from the hospital; doctors working while in labor; doctors even dying of unacknowledged illnesses while they were on duty in call rooms.

“Nothing will keep Dr. Denison from the OR” was the admiring comment about an orthopedist rumored to have gone to work while suffering from food poisoning (he was given IV fluids in between cases).

In this way, a Good Doctor is often glorified as someone who is not only an excellent diagnostician, compassionate and hardworking, but also somehow above and beyond simply being human. Actions or behaviors that we’d label as noncompliance or foolishness in a patient somehow become legendary feats when perpetrated by a physician.

In my case, I undermanaged my pain so that I could continue working; I didn’t let myself admit that I was, in fact, a fallible human. Only after the procedure could I bring myself to admit the extent of the physical and emotional pain I’d suffered.

Ultimately, it seems to me, the most relevant question wasn’t “How long have you been ignoring your kidney-stone problem?” but “How long have you been ignoring the lack of humanity in the standards that we physicians inflict on ourselves?”

Kidney stones can pass, or be removed. How long can we tolerate not allowing ourselves grace?