How long will it take this man to get in the room? He is already 20 minutes late for his appointment. If it were not for all his paraphernalia including, his walker, shopping bags and seemingly endless layer of clothing this clinical encounter could be at least halfway finished. And now he is finally in the room. It takes another 2 minutes to sit down. Much of this time is taken to remove the coat, jackets and shirts. This layered clothing is necessary for these cold winter months. Each layer removed allows the emanation of increasingly pungent body odor. He has not bathed for days or even weeks. Because of patient confidentiality I have to close the door and I am trapped with seemingly visible vapors. I must make this encounter is brief as possible.
Mr. PJ ‘I exclaim with forced smile and enthusiasm. It is so good to see you. I am glad you were able to keep your appointment. We have not seen you and several months. I was beginning to worry about you.’
Mr. PJ remains silent. He has a worried look on his face. This is part of his natural demeanor. Sleeping on the streets this time of year takes away any pretense of being comfortable. He wears most of his collection of garments because he cannot trust the boarding houses to keep these precious items from being stolen. He only goes there at night when it is too cold to lay on the vents on the street and too late to beg. He is only here this late morning because he wants to show me something.
‘Dr. Johnson’, he begins ‘I had a very difficult time making it here today. I am having a lot of trouble walking lately because of some sores on the bottom of my feet.’
He then begins to remove his boots. They appear quite heavy and are laced up to mid-calf. It seems an interminable amount of time. Each boot is covering layers of dirty socks which cover dirty, smelly feet. Time drags on. The odor is now palpable. I move forward to open the door, but he stops me.
‘Dr. Johnson, don’t you want to see?’
With that he displays the warts on the bottom of his feet. I must hide my revulsion and take time to visually as well as manually inspect his feet. I don a pair of latex gloves and turn on the bright overhead lamp. I recognize it has been a struggle for him to come to see me. I must be patient enough to overcome my own struggle so that I may pretend to thoroughly examine. This Dr. must learn to be patient.
‘Oh yes I see Mr. PJ.’ I have come to a clinical decision in less than 10 seconds. ‘We will have to find a way to clean your feet here today and apply some ointments. You also need some clean socks. How long have you had these boots?’
‘Dr. Johnson, he replies, ‘these are my favorite boots because they keep my feet warm even when they get wet. I don’t have any place to wash my feet and I don’t have any money to buy new socks. How can you help?
I happen to have in my car several pairs of new socks which I purchased just for such an occasion. But I have no answers as to how to keep his feet clean and of course what will be doing about these sweaty dirty boots. A cursory wipe with a moist clean towel and the application of moisturizer is all I can afford right now. I give him the socks and advise him to return as soon as possible that I may inspect his feet again. He needs to see a podiatrist to provide definitive care for his plantar warts. However, he doesn’t have the money for transport, and I don’t have the patience to untangle the web of social economic determinants which prevent him from getting proper care. I am not that patient.
The word ‘patient’ has its origin in Latin. It means “quality of being willing to bear adversity, calm endurance of misfortune and suffering”. These are the very things I avoid. As a busy doctor in a busy office the last thing I want to do is be patient. I would rather Mr. PJ be the patient. I would rather him bear adversity, the endurance of misfortune and suffer. That is his role not mine. But to be truthful if I am to be a good doctor, I must learn to be a good patient. I must begin to understand the suffering, the challenges, weaknesses and even bear the smells.
Jesus the Christ was the perfect patient. He was the great healer. He understood suffering. If I am to be the healer He wants me to be, I must make it my goal to listen to even if I cannot fully appreciate the misfortunes of the many Mr. PJs that come to my office. To be a good doctor is to be a good patient. Learn to suffer as Jesus did.
Romans 8:17 KJV and if children, heirs also, heirs of God and fellow heirs with Christ, if indeed we suffer with Him so that we may also be glorified with Him.