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An Open Letter to You, My Patients

Dear Standardized Patient

Number 1, and Number 3, Mr. C from the 3rd Floor

of the Reinberg Building, and Ms. P from

across the hall, dear

Mr. L from just last Thursday, and

the Mrs. L I’ll meet one day,

Did I ever say

thank you?  I don’t mean

thank you for your time, for your

patience.  I don’t mean thank you

for your honesty or for postponing lunch.  I don’t

even mean thank you for tolerating my three

attempts at palpating your


What I mean is,

thank you, because I saw a mother today,

Rosa, who has been

in the hospital for two weeks.  In the prior

hospital for three months.  Sick

before that for three years. 

She was tired

and dyspneic, understandably de-

pressed and rather anxious.  Ill. 


So ill  

that when I listened to her story, I heard

your voice, Ms. P, the voice of

an ulcerative colitis patient and

activist, the voice of a young law student

with a message.  I heard

your words, and I remembered, “Be okay

with the patient not being okay. 

That’s what doctors forget.”  And Ms. P,

Rosa and I counted

that wavering second together.  Rosa and I sat

in her months of hypertensive fear in

the absence of her children.  Ms. P,

Rosa had that moment where everything was

for her - because of you.  I only wish you were there

to feel.

And Rosa and I discussed her cavernous

finances, Standardized Patient Number 3, just like you

and I did, only better

for Rosa, because of you.  We talked

about the paper-thin pile of

medical bills she couldn’t pay.  The options

she didn’t have.  The help

she might find with a social worker.  And I’ll admit,

we fumbled a little.  I didn’t know

the grammar

of what a hospital could do.  I couldn’t possibly know

what her home state of Tennessee might offer. 

But we talked about these social 

Determinants of health, Standardized Patient Number 3.  

We did, and I know

you’d be proud.

because your adenosine moved me 

there, and Mr. C, you were also in the room, as I did the physical exam. 

I saw you.  The age spots

on the back of your ninety-year-wise hand guided

the pale motions of my trembling palm.  You steadied me. 

In your gruff tone of inhaled smoke, you

encouraged me: “I trust you. 

You’re my doctor.  Remember.”  I remembered, Mr. C. 

I remembered

to trust in the pressure I used

to palpate the liver, I remembered to trust

in the reading I obtained from the blood pressure cuff. 

I remembered, Mr. C.  It’s you

I remembered.

Oh, and if you could have seen

Rosa’s face, Standardized Patient Number 1.  If you

could have measured her trigeminal tremble

when she talked about her three little boys.  Those little

rascals, all basketball players

in their own leagues.  One was headed

to college.  Rosa would have wanted you

to know; she was so proud. 

And one was headed to

high school.  Oh, Standardized Patient

Number 1, if you could have seen the refractive

index of her eyes.  The only light in the room. 

Those three

little boys.  Those three little

stories that I asked because you told me

how much you loved that I even cared.

To ask those little questions

and to make those little gestures,

Standardized Patient Number 1.  That was your doing. 

And dear, dear Mr. L.  You and I barely spoke.  I said

hello.  You said you had

prostate surgery.  I helped you

to your robe.  You asked for a nurse,

as well.  And that was it, Mr. L, that was

all we ever did.  No exam

or history.  No findings or

presentation.  Just that.  Simple gestures,

like I shared with Rosa.  The simple weight of handing her

a book - not a pound.  The minute echo of an entering

knock - woke her up.  Mr. L, those gestures were

for you, for Rosa, because of you.

You know, I can’t even

remember who I was


Before you Standardized Patient Numbers 1

and 3, before you my dear, dear, Mr. L.  I can’t

remember.  The silence 

that came before your whispers in the hospital halls.  How  

many arteries per hour my blood surged 

sitting beside a patient without knowing. 

What you taught me, Ms. P and Mr. C.  How you

trained me.  Telling me I am ‘your

future.’  How you were glad

to help.

But you didn’t know.  You couldn’t. 

How every patient now has

the broad frame of your nose.  How

every hand is calloused as yours.  How every

thought trembles with the 

resonance of your cartilaginous folds.  Each time another Rosa enters.  Each time.

I can only

wonder, Mrs. L.  What gift

your presence will be.