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.
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
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
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.
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
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.
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
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.