The Poor Historian
Martin Hess sat with arms crossed in the family doctor’s waiting room. This was the third doctor he’d visited in as many months. Frustration and fear called up an image of Ben, who recently sat right where he was, before his nightmare began.
Ben and Martin were friends from the local gym and had both celebrated their 40th birthdays together last June when Ben got the news about his kidney cancer. In six months he went from fitness buff to skin and bones. He had been gone almost a year now and Martin still shuddered to think of how that disease ravaged his friend.
Three months earlier, when two or three Advil no longer had much effect on his back pain, Martin went to an urgent care center. He struggled to describe his pain to the medical assistant who was engrossed in her computer data entry. “It’s pretty bad but worse on some days, maybe not the worst pain I’ve ever had and I just wondered if…maybe I’m overreacting but my friend…”
“The doctor will be in shortly,” she interrupted, then hit the last computer key like a pianist’s final recital note and dashed out the door.
The doctor was friendly when he came in the room, but then was all business. So you have back pain–upper or lower? How severe? Where is it exactly? How long have you had it? Have you had it before? And so on. As he climbed onto the exam table, Martin caught a glimpse of the computer screen where the assistant and doctor entered their notes. “Poor historian,” it said at the top of the page, but the rest a series of check boxes that he could not decipher.
Poor historian? Was that referring to him? He wasn’t a historian at all as far as he knew.
The doctor prescribed an anti-inflammatory and muscle relaxant, and suggested he call if the symptoms worsened, or were not resolved in a week or so. After taking his medicine later that night, Martin imagined a tumor mass slowly growing and eroding into his flesh and vital organs.
He knew he needed follow up, but was reluctant to return to the urgent care physician who seemed harried and inattentive. This time Martin went to a local primary care clinic, a satellite of a reputable regional health system.
Dr. Kay was energetic, and seemed eager to help. Martin began to recount his experience at the clinic, trying to convey his frustration that his pain did not respond very well to the anti-inflammatory medicine, when Dr. Kay broke in.
“I hope you are not expecting any narcotics–we don’t do that here,” she said abruptly.
“Do what?” Martin asked, feeling suddenly confused.
“Pain management. That is just not what we offer here. Too many people want us to handle their narcotic prescriptions and we just can’t provide that service. I would be happy to refer you to a Pain Management center though.”
Now Martin had gone from confused to bewildered. Was this the curse of the so called “poor historian?” Pain management sounded good–maybe that doctor would know how to diagnose and treat him. He mulled over possible responses until his temples throbbed and neck muscles tensed and he just blurted it out.
“OK, send me to pain management.”
“Thanks for understanding.”
As it turned out, the pain management clinic was not in his insurance network and would cost him $400 for an initial consultation.
So, Martin decided to query some of his co-workers about their doctors.
Marlene, a manager spoke up first.
“I’ve been with Dr. Athy for ten years now, and I really like him.
“What do you like about him?” Martin asked.
“His staff is friendly, and he never seems rushed. He answers all of my questions,” Marlene replied.
Fast-forward 3 weeks, and here he was.
If this didn’t work out, he wasn’t sure where he would turn.
“Mr. Hess, come on back,” a cheerful young woman said. “I’m Sandy, Dr. Athy’s medical assistant.”
Things were better already–at least she introduced herself!
Sandy walked him down a long, brightly lit corridor and into a neatly appointed exam room.
“The doctor is running about fifteen minutes behind schedule, but you are his next patient.” Her smile put him at ease.
Soon came a knock on the door. “Hello Mr. Hess, I’m Dr. Athy. It’s a pleasure to meet you,” he said extending his freshly sanitized hand for a shake. His white coat, no tie look exuded a relaxed professionalism.
“You can call me Martin,” he said, returning the polite handshake.
“OK Martin,” Dr. Athy said, “Tell me how I can help you today.”
“It’s my back. It’s been bothering me for about 3 months. I don’t want to say too much. That hasn’t gotten me very far.” Martin said, careful not to utter a word about pain medications.
“Tell me more. It sounds like there is a story here,” said Dr. Athy, his eyes showing sincere curiosity.
Martin hesitated, but then started to speak, recounting his story from the beginning. After a minute or so, he asked, “Should I continue? I know you are busy.”
“No problem Martin, go on.”
Martin continued, telling Dr. Athy about his symptoms, saying that he had been referred to something called Pain Management, even though he had no idea what was wrong with him.
“That must have really frustrated you,” the doctor said.
When Martin finished his story, Dr. Athy asked a few follow up questions, performed an examination, then moved away from the computer pulling his chair up closer to Martin.
“I have a few thoughts about the cause of your pain, but first I’d like to know what you think it could be from. Have any possibilities crossed your mind in the last month?”
“I guess… It’s probably nothing, a strain or something,” Martin said.
“You don’t sound sold on that. Is there something you are especially worried you could have?”
Martin wasn’t sure what to say. The doctor sat silently while Martin deliberated with himself for what seemed like an hour, before saying, “My friend died of kidney cancer last year. He had back pain too, and I can’t help thinking of a cancer inside of me.”
What a tremendous relief it was to get that out. It was like he had been living in clothes that were two sizes too small for months and he finally found the right fit. The back pain even seemed to ease.
Dr. Athy reassured Martin that the character of his pain did not indicate a kidney problem, but said that he could understand why he was worried. Martin felt less foolish and ignorant admitting his true concern. Dr. Athy suggested another trial of anti-inflammatories and some stretching exercises. He also recommended a follow up visit in two weeks to evaluate Martin’s progress.
As he thanked the doctor and prepared to leave for the checkout, he recalled what he saw on the computer screen at the urgent care center.
He turned back and asked, “Dr. Athy, what does it mean to be a “poor historian?”
“Well,” the doctor said with a little hint of a smirk, “That’s what we say when we’re not listening carefully enough.”
This is a work of fiction. Any similarity to actual persons, living or dead, or actual events, is purely coincidental.