Have you tried this yet? Telehealth has been around for about ten years and a quick service for minor issues.  We have never used this for radiation therapy cancer visits but engaging with patients who do not require an in– person exam reduces their risk during the pandemic. What I am finding is that sometimes it’s a hoot!

“Doctor! You don’t look sick! How come I gotta talk to you on the phone? They say I can’t come because I might catch a virus.”  I am sitting at a computer in an exam room. Dalia is in front of me on her phone with facetime.  At 83 she needs to be protected but doesn’t fully understand how staying away from the doctor is better for her health. Her face is covered with a mask. “Dalia, is anyone with you?” She assures me no one- “Dalia, I am far away from you on the computer so you don’t need to wear a mask. We both giggle. “Doc, this is the craziest thing! I just want to come in and see you- how are you gonna examine me?” We review the reports I have but I agree this is profoundly limited.  We  set a time in a month for a “real visit”.  

Larry was in this week for a check up. At 87 he is having none of it. “Doc, if I am gonna die, you gotta give me a hug. I might not make it next year.” He always brings a smile. “Larry, your mother lived til 101 and your cancer is controlled, so no hug today, stay home and we will see you next year!”

Ginny is newly diagnosed, has several procedures this week and is frankly terrified. “Doc, I just need your comfort and strength.” You don’t get that from a computer. Mickey came in for a followup. “We could have talked over the computer” I say. She shakes her head, “Doc I live with my 96 year old mother, I was dying to get out for the morning!”. Harvey is happy to call it in and escape the prostate exam. Olive tries to stick her foot in the camera so I can see the swelling. We laugh about her being a contortionist. Mike is shy but finally turns around to show me a rash on the buttock that looks like shingles and needs treatment immediately. Understanding that cancer patients are frequently immunocompromised keeping them safe at home is important but limited.

The laying on of hands is a revered part of doctoring. I recall the first time we examined each other as med students, the scientific learning took a real turn. I have always felt that the bond formed when a physician examines a patient is a force. I never take for granted no matter the years, that you have placed your trust in me to use my skill for your benefit. It is always an honor and a sacred trust. It is never haphazard or routine. Touching another person for an exam has healing properties and the impression that telemedicine can replace is a fallacy.

If your doctor’s visit is set up for telehealth, go in prepared before you hit face time or Zoom. Make a list of your concerns and questions. Since you are not physically examined, this visit is unlike most and involves talking with your doc and they can only help if you provide real information. They are there to help in spite of the circumstances- we all know it isn’t thorough but it can be efficient and safe.

 I will see anyone who refuses medical care over a computer. My patients have a fearless spirit. They know that the virus isn’t seeping under their doors, tracking them down. They have learned to avoid risky behavior.

You and the USA have seen tough situations and prevailed. We will again. I will hug my patients again, I will give up telemedicine for the hand to hold and the touch to calm. I will be there for you and you will be there for others. Let’s be unafraid together.