Borrowing Tom Hank’s line from “A League of Their Own” circa 1992, the year I started my practice, I was quick at the time to lay down my own “rules”. Some use positive affirmations, for me I would just say, “There’s no crying, throwing up, bleeding, whining and definitely, no coding! in the center”. One could only hope, but good to have goals.

Other than first grade, or first time at bat in T ball, one of the most vulnerable times in your life will be sitting on an exam table in a thin little gown shivering and often frightened. I have been there too. In my office, I instruct the staff to settle the patient in the chair (fully clothed). This allows for engagement as a person, not patient. Then, even in Florida, when we move to the exam table, I allow them to put on the jacket or sweater like a security blanket. If I sense jitters are coming, or fear is near, I begin right away with the lung exam. Patients didn’t know (until now) that this is deliberate. The slow deep breathing, under the stethoscope, as we know in yoga and meditation, reduces anxiety quickly. Then the remainder of the exam and engagement proceeds more calmly. If I know it is going to be a tough visit, I join in with the breathing too!

Of course this does almost nothing for the frightened father, wife, son witnessing. I say ‘almost’ because, while the support team is writing, questioning and trying to process, this small moment is transformative. They begin to see thier loved one gain control. They allow them the chance to speak, they marvel that the patient is developing a strength that will empower them all.

Here is another example of why I am not a fan of virtual medicine which completely removes this intimate interaction. It is called “the laying on of hands” and the physical exam is a critical part of the bonding between physician and patient. As I am now covering other offices, too often patients are in chairs with bloodwork and xray results discussed without a healing touch. In the “new normal” of medical care this will be lost. Patient Billy was so shocked, “Hey Doc! I haven’t had my prostate checked for five years!” Really? He has prostate cancer and for me just reading off a psa result won’t do. I found microscopic bleeding and since radiation for prostate can increase rectal cancer in a small number, I sent Billy off for colonoscopy, which he also never had.

Engaging with others my age and also seniors, I was asked recently why I don’t retire and enjoy time for myself. I was quick to reply without even thinking. I did not say that I want or need to work. I didn’t say I enjoy caring for patients, I didn’t say I don’t want to waste talent, experience and training. No. My immediate response was, “I love my patients”. I deliberately chose a patient- centered practice rather than procedures (‘oscopies, ortho, radiology, pathology etc.) Cancer was a perfect match. We often hear that you should love what you do. Perhaps it is running a business or a marathon. Perhaps it’s practicing yoga or painting. I share much that is personal on these pages, so you will not be surprised to hear me say, “When loving what I do, especially as an empath, involves caring for people at a critical time in their lives, I can find no other calling that will fill my heart”. (Plus I suck at pickelball).

And so, when a patient returns after a terrifying time of treatment, or years of care and management, then there will be tears of joy and relief on both sides and I make an exception. There is definitely crying in the cancer center.