15 emotions in 15 minutes

 Andrew Kaddis

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Curiosity is the first emotion I encounter as I arrive at my patient’s room, who is presenting with an urgent “cough” concern. As I grasp the handle to enter the clinic room, I quickly consider some of the possibilities: viral illness, severe asthma, COPD, or even cancer. I experience a moment of relief with a simple glance at the sheet displaying stable vital signs and seeing my masked patient sitting comfortably. My overused opener “What brings you in today?” surprises me with a response of: “CAN’T YOU SEE I’M SICK?!”. My fear quickly subsides as I smile and begin to carry out a focused history and physical with the remaining 14 minutes and 29 seconds that I have.

 

My patient tells me an elaborate story of how he became ill, and I begin to be confused with the complex chronology of events that led to his current episode of sickness. A few specific directed questions get me back on track. Empathy follows as he tells me how much his acute illness has affected his life and job. When he reveals his current project as a contractor working on a Victorian house restoration, I experience a brief moment of nostalgia, as I recognize that my childhood dreams of becoming a craftsman are manifested before me. And as we continue our conversation, I sense myself developing an acceptance of my patient’s pre-contemplative state of change with respect to his smoking habit, which is likely worsening his symptoms.

 

Frustration with the health system grows as I glance at my watch that informs me I am now halfway through my time. I feel guilt as I cut the conversation short in order to leave time for the physical exam. Interest in performing a careful lung exam allows me to uncover mild expiratory wheezes with no other adventitious sounds or signs of consolidation on auscultation. My stomach growls with hunger during the exam, telling the patient that I am ready for lunch. Having narrowed a differential diagnosis, I am optimistic about my thoughts as I excuse myself to present findings to the senior physician. I return with minutes to spare and am happy that I am able to offer medications and guidance to get this man through his sickness. Finally, I am grateful for the privilege to be a part of my patient's life during this brief yet memorable experience.