I’ve Cried in Front of a Patient Twice in Fifteen Years


I’ve cried in front of a patient twice in fifteen years.  

One was in front of a patient and his wife.  

The other was in front of about twenty-five patients and it happened a few weeks ago.

So I don’t know how you feel about weepy doctors. Some say it’s unprofessional. Some say it’s unhealthy. I say it’s a li’l embarrassing, but overall just real.

So the first one is an obvious one: Talking to a gentleman in his fifties and his dear wife, telling him that he has a really tough cancer diagnosis. Even though I have done this quite a few times, it is always intense and it never gets one bit easier. Thankfully there is usually a sense of strength and calm that comes over me in these times.  

There was nothing different about this time, but somehow the look that he gave me caught me off guard and the tears flowed. They were tears of I KNOW THIS JUST SIMPLY SUCKS AND I’M SO SORRY YOU ARE DEALING WITH THIS.  Ironically they were followed by laughter as I reassured him that when your doctor cries, it actually doesn’t mean that your prognosis is any worse than when she doesn’t!

A few weeks ago was kind of a random one honestly and totally unexpected.  

You may have heard about my completing flipping my private practice on its head ...changing locations, changing practice model, changing business model.  It is EXCITING.  It is the RIGHT THING to do.  And it is SCARY.

Have you ever had something to tell someone and you had no idea how they are going to react?  Were they gonna get it?  Were they gonna get you?  

Sometimes (like all the time) you build it up in your head to be so different than what it actually turns out to be.  Sometimes (like all the time) you walk through people’s reactions in your mind that end up to be so different than what they actually are.

A few Saturdays ago I met with a group of twenty-five patients after office hours to answer their questions about direct primary care and the changes in the care I am offering them.  I have a tendency to do presentations on the fly and this was no different.  The change is exciting and a step to advocate for how healthcare should be delivered, so I was excited to share all the benefits.

Just like the first waterworks, there was nothing different about this presentation, but somehow a single thought and the tears flowed.  I was making the point that we have been somewhat brainwashed to think that health insurance equals healthcare, but in reality, that connection is not solid.  

Insert thought: So if I’m not “accepting” someone’s health insurance, then they think I’m not accepting them.

And then the tears.  “Wait. What?” you think.  “I don’t get it.”  Believe me.  I didn’t either.  And probably those people in the waiting room didn’t either.

What I never really paused to think about in this process is how intense the relationship can be between a patient and a physician who has been together for years and that was the kicker.  

There is emotion in that relationship.  And there is humanness in that relationship.  

Just like the first time, those tears were followed by laughter as I assured the gathering that just because your doctor breaks up with your health insurance, it doesn’t mean she breaks up with you.  It actually means you can have a relationship that is based on healthCARE.

It’s not you, it’s your health insurance.