No time like the present

Asking questions about a patient’s life can be the best use of a doctor’s time

nna had a list of things to ask the doctor that day. A niggling pain in her foot, a mole on her left shoulder, and if time allowed, she might be able to get that blood test she had been meaning to ask about. An article in a popular magazine, six months earlier, had got her thinking about her ovarian reserve and since then, she had been consumed with a feeling that as a responsible, single, thirty-year-old, she should have a blood test done to check this. If there was a problem she could, at least, think about freezing her eggs as a guarantee against future childlessness. The article had come to her attention at the same time as the end of a long-term relationship, with a man she thought she would be with for the rest of her life. She wasn’t even sure that she wanted children, but a future partner might expect her to have eggs in reserve, if by the time she met him, her ovaries were no longer functioning. She would ask the doctor about the test.

It was, Anna told herself, a perfectly reasonable question: The answer was either, “yes” she could have the test, or “no” she couldn’t. But the doctor did not answer straight away. Instead, she had set down her pen, sat back in her chair and took a deep breath, searching Anna’s face as if she had only just realised that she was there. When she did speak, she had asked a question of her own. “Tell me, Anna,” she had said. “We have known each other a long time. What has happened to make you think of your life in terms of ovaries, eggs, and freezers? What sort of future do you see for yourself?”

And before Anna could help herself, the words had come tumbling out. Words that she did not know were in her. Feelings that she did not know she had. Amidst tears and sobs, a story emerged of loss, failure, and disappointment. A story of lies and broken promises, that had left her feeling used and abused. Of the loneliness of finding herself single again. Of the fear of a future filled with bitterness and resentment of other people’s good fortune. Anna had already noticed that she had started to avoid her married friends and faked joy at the news that they were pregnant. She told of the crippling self-questioning, wondering if she was to blame, if she had been too demanding, or not demanding enough. Was she right to have ended the relationship, even if it was an unhealthy one and the constant wondering if she was ever going to meet someone that would help her feel safe and happy. She envisioned a bleak, joyless future with no one special in her life.

The doctor sat and waited, thinking it best not to interrupt, not to question, offer solace or reassurance. Instead, she moved the box of tissues closer to Anna’s chair. She had known Anna since childhood, a confident, sociable and happy person. Not that long ago, she had graduated college with a first-class honours degree in biochemical engineering and was working in Dublin. Her distress had come as a surprise, but she was glad that at least she was sharing it. She was glad she had not simply answered Anna’s question. As the sobs subsided, she sat forward in her chair. She would have to call time on this. She was also aware of the clock ticking, except hers was a real one, not a biological one. At times she wished she could press a button and stop those hands from going around and around. Inviting people to share their stories of distress required allowing time for that story to emerge and time for the person to recover from the telling, before facing once again the everyday world. It was time well-spent, but it came at a cost. And there was no knowing when it was going to be the most important thing that the doctor had to give. She knew that the people waiting to see her would be getting restless. That they would all have their own concerns, requests, and expectations.

“So,” she said to Anna, who was busy removing the last traces of mascara from her cheeks, “do you want to know what I think about the blood test for ovarian reserve?” Anna sniffed again and stuffed the last remaining tissue up her sleeve. The question that had been bothering her for six months no longer seemed important. She felt better, although she could not say exactly why. “Perhaps we can talk about it again another time,” the doctor said. Anna nodded, before gathering her things and getting up to leave. “Thank you, doctor,” she said, her hand on the door handle, “I suppose I will get an appointment in the post for removal of that mole.”