ears ago, one of my patients came to my office with fatigue, shortness of breath, a heavy sensation in his legs, and difficulty concentrating. I asked him detailed questions about his medical history, did a physical exam, made a list of possible diagnoses, and ordered lab work and other tests. When this workup didn’t yield an answer, I sent him to specialists. They, too, couldn’t find a cause for his symptoms.
Though I’d been the man’s primary care doctor for a decade, I didn’t know him very well. He’d always been healthy and had sought my help infrequently. Now his visits and calls came fast and furiously — really furiously. As my methodical evaluation proceeded, my patient grew frustrated, and then became angry with me.
He eventually transferred his care to a physician who gave him a controversial diagnosis and offered an unorthodox, expensive, and painful course of treatment. Though I shared with him my skepticism, he wasn’t discouraged. In fact, he was thrilled. At last he had an answer, a plan.
In the days after the presidential election, I’ve considered its outcome from many perspectives: as a woman, a feminist, a mother, and a doctor. As a physician, I’m especially worried about the effect of election on the nation’s health. I remember the days before passage of the Affordable Care Act (and its predecessor in Massachusetts, where I practice) when my patients would forgo cancer screening and essential medications when they were between jobs and without health coverage.
I’ve seen firsthand the effects of gun violence, reduced access to reproductive and mental health care, and misinformation about vaccines, all of which could be made worse in the coming years.
I’ve also found myself thinking about my former patient. Why him? I saw in his story some similarities to the 2016 election. Perhaps countries in pain, like people in pain, are so desperate for relief that they make rash choices. In my mind I cast Hillary Clinton as the plodding physician, Donald Trump as the quack with big promises, and the American electorate as the impatient patient.
It gives me no pleasure to report that the treatment my patient chose against my advice didn’t work. He continued to get sicker and, many months after his symptoms first appeared, he was diagnosed with a rare and incurable disease.
When I visited him shortly before his death, I found him pale and weak, but infused with the grace that the dying so often acquire. He was no longer angry with me. We held hands and spoke of his family and his work. He asked about mine.
I regretted that I wasn’t able to make a diagnosis sooner for my patient, that I’d been unable to spare him unnecessary pain and expense. But what I regretted most, and what still makes me sad, was that I hadn’t known him better, and that now I never would.