My first housecall

Finding the answer

During a clerkship elective in rural BC, I was working in a clinic with a family physician. One day he received a call from one of his patients, Mrs Stewart. She was an elderly woman who was feeling too ill to make it to the clinic for her scheduled appointment that afternoon. The doctor listened to her for a while, then he asked her if it would be okay if he visited her later that day. She said yes.

As we wound up things at the clinic, my preceptor asked me if I’d like to join him. Wanting to be keen, I agreed. And besides, I’d never really been to a patient’s house before. As we entered the house, I saw Mrs Stewart lying on her living room couch. She was covered with a thick wool blanket, and the only sound in the room was the gentle hum of her nearby oxygen tank. At first, nothing was said. The doctor slowly walked into the living room and sat down on the beat-up coffee table beside the couch. He calmly reached out and took her hand. Finally, after what seemed like an eternity of silence, she said, “Doctor, I’m so glad you’re here.”

He asked her a few questions about how she was feeling, and she answered with quick-witted remarks. He reached into his bag and pulled out a blood pressure cuff. Her blood pressure was a bit high. Then he took his stethoscope and listened to her slowly failing heart and lungs. This brief physical examination probably didn’t help him much, but she seemed to appreciate it nonetheless. He put away his tools, and they continued to talk.

While they talked, the room was slowly filling with Mrs Stewart’s family. There were now 7 of us in the room. Looking around, I noticed how well the doctor fit into this setting. You would have thought he was a part of her family. In a sense, maybe he was.

As I stood in that living room, I was suddenly struck with déjà vu. Emotions and feelings woke up, and I felt as though I had been there before. Although I knew I’d never been to this house, I was sure I had been someplace similar. My mind was racing.

I stared at the patient. The combination of fear and strength in her eyes was something I had seen before. Her ability to laugh despite her dire circumstances was something I had seen before. Her absolute confidence in her doctor’s abilities and advice and the way his words comforted her was something I had seen before. Then it hit me like a ton of bricks. This wasn’t my first housecall. My first housecall was nearly 23 years ago.

Since I was a child, I had wanted to be a family doctor. And there were many reasons. But it wasn’t until the moment when I stood inside Mrs Stewart’s living room that I realized the reason. I wanted to give my patients the sense of comfort this doctor was giving Mrs Stewart, the same comfort that I believed I was giving my great-grandmother many years ago.

Through the good and bad

During the course of my medical training, it has become abundantly clear that family physicians are best suited to this type of primary care. Well-crafted buzzwords like physician-patient relationship don’t adequately describe the connection between family doctor and patient. It’s the family doctor who has known the patient for years and decades. It’s the family doctor who knows the whole family. It’s the family doctor who, in a sense, becomes part of the family. And it’s the family doctor who is there for the patient through the good and the bad, who is a source of advice and comfort. That’s why I went into medicine, and that’s why I want to become a family doctor.

So, whatever became of the toy doctor’s kit that my great-grandmother had given me so long ago? It’s sitting on a bookshelf in my bedroom. Whenever I look at my toy doctor’s kit, I’m reminded of my first housecall and what medicine really means to me. Medicine is much more than diagnoses, laboratory values, and medications. Medicine is a vehicle through which all of us are able to touch and make a positive difference in the lives of others, and nothing in life is more important than that.