Dear Doctor,

I am a good patient. I’m organized, I know my health history and I’m particularly polite. I’ll thank you just for giving me bad news.

I look up to you. I do see myself as a partner in my care, but I depend on your expertise. I appreciate the years of schooling and sleepless residency nights that have trained you to know what might be causing my pain and how to adjust my medications.

My appointments always run smoothly. There isn’t overreaction or disregard for your advice. It may seem like I am open and honest with you, but I have a few secrets.

 Secret #1: I trust you, sometimes more than myself. This makes me second guess my symptoms. Because I live with a chronic illness, I have learned to cope with pain and physical abnormalities that might be concerning to you. If you deem my condition stable I will push my concerns to the back burner. The headache? It’s no big deal. The nausea? Barely noticeable.

Secret #2: I may look strong, but I’m scared. I don’t want to cry in your office, so I wait until I’m in the car. That warm smile and hearty handshake I offered were covering up the worry that has taken over my thoughts. The future feels wild and unpredictable. I’ve been in the health system long enough that I should be used to these fears, but at each appointment they feel new.

Secret #3: I push the limits. Maybe this is more of an open secret, but I sometimes sway from that healthy lifestyle we’ve discussed. I occasionally eat more sodium than I should, and I know that exercise is important, but I skipped all of last week. I do pretty well, so I don’t mention these slipups. I need to better understand how important this is to my care. Can you help me recognize, in my own life, what the benefits of these changes will be?

I would like to have a more authentic, even less polite, relationship with you. I want to share these secrets. I want you to be able to care for me without either of us feeling self-conscious. I will work to make that happen. I’ll tell you about all of the symptoms, even the ones I’m pretty sure are only in my head.

In return, I ask for your patience, your questions and your concern. Invite me to tell you the down-and-dirty of living with my condition. Talk through it with me. I know this is hard in today’s health care pressure cooker. We both want more time. I promise to come prepared, meet you in the middle and share if you will listen.

I will still be a good patient. Still show up on time. Still thank you even when you give me bad news. But a more authentic, secret free, relationship will serve us both better in the long run.

Sincerely,

Your Patient

Danea Horn is the author of Chronic Resilience: 10 Sanity-Saving Strategies for Women Coping with the Stress of Illness and blogs at Chronic Resilience.