Nothing seems to please a fly so much as to be taken for a currant;
and if it can be baked in a cake and palmed off on the unwary, it dies happy.
-Mark Twain

Returning to clinic after time off for a summer break, I worry I’m like a fly hiding among the black currants hoping to eventually become part of the currant cake.  Just maybe no one will notice I don’t quite fit back in.

In 33 years of practice, even after bearing three children and going through several surgeries, I’ve not been away from patients for more than twenty consecutive days at any one time.  This is primarily out of my fear that, even after a few weeks, I will have forgotten all that I’ve ever known and if I were to actually return to see patients again, I would be masquerading as a physician rather than be the real thing.   A mere fly among the currants palmed off on the unwary.

Those who spend their professional lives taking care of others also share this concern if they are truly honest: if a patient only knew how much we don’t know and will never know, despite everything we do know, there would really be no need for us at all, especially in this day and age of accurate (and some terribly inaccurate) medical information at everyone’s fingertips.  Who needs a physician when there are so many other options to seek health care advice, even when there are a few flies mixed in?

As I walk back into an exam room to sit with my first patient after my time away, I recall over thirty years of clinical experience has given me an eye and an ear for subtlety of signs and symptoms that no Googled website or Internet doc-in-the-box can discern.  The avoidance of eye contact, the tremble of the lip as they speak, the barely palpable rash, the fullness over an ovary, the slight squeak in a lung base.  These are things I am privileged to see and hear and make decisions about together with my patients.  This is no masquerade; I am not appearing to be someone I am not.  This is what I’m trained to do and have done for thousands of days of my life.   No need for the unwary to fear.

The hidden fly in the currant bush of health care may be disguised enough to be part of the cake that an unwary patient might gobble down to their ultimate detriment — but not this doctor.  I know I’m the real thing, perhaps a bit on the tart side, but offering up just enough tang to be what is needed.

And I will die happy doing this.

Emily Gibson is a family physician who blogs at Barnstorming.