I guess it shouldn’t have been a surprise.

Her house was exactly as I expected it to be.  The door couldn’t have been more fitting; red wood with a green holiday wreath attached perfectly in the center.  The carpet was so white that I almost took off my shoes on the front porch before entering through the threshold.  The room was warm.  The ambient temperature was accentuated by a plethora of colors and fabrics in contrast to the stark carpet.

I stepped into her living room and unloaded my bag.  I took out my equipment carefully: computer, stethoscope, blood pressure cuff.  I glanced up at the book shelves as I prepared.  They were full of objects placed neatly in regular intervals.  Each was in its correct place.  The place, I had no doubt, that it was inherently meant to occupy.

It was a new feeling of intimacy for me.  Not the kind one gets from doing a thorough exam, more like how you feel after you have been talking for a few hours at a coffee shop.  For possibly the first time in my professional career, I was on someone else’s turf.  This was not my examining room.  There were no sterile walls or misfitting gowns.  Even my lab coat had been abandoned in the back seat of my car.

We stared at each other.  I cowered behind my computer as she relaxed in her reclining chair.  She looked more gaunt than usual.  Beneath the stylish clothes, manicured hands, and recently styled hair was a cachectic woman.  A woman who faced her cancer with the same cleanly order she decorated her shelves.

And I understood.

There would be no chemotherapy or surgery.  There would be no blood soaked gowns or protruding tubes.  These things were far too disorderly.  She would gladly trade in a few morsels of time to avoid such indignity.

She would die in her bed.  In her bedroom with her adroitly adorned picture frames and her fluffy pillows.  A little too soon for my taste as a doctor, but maybe that was ok.

I finished my exam and made some notations in the record.  I printed a few prescriptions to keep the pain and nausea at bay.   We shook hands before I left.

Crisp, clean, orderly.

It was like I was seeing her for the first time.   Seeing her as she really was.

And not some deformed image spit out by our health care’s disfiguring house of mirrors.

Jordan Grumet is an internal medicine physician and founder, CrisisMD.  He blogs at In My Humble Opinion.