Ruth was problematic.  Well into her seventies, her body may have dulled but her tongue was sharper than ever.  And she used it to lash me with complaint after complaint.  If it wasn’t her knees, it was her ankles.  If it wasn’t her ankles, it was her hips.  I battled the impossible month after month, year after year.  Our interactions left a bitter taste in my mouth.  Nothing makes a physician feel more impotent than the stubborn problems that refuse to bend under our practiced hands.

I am fairly experienced with complex medical issues.  I have never shied away from diagnostic challenges.  But I have to admit that Ruth seemed to push my buttons just so.  I started to dread our visits.  I winced every time her name came up on my schedule.

I am not proud of this.  The covenant between doctor and patient is sacred.   Neither a patient’s attitude nor my inability to solve her problems is an adequate excuse for such feelings.

It all changed instantaneously.  I was walking lazily through the botanic gardens with my family one weekend when I spied Ruth a few hundred yards away in the rose garden.  She was surrounded by children and grandchildren.  The young ones teased and coaxed as Ruth hopped back and forth with her walker.  Her laughter wafted effortlessly through the air.  She was alive and animated.  Her gait straightened, her limbs moved, and her face was alight with joy.  This was not the same crotchety woman whose visits I had grown to loathe.  I stared awestruck for a few moments before moving on.

A week later, Ruth hobbled into my office with none of the aforementioned spring in her step.  After making small talk, I mentioned that I had seen her from a distance at the gardens.  I talked of how alive she was amongst her children and grandchildren.  How her laughter caressed each brow, patted each back approvingly.  I saw no evidence of a body crippled by arthritis.

I could see Ruth appraising as I spoke.  She was waiting for me to get to the point.  Eventually I stumbled through my thoughts out loud.  I wondered why I had never seen such joy in the office.  Although I am only familiar with a fraction of my patient’s lives, I usually have a distinct feeling for who they are.

As Ruth replied, I could see the the amusement in her countenance at being asked such an absurd question.

“Joy?  Meh.  You expect me to be joyful at the doctor’s office?  This is where I go to complain about my knees?”

Her eyes sparkled and I nodded with a more profound understanding of our relationship.

And so it is with my writing.

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.