The Yale Journal for Humanities in Medicine

Notes from a Healer

Across the Threshold

Once, when I was a teenager waiting in a hospital hallway, I chanced to see a white-coated woman doctor pull a medical chart from a box mounted on the wall outside an exam room door. She leafed through its pages before she knocked briefly on the door and stepped into the room. I saw her face brighten, and heard her voice croon a greeting before the door closed behind her, sealing doctor and patient inside. Although I could hear muffled voices, I couldn’t make out the words. But I was certain that whatever they were talking about carried great significance, like the words of a penitent to his priest in the confessional.

Decades later, now trained in clinical medicine, I find myself in the same position as that doctor countless times a day: reviewing a medical record, rapping gently on an exam room door, and stepping across the threshold into another person’s world.

Patients say things behind closed doors that they would never think of divulging in other settings. Most times (not always) patients shed their masks, lower their guard, allow themselves to become vulnerable to the extent that they feel they can safely tell their story. Over the years I have counted it a privilege to listen to the stories of my patients. I know that when they tell me their stories, they have a chance to experience some degree of healing, of being made whole again.

We are all vulnerable at core; we all fear rejection by others. Each one of us has a deep-seated need to be understood, and it is in telling our stories that we begin to understand this need. We all desire acceptance: we want others to see us and embrace us for who we are, warts and all. As Victor Hugo wrote: “The greatest happiness in life is to be loved for ourselves—or rather, loved in spite of ourselves.”

I have listened to many stories over the years—stories of illness, stories of addictions; tales of misdiagnoses, tales of treatments turned worse than disease. I have heard hope straining to rise above despair; I have witnessed love struggling to triumph over hate, apathy and indifference; I have watched pain pour out of old hidden wounds.

Once, an elderly man stopped by the clinic where I worked. He sat in the chair opposite my desk and proceeded to tell me about his wife when the two of them were young. She had a problem and sought guidance from a deacon in their church. After months of counseling, his lovely young wife announced one day that she was leaving him. He later found out that she ran off with the deacon. At seventy-six years of age he told me that he still loved her deeply, and still carried the pain of her betrayal in his heart.

It takes a bit of nerve to step across that threshold into another’s world. You never know what awaits you there. You never know what stories might be poised, ready to spring off the tip of the tongue, until you acknowledge the patient as person, and listen.

About the Author

Brian T. Maurer has practiced pediatric medicine as a Physician Assistant for the past three decades. As a clinician, he has always gravitated toward the humane aspect in patient care—what he calls the soul of medicine. Over the past decade, Mr. Maurer has explored the illness narrative as a tool to enhance the education of medical students and cultivate an appreciation for the delivery of humane medical care. His first book, Patients Are a Virtue, recently reviewed in The Yale Journal for Humanities in Medicine, is a collection of fifty-seven patient vignettes illustrating what Sir William Osler called “the poetry of the commonplace” in clinical medical practice.

Published: March 3, 2008