The story just didn’t fit. The aches and pains, the shortness of breath, and yet the normal physical exam and heart studies.
I sat across from Tom, a 68-year-old long-time patient of mine. His daughter joined us in the exam room. I began to suspect that there might be factors beyond the physical involved here. Was it work? Tom was still working and maybe he was being “forced out” by his company because of his age and economic factors. Should I even explore these issues? Should I just be content to tell Tom the good news – his heart was fine – and leave it at that?
Part of being a doctor is, of course, helping people feel better. My job would certainly be simpler if psychological factors were never involved, but that’s just not how the body works. I felt compelled to explore this side of Tom’s life. “So tell me,” I began, “How are things at work and at home?” I was rather startled that within a short time, both Tom and his daughter were in tears. What issue did I uncover?
It seems that Tom had become estranged from his other daughter. And when the issue would come up at home, so also would various somatic symptoms – headaches, chest pain, shortness of breath, a generalized nervous feeling, etc.
I certainly didn’t know what caused the rift between Tom and his daughter. We spent some chatting about it, though, and I hope with the connection between this strife and Tom’s feelings, his family will be able to help Tom and his daughter put the fragmented pieces of their relationship back together.
An old story is told of a rabbi who instructs his pupils to reconcile with others, “On the day before you die.” “But Rabbi", the confused students said, “We can’t know the exact day on which we are going to die!” The rabbi looked at his students and responded, “Precisely!”
If you have a comment or question about this blog entry, email Dr. Roffman at firstname.lastname@example.org.
Dr. Joel Roffman has spoken to many church, synagogue and support groups. His book, Coping with Adversity: Judaism’s response to illness and other life struggles is enjoyable, uplifting and informative. It is meant for people of all faiths and can be viewed at http://www.copingwithadversity.com/. It is available at Barnes and Noble, Borders, and Amazon.com.