Query

Figure. Photo by: Fred Sebastian

The music was loud. People were dancing in the living room, the kitchen and the bathroom, I think. Conversations were held at decibels. Every so often, someone would crank up the stereo. The party was several bottles of wine old, and the last thing I was thinking about was the fact that I'm a doctor.

In social situations, I'm loathe to reveal the fact that I'm a physician. When I do, nights supposedly “off” are spent listening to tales of knees gone wrong, persistent coughs, breast lumps and hot flashes. “Can you get me an MRI faster?” I've been cornered beside the punch table for advice on vaginal discharge. I know these people are merely looking for a sympathetic ear; most are already under a doctor's care. I listen for a while and then break out my stock response: “It sounds like you are very concerned about this, and I think you should discuss it with your physician.” Only occasionally am I forced to be more insistent and tell them that I am not their doctor and that it would be inappropriate for me to offer medical advice. And forcefully repeat that line until they get the picture.

Yet it's hard not to be known as a physician in my small town. It's like knowing who the police chief is or the mayor. So I've come to terms with the fact that my reputation often precedes me and that it is inevitable and that I'll be asked occasionally for extracurricular medical advice.

And so, at this particular party, a girlfriend of a friend of mine, a woman I hadn't met before, walked up to me. It was hard to hear her; someone had cranked up the volume yet again. I made out the word “doctor” and “problem” and figured I was caught. I pointed to the door, thinking that outside was the only place where we could hear each other.

After a short hesitation, she began to tell me about her struggle with depression, which began three years ago. She began to weep as she mentioned that she felt she'd be better off dead, that everyone would be better off if she just died, and that lately she had begun to fantasize about slitting her wrists or driving into a telephone pole, she wasn't sure which, but that she thought it would be soon.

Vaginal discharge and bum knees are a low-stakes party annoyance, easily dispatched. But what was I to do about this particular disclosure, at a party? If I were in my office, I could arrange for urgent treatment.

Then I got an idea. I asked her why she felt the need to tell me how she was feeling. There really is only one answer to that question: because she must think, in some way, that I might be able to help. And once she said that, I harnessed it. I asked if she thought she would be safe tonight, and she nodded yes. When I asked if she was under the care of a family physician, she told me no. I told her that I should see her in my office tomorrow so that we could talk more about how she was feeling and what to do. I advised her not to drink any more alcohol in the meantime.

Someone turned the music up even louder.

Other than my ears, I did feel alarm bells ringing. Was it right for me, who met this woman at a social situation, to act as some kind of saviour? Especially after I'd had a few drinks? It's not the ideal way to add patients to a practice. But what else could I have done? I could have recommended that she go to emergency, but that seemed drastic and would also have been a convenient shirking of responsibility. It seems that part of being a doctor is that people see me as a doctor, and that the responsibility follows me wherever I go.

I went back in and smiled at my friend, her boyfriend.

— Dr. Ursus