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  • Writer's pictureChristina

A Normal Patient Visit: September 2023 Update

My patient asked me if this was a normal type of visit for me. She said that she didn’t know whether to expect counseling or coaching or therapy, and she wasn’t sure she was doing it right. I smiled, because we were already an hour into the visit, but I didn’t mind; this was my last visit of the day. We had just been talking about how she held herself to higher standards than those around her, and she wouldn’t even allow herself to show weakness unless she was struggling with something which was “normal” for other people too. So now she was concerned that she should be making the right use of time during this visit.

But my office visits are as unique as my patients. Sometimes, my patients bring me chocolates. Sometimes, I bring them tea. Sometimes, all they need is an email or a prescription left at the front desk. Sometimes, a ninety-minute visit barely begins to scratch the surface of depression or trauma. I have visits with freshly arrived volunteers about what they can do to stay healthy. I have visits with kids about how to keep their vaccines up to date even when certain doses are hard to find in-country. For nearly a year, one patient took my last Tuesday appointment every week- she had already recovered from severe depression but she wanted someone to talk with about the future and her lifestyle goals.

Even though Lilongwe is a capital city, it is a bit like a small town, especially when it comes to healthcare. Just like patients come to see me in clinic, I visit them in their places of business – restaurants, shops, nurseries, ice cream parlors. I walk with my patients and jog with my patients. Sometimes I do house calls. Sometimes I leave them paperwork for immigration or drop off devices to help them measure their oxygen when they have COVID.

I talk to most of my patients about healthy lifestyles, and I pray with almost all my patients. I’ve started to know my patients well enough to say, “this is normal for you” or “this is a big improvement for you.”

So when this patient asked me if she was talking about the “right” things during our time together, it was hard to give her a straight answer. She was a doctor, and she was having a difficult time, and she was maxed out on medications from another provider, and I didn’t want to make changes at this time. We talked a lot about her stress, her support systems, her fears, and a bit about her hopes. I spent a lot of time reassuring her, but I also shared more about myself than I did with other patients – about hard times in my life and my training, about my personal and professional experience with physician wellbeing. You could say that I wasn’t being a normal doctor the full time – I was taking more than an hour for the visit, I was talking a bit about my life, and I was even telling her how my own perfectionism and “inner critic” meant that I had to be particularly careful about stress and expectations. Sometimes she writes down what I said, and once she recorded our conversation, saying that she wanted to repeat messages of affirmation to herself after the visit.

It’s funny to me sometimes how things I say can seem like wisdom to others. I have my own inner critics, and I try to channel voices of affirming inner mentors when they pop up. So it’s ironic that my voice could be a mentor or a guide to this younger doctor, struggling with some of the same and some different things than I am. We’ve been communicating via email for the last week. She feels like she has found a friend, and I have found a motivation to think more about what drives and challenges me.

No, there’s no “normal” clinic visit for me. Just like there’s no one standard patient. But I love this work that I do, and the relationships and transformation that often comes with it.

This month, please pray for me and Greg and the opportunities we have here to share God’s love.

Thank you for your prayers and support, Christina + Greg

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