A little small talk in the produce section illustrates the challenges of small-town doctoring.
It was very kind of you to inquire after the state of my garden when we bumped into each other at Safeway this morning. We haven’t seen much of each other lately, and I was pleased to hear your early peas are already flowering. We waved good-bye to each other and went about our business. Or so I thought.
Moments later, you cornered me as my food items were being scanned and asked me “What do you think about all this stuff they’re saying about Fosamax? Should I stop taking it?” I was unprepared for such a question, because my navel oranges were bumping into a couple of large globe artichokes, threatening to clog the upstream progress of some red seedless grapes onto the rolling mat that conveys groceries towards the bagging platform.
You see, when I go to Safeway, I go not as a family doctor, but as an ordinary citizen in need of some vanilla soymilk and a package of Wasa crispbread. At the supermarket, I do not bring the analytic mind that accompanies me to the hospital or to the clinic, but the harried householder’s mind, concerned about bank balances and the dire possibility of running out of orange juice before the weekend.
In other words, I do not like to be asked medical questions when I am conducting my everyday errands. I do not like to be cornered in the supermarket, or at the coffee stand, or when I am out to dinner on a rare night off. I do not enjoy being told about the nagging pain in the back of your left knee when I am trying to decide which 12-pack of toilet paper is the best value this week. I find the intimate details of your vaginal discharge a bit too much to stomach when I’m waiting in line at the salad bar. And if you decided several weeks ago to stop taking your ACE inhibitor because it “made you feel funny,” then surely further discussion on the subject can wait until your next appointment, and need not take place in the parking lot outside Radio Shack, where I ran in to buy a replacement battery for my cordless phone.
Perhaps you were not aware that dread of running into patients at the supermarket is one of the major reasons why I occasionally consider moving back to a more populous area, where I could walk into a shoe store and try on some sneakers without having the wife of a man whose buttock abscess I incised and drained last week sit down next to me and ask whether they could be doing more to take care of his diabetes. Certainly there is no way for you to have known that I feel compelled to drive several hundred miles out of town to have my hair trimmed, and even when seated in the barber’s chair at some distant SuperCuts, I lie about my profession. Sometimes I say I’m an accountant, sometimes a freelance writer. I am running out of plausible lies, so I will have to turn to the implausible: What do I do? Oh, I'm a snake charmer. I need to keep my hair short so my anaconda can’t do too much harm when he’s feeling frisky.
I do not expect you to be a mind-reader. I only ask you to obey the simplest social niceties, and refrain from asking me the risks of postponing your screening colonoscopy the next time we run into each other in line at the post office. You would not want me to discuss the intricacies of your mucosal atypia in the hallway of the hospital, so why would you expose yourself to such scrutiny in the “Just Released” aisle of our local Blockbuster?
I look forward to hearing about the progress in your lettuce beds, about the first peppery radishes you pull from the loamy earth. If you must corner me at the checkout stand to tell me of these developments, however, I would appreciate your help in bagging those new red potatoes that have escaped their plastic sack and are rolling down the rubber conveyor belt, perhaps my only line of defense against your well-intentioned questioning.
Theresa Chan, M.D., is a board-certified family physician who lives and practices in rural Northern California. She writes about the unique challenges of practicing medicine in a small town on her blog, Rural Doctoring, www.ruraldoctoring.com. This essay is excerpted from one of her blog entries.