Arthur R. Bartolozzi IV1

1Harvard Medical School, Boston, MA, USA
Address correspondence to: Arthur_Bartolozzi@hms.harvard.edu

The psychiatrist sat in an office across the hall.

His office feigned clinical friendliness, but his eyes told a story of circular, regressive arguments.

I glanced over as I entered behind the surgeon into a windowless room.

“I feel full all the time.”

Your new stomach is a walnut.

¿Cómo se traduce?

“My mom’s roux-en-y was bad like this too.”

You didn’t have that surgery.

(Maybe you should have.)

“I have pain when I eat or move.”

You have gallstones.

We can do something about that.

“But that means surgery.”

You are morbidly obese. You need it.

The “you” statements are hard

For patients to process without resentment, and doctors to tell without condescension.

(And then there is the uncertainty of advice.)

Patient-centered-medical-care breaks down when faced with these contradictions.

We’re meant to communicate, to educate, to advise, and in the end, never to choose.

But when the chairs in the waiting room grow to four feet across,

And the diabetes-hypertension-cholesterol can disappear,

How do we physicians control our rumbling urgency?

A lady was crying at the reception desk. I was on my way out and threw a parting ear;

Inability to exercise to lose weight prohibited her from a surgery to help her lose more.

The circle continues.

“No Wasted Chair Space” by Tony Alter, used under CC BY 2.0. Retouched by Noor M. R. Beckwith and the HMS Review Editorial Board.