Can I break down, please?

I saw a ‘specialist doctor’ today, the one I described here. Again, the appointment started with a chat about us, foreigners, in the UK (I was quite surprised he remembered our earlier encounter) and then smoothly proceeded to the results of my tests. All was great until I asked: “Is it a waiting room?”

This is the first time I reacted to something I have ‘always’ noticed, but I didn’t bother to react. This time, almost prime-ministerially, I decided that enough was enough. During the first 3-4 minutes of my appointment with the very nice doctor, three nurses (I think) walked in, shuffled what looked like patients’ notes and left. There was no knock on the door, no sound, just the door opened, a person walked in, handled the papers and walked out. No sound, no acknowledgement, as if they (or, indeed, we) were invisible.

Even though I turned around every time, the nurses paid absolutely no attention to me or the doctor.  More than that, the doctor seemed not to notice them. It was not the door that was the barrier between us (the doctor and myself) and the rest of the world, it was an invisible wall. The wall was so perfect that the nurses never even looked at me or the medic. They didn’t see us; the doctor didn’t see them. And then I wrecked it all.

You see, I, a patient, didn’t know I was supposed to play invisible cloak or wall. Every time the door opened, I turned around wondering what was so important that someone was interrupting my conversation with the doctor. And after the third time, I said quite loudly:

Is it a waiting room?

The doctor’s face turned uncomfortable and he apologised. The nurse, still not acknowledging us, simply left. I have no idea whether it was what I said, but no one else walked into the surgery again.

Now, for the linguist/social scientist, the whole situation was very interesting. It was all about negotiating who is part of communication and interaction, who is the licensed recipient of what’s communicated and both the doctor and the nurses played their parts to perfection. But then, if I may, I’m sorry, really, I would like to drop the linguist’s identity and become a patient. I would like to talk as a patient.

And so, are you kidding me? I’m talking about very intimate, difficult, emotional things, and you just barge in without even knocking on the door! What if I am crying, sobbing, distraught? You will just pretend that you don’t see me and I will play along? And you, nice doctor, just because you got used to people walking into your surgery, you assume that I follow along, happily not noticing them? I mean, what else will happen? Will someone sweep the floor as we talk? Change a bulb and bring you lunch? Please, do not limit yourself – let’s have contractors decorating as well! I’m sure they can also be given the invisibility course.

Really? You think I’m going over the top? Exaggerating?  So, for pity’s sake, where is the point you will think: No more! I need time with my patient! And that the patient must think they are in a safe environment in which they can break down and it will be between you and them!

As it happens, I was receiving some not so great news (nothing major, yet, but more tests are needed, the doctor was doing a lot of reassuring), but all I was thinking was that I needed to keep my face, my emotions in check, because in a second yet another ‘invisible’ nurse might come in and see me in distress. And as much as I do masculinity studies, being all-critical and stuff, privately, I am not outside the dominant model of masculinity and I don’t particularly want to cry publicly (and I’m not saying I wanted to cry!). There is a very small and very select group of people who saw me cry and I prefer to have some say over how and whether it expands.

And this is how my appointment felt. I felt being in a waiting room at a railway station with people constantly walking around me.  No, please, don’t give the nonsense that they were nurses, so it’s different. I didn’t come to see those nurses, they had no stake and no role in my conversation with the doctor. I had no control over whether they saw me, heard me, let alone judged me (please, spare me the rhetoric). I had no control over what reached them.

OK. Let me repeat what I wrote some time ago. Half the medics I follow on Twitter tell me daily about empathy, patient-centred, narrative evidence and I just cannot deal with the dissonance. I mean, do you live in an alternate universe or do I simply not get it? Yes, the guy (I do beg your pardon – the specialist doctor) is really a nice person, who really does have his heart in the right place, but he (or is it his boss?) still doesn’t understand that I need some privacy!

I really sometimes wonder about the rhetoric and the reality. I am happy to accept that I am the unluckiest patient in the UK and that I bring it all on myself by noticing too much, but, surely, you must have already discovered privacy, no? My conversations with you, doctor, are difficult enough without worrying that someone can simply come into your surgery. And no, you playing the invisibility game doesn’t reassure me. So, here is my plea. If you must, continue talking about empathy, quite frankly, I couldn’t care less. But how about also making sure that your patient is in an environment in which it is safe to break down? If you wish, I can pretend you’re not doing it. Wink, wink.


  1. O how I like this too!
    When I had cervical CIN 3, the doc sent the nurse out of the room to ask my sexual history (he told me it was personal – i thought it was unnecessary, but what do i know!). She came back in – with me on my back – and him lasering my cervix – the first thing she did was turn to the sex bit in my notes. I dont know why the invisibility wall didnt stop me seeing that!?

    1. Dariusz Galasinski

      Gosh! I must admit that whenever I had to undress for examination, I thought I was fairly safe. And the sight of me in my underwear would be reserved only for the doctor. I wonder now…

      Still, I wonder whether the nurses coming in and out are assumed to have the same ‘medical gaze’ and so if they look, it somehow doesn’t count.

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