Do you always feel comfortable asking your doctor all of your questions?  I thought I did, until late one summer, when my legs suddenly started to itch.  It began on the lower aspects of both shins and spread steadily, up to my knees, then my thighs, and then my arms, with little pink bumps.  The itching was moderate, I could still get through my day, but I didn’t know what it was.  After a few weeks I made an appointment with dermatology.

I was a model patient—told my story in chronological order, all the pertinent details laid out neatly for the resident who saw me first.  I made his job easy; he appreciated that.  We both surmised that it probably wasn’t anything serious, maybe viral, and would likely resolve with time and some steroid cream.  The attending entered several minutes later, having heard the story outside of the exam room.  We all agreed on the diagnosis and treatment, easy-peasy.  I felt proud for keeping their clinic on schedule.

Then I suddenly remembered other bumps on my hands that I had always wanted to ask a dermatologist about.  Present for years, there were just a few—pinhead or smaller, round, translucent nodes on my palm, which would always grow back a few days after I pinched them off.  I showed them to the attending doctor and asked what they were.  He said they were nothing, and that I could just live with them.  And that was that.  I only realized later how unsatisfied I felt.  What were they?  What caused them?  What should I expect, would they ever go away?  I just wanted to know, to learn.  He didn’t really answer my question (though I suspect he thought he did), and I felt too sheepish to ask anything more, as if I were wasting his time.  I can’t blame him entirely—he was not intentionally dismissive or rushed; actually he was perfectly pleasant.  But something made me shut up when I really wanted to engage him.  It fascinates me to this day: I am a doctor; I gave my doctors what they needed from me, and could not get what I needed for myself.  The rash resolved with ointment and my hand bumps persist.  I still regard them with annoyed curiosity, and remember that encounter.  It was humbling, to be sure.

By contrast, my kids’ allergist regularly invited me to ask questions.  He knew my background, and explained things to me in a collegial way.  He would then speak to my kids in language that they could understand.  I always came prepared for his appointments, a list of events and questions in hand.  Toward the end of every visit he always asked, “Anything else?”  No, we’re good.  Some more small talk, follow up plans…  “Anything else?”  Umm, no, thanks, I think we got it.  Prescriptions, parking validation…  “Anything else?”  Really?

At first I started to wonder, ‘Am I missing something?  Is he hinting at me?  What else, there must be something else, think, woman!’  And, ‘Does he have some kind of tic?’  Then I realized: He made an intentional practice of making it safe for patients to ask questions. He understood how patients got tongue-tied in his presence, and made repeated, conscious efforts to untie us.  Brilliant!  Maybe it cost him a few extra minutes each visit, maybe not.  His sincere interest in my concerns, though, earned him my trust and respect.  As a fellow physician, I know the value and rewards of that.  And now I ask my own patients often, “Anything else?”