Initially, it was just an occasional ache in my left shoulder. I don't remember exactly when or how it started, but the ache soon became a pain. It typically appeared when I used my left hand to scratch my back or to lift a wallet from my left hip pocket. The pain was intermittent, never severe, and did not disturb my sleep. Although I had full range of motion with my left arm, there was a distinctly tender spot localized to the acromioclavicular articulation.
Not knowing any better, I figured that the pain probably resulted from bursitis, or, because of my age (85), arthritis. So after 6 months of discomfort, and without having taken any analgesic, I decided to see a shoulder specialist for definitive diagnosis and treatment. My usual orthopedic consultant had retired, but he unhesitatingly recommended “Dr. X”, someone I didn't know. I took the advice and made the appointment.
Dr. X entered the examining room right on time. With a warm smile and a firm handshake, he said, “Glad to meet you. How can I help you?”
He then listened intently as I described my ailment. After asking me several specific questions, he examined me with an expertise that was easy to recognize and appreciate. When finished, he said, “I know exactly what the problem is, and I don't need an x-ray or MRI to confirm it. You have biceps tendinitis, and a steroid injection will give you rapid, and possibly permanent, relief.” The injection was almost painless and began to take effect immediately.
During the drive back to my office, I marveled at what had just unfolded. First of all, Dr. X was punctual, which eliminated the long time that I and other patients ordinarily spend waiting to see the doctor. Second, his manner was comforting, respectful, and professional. Third, he listened to me carefully and examined me thoroughly. Fourth, he used his brain and sensory faculties to make the diagnosis and didn't rely on complex and expensive imaging studies for guidance.
Given the sad state of healthcare delivery these days, my encounter with Dr. X seemed unreal. It reminded me of a popular tune in the 1930s, the lyrics of which began with
Did you ever see a dream walking? Well, I did.
Did you ever hear a dream talking? Well, I did.
For me, those lyrics now had special meaning, because the dream that was walking and the dream that was talking was Dr. X. Would that all of us practice medicine as he does.
Submissions for Peabody's Corner should: 1) focus on the interpersonal aspects of a specific patient–doctor experience; 2) be written in storybook fashion; 3) contain no references; and 4) not exceed 5 double-spaced typescript pages.
Dr. Fred is an Associate Editor of the Texas Heart Institute Journal.