The fact that I’m sitting here at all, debriefing on a full physical examination performed by a young, attractive, male doctor blows my mind. At the moment, that’s how I’m feeling about things.

“I think so, yes,” I respond after a considered pause. “I was pleasantly surprised.”

“How so?” he asks.

Damn. I didn’t think this through so well. Now I have to explain.

Being in that exam room with him made me recall some experiences at the doctor in my adolescence that I’d just as soon forget. No wonder I’ve been ambivalent to have a physical. I’ve been scared.

This experience has been quite different from the others, and I find myself much more open to seeing a primary care provider. And that’s because of him. As I sit here with him I wonder, does he make all of his patients feel this way, like somehow he can see inside of them, or is it just me?

I’ve come to realize that, for reasons that aren’t readily apparent to me, there’s something about him that makes me feel safe. And it’s a kind of safety that I didn’t even realize was missing until now. And that is a completely unexpected, pleasant surprise.

“Well,” I say after a long pause, “it just wasn’t nearly as bad as I’d expected. And that has everything to do with you. Your demeanor. It … eased my anxiety rather than making it worse. So yes, pleasantly surprised,” I say with an awkward, appreciative smile.

“Well, I’m glad,” he says with a nod and a genuine smile. “You know, you’re not alone in that respect. More patients are anxious than not, in my experience. And I do think it’s important to address it rather than pretend it isn’t there which, unfortunately, is what many clinicians are inclined to do.”

I nod in silent agreement.

“So, let’s talk about your exam. And please, stop me if you have anything to add, or any questions, okay?”

“Okay.”

“In general, things are looking good, Molly. Your weight and BMI are in range for your age, and your heart and lungs are healthy. I made a note to monitor the heart murmur, but you don’t need to do anything more where that’s concerned. Your circulation is quite good, which speaks to your tight diabetes control. Being a non-smoker and exercising regularly are excellent ways to maintain your cardiovascular health, so keep up the good work there ...”

He isn’t referring to any notes or scrolling through that tablet. I’m impressed. He must see hundreds of patients but it’s like he has our whole encounter memorized. That astute intuition of his kicks in and he pauses, regarding me inquisitively.

“Talk to me, Molly. What’s on your mind?”

There really is no hiding from this guy. Should I tell him? Why not? Everyone likes positive feedback, right?

“Just the fact that you’re talking to me without your face glued to a chart or computer screen.”

“I see,” he says, amusement momentarily lighting up his features. “Is that a problem?”

Now it’s my turn to be amused.

“Not at all. I appreciate it. It’s just not something I see very frequently. Or at all. Sorry. Go on. I didn’t mean to interrupt.”

He smiles, refocusing his attention on my clinical debriefing.

“Your blood pressure was running a little high but, as I said earlier, I don’t think it’s a reliable baseline because I know you were anxious today. So we’ll table that for now. Abdominal exam was unremarkable, no problems there. Your well woman exam was unremarkable. Your breasts are healthy, but I do want you to have a mammogram before you see me next time, because it’s been over a year since your last one. Pap results won’t be back for a couple weeks, but I’ll let you know when we receive them, okay? And of course we’ll send a visit summary over to Simmons as well. Questions about any of that before we move on?”

I’m trying to absorb everything he’s said but it’s a lot of information all at once. And I find myself distracted yet again by the tubing of his black stethoscope, draped around his shoulders as before, the diaphragm on his chest. I look at it and get butterflies in my stomach. “No, I don’t think so,” I reply carefully.

He leans over to grab the tablet from the coffee table, and then repositions himself in his seat so that he’s closer to the edge, and to me.

“Okay then … so … let’s take a look at these labs.” He leans in so that I can see the screen as well, and scrolls down to two sections that say Complete Blood Count and Lipid Panel.

“If you look at the column here on the far right, you’ll see the target range or standard therapeutic value for all of these tests. The column just before that shows your values, and any outliers automatically show up in red.”

I glance nervously at the screen to see how much red is there and, to my relief, there’s only one.

“These results are quite good. The CBC or complete blood count is a good indicator of your overall health. If you were anemic or suffering from some kind of systemic inflammation or infection, these numbers would be out of range. Yours look quite good. The only outlier here is the white blood cell count, but I’m not too concerned by the elevation. While it is slightly elevated, things like stress or inadequate sleep can impact the number, or your body may be fighting off a low-grade infection of some kind. Or both. Not to worry.”

“I’m relieved to hear that. When I see a red outlier for white blood cells, it screams leukemia to me.”

“I understand, particularly in light of your father’s history. It makes sense that you’d be hypervigilant. Now if the number were consistently elevated or steadily increasing over a short period of time, I’d be concerned. But we don’t see that here. I’d recommend we retest in three months. Given your anxiety about it and the family history, that seems reasonable to me. Would you agree?”

I nod quietly as thoughts of my dad flood my mind momentarily. It is a relief to hear that there’s no need for concern. His words draw me out of my memories and bring me back to the present moment.

“As I said before, you did very well today. I know that you were anxious about the exam, and worried about what it might reveal. Hopefully these findings encourage you. You’re in good health and do an admirable job controlling your diabetes. You should feel very good about all this. You really should. Give yourself some credit.”

He nods encouragingly and scrolls down the page a little further, stopping at the lipid panel.

“Okay. So here’s your lipid panel. That shows me your cholesterol and triglycerides. Your cholesterol is in a nice healthy range, which is helped some by the statin you’re taking, but you get extra credit for lifestyle and diet. So no need to change anything up there. Keep up the good work.”

Then he shuts down the tablet and replaces it on the coffee table.

“So ...” He leans forward, his elbows on his knees, and turns to face me.

“I’d like to see you again in six months. Given your T1D I recommend we meet twice a year. We can touch base sometime over the summer for a care management appointment, to make sure we’re aligning and coordinating your care well across specialties, and make any necessary adjustments. Then a year from now I’ll see you again for a routine physical. How does that plan sound to you?”

Just as a point of reference, I want to ask him if today’s physical was “routine,” but I’m not sure I really want to know the answer.

“I’ve only relied on my primaries for referrals and sick visits up to now, so I don’t really have a good point of reference. But this sounds fine.”

“I find this approach works well. I think it’s very important to be deliberate and thorough both with care management and the annual physical. Rushing either one would be a disservice to you. This way we can focus fully on one of them at a time. Does that make sense?”

I nod in agreement and tap quickly on my phone to check the time: 11:00 on the nose.

“Unless there’s anything else you’d like to discuss, that’ll be all for today.”

We rise together and he walks me to the door, opening it and extending his hand. This handshake is more personal than our first, and he touches my left elbow gently as he shakes my right hand.

“It was good to meet you today, Molly. I look forward to working with you. Come, walk with me and I’ll get you back to reception. It can be a little tricky navigating this place.”

We walk in silence down a hall, around a bend, through another door, and then out near the reception area where I checked in earlier. I never would’ve found my way back here, and I let out a relieved chuckle.

“Yeah, I wouldn’t have ended up here without assistance. Thanks.”

“Of course. I’m going to place you into Rielle’s capable hands here, so she can get you scheduled for next time. Please, feel free to reach out before then if anything comes up. You can direct message me easily through MyChart, any time.”

“Thank you.”

He speaks briefly with Rielle, who looks to be in her mid-twenties and a little smitten with her boss. I’m sure all the straight women in this office probably are. She smiles kindly and hands over a stack of release forms for me to sign – probably so that all of my specialists can send my records over here. Then she helps me book my next appointment for late July, prints out a visit summary for me, and shows me to the door.