She was a young lady who had collapsed at work. The first time she had a collapse, and it scared her. She had been brought to the hospital in an ambulance and they strived to find a cause for her collapse. Yet she was anxious, anxious about everything. What they did not know was that she suffered from anxiety. She got nervous about her life, her job, her family, and now this, the collapse. Could she be having a brain tumor, she wondered.
Her thoughts did not help her condition. Paralyzed with fear about the cause of her collapse, her anxiety swiveled around in her mind. She ruminated on how unfortunate she was. She believed with absolute certainty that there must have been something wrong with her. There had to be, because normal people don't just collapse to the ground.
I was a senior medical student, but still a medical student nonetheless. We have been ingrained with the value of asking every possible question, taught about providing comfort and the human touch, simply because we are not constrained by the pressures of working as a doctor; not yet at least.
As I approached her, I sensed that something was amiss, not medically, but just that searching look in her eyes. Any experienced physician would have noted it, but I happened to be the first one there. Her eyes darted around the room before finally fixating on me in an almost pleading manner. So I began my history, fulfilling all the components. But then I asked something different. Something that would seem out of place in the hustle and bustle of life in the emergency department. Something we were all once taught but sometimes tend to overlook as we seek the medical answer.
I asked, “What worries you the most?”
She looked at me in stunned silence, trying to mouth words which never seemed to come. Her eyes widened before relaxing again. No one had ever asked her this. It was always about the medical problems. Her collapse, any seizures. No one had asked her what bothered her the most; because it was not the collapse which bothered her, but rather the cause of her collapse, the anxiety which ran marathons in her head. Now finally, someone might know. Someone had asked the right question. She found her outlet.
I was not expecting the outburst of emotion and sentences that followed the question. She started slowly, with large gaps between her words, as she contrived to elucidate the pent up emotions. When her thoughts strung together like beads on a chain, her words were hurried and quickened to match the pace of her anxiety. And after ten whole minutes of explaining, she was quiet. A silence that portended a plethora of meanings. A silence that brought her so much relief, so much comfort. A silence she always craved for, always desired but never had the courage to experience.
All because no one ever asked the question. Now that someone did, she shared the burden. It was half the weight off her chest, and nothing mattered more to her now. Even finding a solution to her anxiety wasn't important anymore; neither was the collapse. She was experiencing a newfound freedom.
All because of one question, the one oft neglected question in the search for the medical cause for every medical problem. The one question usually only the most experienced clinicians find the time for. The one question that might not save a life, but most certainly saves a lot of discomfort.
“What worries you the most?”