A choreographed dance twirls on, here then there, seemingly unpredictable. A cycling team moves about the large field of racers, the team’s order in flux for two hundred and ninety-nine laps, the lead-out happening fluidly but not until lap three hundred. A dynamic interplay of complex molecules lining the cell membrane seems chaotic until the oxygen molecule combines with hydrogen, and we realize the gradients around the membrane have changed ever so slightly to allow creation of energy.
And so it is with the mind of the expert clinician moving through time as patients come and go. Each patient encounter is different, the agenda quickly set, the humor wittingly played, the diagnosis not missed, the facts presented clearly, admonishment not withheld, and encouragement given generously. I recognize snippets of scripts with which I am by now well acquainted - the chest pain differential, the depression screening, and the bad news delivery. And yet these disappear into a more fluid background as quickly as they come, by no means determining the course of the interview but rather playing their appropriate part. The result is somehow a patient who clearly receives exactly what was needed in the moment of the visit. The difference between the expert clinician and me is that the expert’s interview, clinic day, and even mind, dances. The result is strikingly beautiful.
John Marshall, MS