Time to Turn My Body In
A True Story
He’s a policeman, member of the SWAT team, the elite Emergency Task Force. He deals with hostage-takings, and guards visiting presidents and prime ministers. Marius (not his real name) is muscular, handsome, in superb physical condition. As part of his job he is actually paid to spend some of his working hours in a gym, training to stay in excellent shape.
Seldom have I seen a patient who appeared less in need of a doctor. Yet when I come into the consultation room where Marius waits for me, he’s pale, gripping the edge of the examination table where he sits, palms sweaty.
“It’s chest pains, Doc. I’ve been getting them for two years.” Listening intently, I feel my brow furrow. “Apart from the checkup I needed to join the police, this is the first time in 15 years I’ve gone to a doctor for a problem.” His voice is shaky. He pauses, swallows, regains control. “I think it’s time to turn my body in.”
“Turn your body in?” The body in question is all of 33 years old.
He gives a short, quick nod. To this police officer, his body is a criminal who’s been escaping justice. He’s finally decided to capture the fugitive and turn him over to a judge: the diagnostician. Me. And he’s dreading the verdict.
The Thinker, on a pedestal I put him on
“Honestly, I’d rather face a gun”
He’s worried he’ll have a heart attack. I take a full history: his pains come on when he’s anxious or when he lifts weights. There is no family history of early heart disease. He has no diabetes or other coronary risk factors, no other symptoms of concern. I check his pulse and blood pressure, examine his lungs and heart. I find nothing abnormal, apart from tenderness in the muscles of his chest wall.
The pains are caused by lifting weights, and by muscle tension. I reassure him lavishly. He relaxes a little.
To be 100 percent sure, I order some blood tests and an exercise stress test on a treadmill, and Marius returns a few days later for the follow-up. When I open the door, I’m greeted by a familiar picture: the powerfully-built young man sitting, clutching the edge of the examination table, leaning forward. I ask him to undress down to his undershorts, and this time I do a full physical examination. I chat during the exam, trying to put him at ease.
“Everything looks great. The examination is just as normal the second time round. Blood pressure, heart and lungs, everything is fine. Your cardiogram and exercise stress test are perfect. And all your tests including cholesterol profile and blood sugar couldn’t be better.”
His face is pale, sweaty.
“There’s nothing worrisome. The pains aren’t related to your heart. They’re caused by a strain of your chest wall muscles from working out.”
He adjusts his grip on the exam table.
I explain how to relieve the problem; still he doesn’t relax.
“Are you feeling a little anxious?” I ask gently.
He presses his lips together, nods. I look enviously at his muscles. Next to him, I look like a skinny runt. When I was in ninth grade, the boys played tackle football during gym class. Along with a helmet, I was given a set of bulky, armour-like shoulder pads and thigh pads, over which I stretched my uniform. I was transformed, mammoth; a new, delightful sensation for a 14-year-old boy.
It didn’t last. When the football season ended, I returned to sports that suited my body type: running, swimming, skiing. I would never be a gladiator.
I look away from his physique, back to his worried eyes.
“Could this be related to something in your past? Some sort of traumatic experience? Maybe when you were a child?”
He shakes his head.
“Maybe you remember one of your parents dragging you screaming to a doctor to get needles, or some other terrible thing?” He moves his head from side to side, stares at the floor. Finally looks up at me.
“Honestly, I’d rather face a gun than a doctor.”
The room tilts for a moment. I look at him, narrowing my eyes. I see no hint of a smile.
“You would rather face… ”
“Yes, I would. At least I know how to handle facing a gun.”
Passing out
Marius wipes the perspiration off his neck and starts to dress. Stretches his shirt over the powerful arms and chest. Shakily pulls his pants up over the burly calves and thighs. Then walks across the hall to see my nurse, Debbie, for the routine immunizations I’ve prescribed.
She gives him the first injection, and he promptly faints.
“Peter, could you come over here?” Debbie calls out. Her voice is calm, professional.
Marius is lying unconscious on the treatment table. In about 20 seconds he comes to. His eyes dart around the room.
“What happened?”
“You passed out when you got your tetanus shot.”
He moans.
“Passed out?” he mumbles. “Shit, that’s embarrassing. I’m sorry.”
“I think you got yourself a bit worked up today.” I touch his shoulder lightly, my hand dwarfed on the vast expanse of muscle. “Maybe, if you like, next visit we can talk about your worries. Why you react this way.”
He groans, tries to sit up. I restrain him; it’s too soon after the faint.
“Thanks, Doc, but no. I’ll stay away. Doctors give me the heebie-jeebies. I may come back some time, but only if I really need you. Like for a broken bone. Or a bullet wound.”
Two men, two pedestals
When Marius came to see me, his strength and virility made me instinctively look up to him. And he was also a symbol I respected. He protected people, as do health-care workers, but in another way. When he fainted, it was like the toppling of a heroic, over-sized statue.
True to his word, Marius never returned to see me again. He was never shot or seriously injured, I assumed. Good news. But I did wonder if he ever figured out what was making him tick, what underlay his panic. Was he physically working out to compensate for the fragility within?
I never found out. I hope he got some psychological help along the way. As for me, I was left with the irony of seeing the hero figure so vulnerable, passed out, flat on his back. In the end Marius’s power was only external; it didn’t extend to his ability to handle himself. And while I—and the world—perceived him as powerful, impervious, he imagined that I was the fearsome, formidable, one.
That I, with a quick diagnosis, could bring his fugitive body to justice.
Marius might be surprised that things aren’t always what they seem on the other side of the stethoscope.
Behind the white coat I’m no less human than him, but doctors hide their frailties. Whatever the situation, patients need us to remain knowledgeable, compassionate, competent; we can’t model those qualities if we let ourselves go. Patients want us to stay unflappable. No matter the stress we may be under.
Marius is permitted to pass out; I am not.
This is a true story. The name and identifying details of the patient have been changed.
You beautifully evoke human complexity: strength, frailty, shame, image: How so many of us use and hide within our professions. Some rise to unanticipated occasions. We all pass or pass out. Each in our own way. I am enjoying getting to know your writing and a part of you. With appreciation.
Great vignette which sends a powerful message about vulnerability and perspective.