A Safe Place

Sometimes something happens at work and the experience perseverates in your mind.   Often it is the experience of having to be the bearer of bad news to one of your patients.  Fortunately, on occasion a patient comes back for the sole purpose of telling you how well they are doing and to thank you.  Those experiences stick for a while too.  Sometimes I wish people with positive outcomes were the ones who came back to see us on a regular basis.  But alas, that is not the nature of health care.

Well, something happened earlier this week that was outside the scope of the usual experiences at the clinic.  For some reason, this event is stuck in my head and I am compelled to write about it.  I feel the need to share it with others because, well, I have never experienced this before and the event touched me deeply.

I was in my office dictating the note for the patient I had just seen and I thought I heard what sounded like a quiet sobbing from someone from the lobby area, where patients enter and leave for treatments like massage and acupuncture.  I think I wondered about what it was I was actually hearing, wondered if it was really the sound of sobbing, probably confirmed in my head that's what it was, and probably presumed that a person there to see one of the other providers was having a bad day.  Nothing sounded urgent, and I continued with my paperwork and prep for my next patient.

I went to receive my patient in the lobby and as we walked passed the one of the cubicles, I saw the source of the sobs, which continued steadily from a woman who was collapsed in a chair, her head resting on the table in her arms, as her body heaved in muffled distress.  Two of the therapists seemed to be sharing the act of providing physical comfort and words of comfort, though every gentle touch seemed to open the heart's flood gates, making the sobs louder and a bit more alerting for the moment.

I made eye contact with the therapist as she held her hand on the despondent woman's shoulder.  The therapist gave me a sad but reassuring grin that everything was ok.

I treated my patient and we exited to the checkout desk in a route that provided the most privacy to anyone still around.

On my way back to my office, I heard the continued sounds of sobbing, sobs that now seemed to need some self-encouragement to continue, with less pressure behind the breaths.  Maybe it was the completely clogged sinuses that prevented her from gaining enough oxygen to produce much noise.  But the waning sobs were still leaking from her body.

This time, as I passed the woman whose forehead was still pressed tightly into her folded arms across the cubicle desk, I stopped to try to recognize her.  She was in one of the massage therapist's cubicles, but it clearly wasn't the massage therapist herself.   The other therapists were still checking in and providing quick physical and mental reassurance as they, themselves, flitted between their own scheduled patients.  I moved a little closer and said, "Is there anything I can do?"  The woman looked up.  It was the first time I saw her face and, despite the swollen eyes and tear-drenched face, I instantly recognized her as one of my previous patients who must have been there still doing some periodic massage or acupuncture at the clinic.

"Oh, Dr. Bliss!"  she said.  "I hurt.  My big dog knocked me down and I hurt here and here and here," and she pointed all over her body, each time with increasing build-up for another waterfall of tears.  Her breathing grew rapid, and her face furrowed deeply and she said, "I have so much going on...."  and she put her head down and sobbed with new vigor.

What could I do?

She was physically ok despite her complaint of pain.  She was obviously in quite severe emotional pain.  That was obvious.  It was also crystal clear that she was in the right place to treat her emotional pain.  It was clear that the cause of her pain was not what mattered at that moment.  At that moment what mattered was that she was in pain and she had a safe place to go with that pain.

I put my hand gently on her shoulder and I told her it would be good for her to just let it all out here.  She could stay as long as she needed.  It might be just what she needed before leaving that safe cubicle place and venturing back into the wilderness of whatever it was that she was having to deal with in her world.

One of the gentle-speaking therapists came over and we both walked away together.  "I think she just needs to let it out, right?" she said.  "I think this is a safe place for her to do that."

Yes, I said.  Exactly.  That's exactly what this is, a safe place. She could stay and cry for as long as she needed.  She didn't need to "cheer up" or to "count her blessings" or "take some medication."  No, she just needed to be.  It was ok.  It was just sadness; it was just despair.  We were cautious but we were not afraid.  Who is afraid of it?  Why be afraid of it?  She was in the perfect place for her and her despair.  This was our healthcare facility where we care and where we help people the best we can. Sometimes the best thing to do is to do nothing and just provide safety.

It was just what she needed, a safe place.  The therapists who let her be and checked up on her, keeping everything calm and accepting and safe, provided such kindness... so much kindness that I cannot get the event out of my mind.

The woman eventually ran out of tears, wiped her face and, when she was ready, she left.  She appeared numb but she did after all, lift her own head up, stand up on her own power, and walk out the door when she was ready... to face who knows what.  She clearly left some of her feelings of helplessness, despair, frustration... and who knows what... on that desk top.  She was now clearly a little stronger.

I am proud of the therapists.  The word proud is perhaps not the best word, but my heart swells when I think of the event.  Kindness.  Gentleness.  Acceptance.  Humility.  These are the qualities that come to my mind.

A safe place.  A healthcare clinic where the lines between emotional pain and physical illness are blurred, more than we may realize.  Healthcare clinics should be safe places.  Ours is.  To the therapists who cared for this woman who once was a patient of mine, thank you.  You are a blessing.