Posted by Dr. Vollmer on January 13, 2015
Lydia, forty-two, noticed a lump in her neck. Hodgkin’s Lymphoma was her first thought. Her sister had Hodgkin’s so she was “sure” she had it too. She watched her sister go through chemotherapy, with much psychological trauma and fear. The wait, forty-eight hours, to see the physician was enormous. Her life flashed before her eyes. Would she see her children grow up? Would she be able to see them graduate high school or get married? Should she tell her husband about the lump or should she wait to see what the doctor says? The prospect of a foreshortened future creates a laser focus on where the meaning lies, where one’s core values land. How will she get through the next forty-eight hours? Should I give her medication to ease her anxiety or should I encourage mindfulness and meditation so she can become curious what occurs to her during this waiting period? Or, can both be true, that medication can calm her down so that she can focus on her thinking? What about my fear for Lydia? Should I express fear or hold the hope that it is either benign or treatable? Lydia’s world has slowed. Every minute causes her to think she may have limited minutes left. I listen. I care. I am curious what pops out of mouth, the order that things occur to her, and how she manifests fear, both conscious and unconscious. I am a safe place for her. She has gratitude for my medical background “just in case it is bad news,” she says. I avoid the platitudes, but I am tempted to remind her that medical frights help us to gain gravity because it pulls us towards things we consider important. It is reminder, I want to say, that paying for parking, maybe annoying, is not a game changer, but a scary diagnosis certainly is. In other words, maybe this reminder of the “big picture” will help her be calm with the “little picture”. I don’t say any of that. I just sit and listen. That’s what Lydia needs today.