Marie 2010

Referateseveral gastroenterologists, some privately (not on our NHS)until he even had rectal sphincter manometery performedwhich showed nothing out of the ordinary. I began to dreadour visits as I knew that somewhere in the consultation Iwould be challenged to find a cure for his constipation. I wasnot even convinced that he had a physical problem that neededmy attention. He would call me during consulting hoursand would ask questions like “ I’ve had two glasses of prunejuice today-do you think it OK if I have another as I’ve onlypassed two tiny stools?”. Matters came to a head one daywhen as soon as I heard his voice on the phone I slammedthe phone down in an act of anger and frustration and didnot answer the phone again for several hours.A few days later I presented to the group. I felt very guiltyabout my feelings toward him, a fellow physician, albeitmuch older than myself and retired. I am generally veryreserved in my behavior and this act of aggression was veryout of character for me with any patient. So I asked the groupto see if they could decipher what had caused my behaviorand hopefully I could thereby understand my feelings.I remember the initial discussion focused on me and mybehavior. One of the group members found it amusing thatI thought that putting down the phone was aggressive. Ashort discussion followed on the difference between nativeborn Israelis and me, South African born. I felt that this discussionwas irrelevant to me and my request as they weremerely pointing out differences in character without lookingfor reasons for my actionsThe turning point in the group came when one of thegroup leaders introduced the “non present third person” inthe consultation. The initial candidates were his late wifeand daughter. But then another member mentioned that Ihad spoken about my father in present meetings. She wasunaware of his physical condition and wondered whether hepossibly exhibited similar symptoms and how I as a son relatedto these complaints of his.It was like being hit by a FLASH of incisive lightning!How had I not seen the connection? My father, as I mentionedearlier, is also a physician and is a couple of yearsyounger than my patient. Like my patient he too is still infull control of his mental capacities. But unlike my patienthe does not live a 2 minute drive from my office but a 12hour air flight away. And the only way I communicate withhim is by phone, the same instrument I had vented my angerwith. I would go and visit once him every two or three yearsand he would pay annual visits to Israel. The FLASH for mewas my insight that my frustration and anger at Mordechaiwas actually an expression of my anxiety for my father’s futurewellbeing and my lack of control over it. I was flashflooded with emotion and I felt a burning need to be withmy parents. It was as if I had been constipated emotionallyand the group opened me up to my true needs. And so thenext day I called my travel agent and booked a ticket to CapeTown where I have visited every year since- even twice lastyear. Maccabi Tel Aviv won the European Basketball Cup inMoscow in 2005 and I was not there. But on mornings whenI lie in bed between my 82 year old dad and 78 year mom,my cup runneth over and for that I thank Mordechai, thegroup and the constipation.And the twist. For reasons beyond my comprehensionMordechai now visits me in my office. He hardly ever mentionshis constipation. I have discovered a wonderful, intelligent.humoristic colleague and it has become a pleasure andprivilege to be his personal physician.Several months ago he visited when I had two 1 st yearAmerican students in my office. “What advice would yougive these young students”, I asked him. “Always listen toyour patients’ stories and treat them with respect. Rememberyou are dealing with people and not with diseases.” Itcould have been my father speaking.XVI-a Conferinţă Naţională BalintBuletinul Asociaţiei Balint, vol. xii., nr. 45, Martie 20109