The doorknob question

Every doctor knows the doorknob question. The visit is over, the notes are typed, I have my hand on the door, and the patient says, “Oh, one more thing.” Then comes the reason they actually came in. The chest that feels tight on the stairs. The lump. The sadness that has not lifted since spring. It happens to me several times a week, and it is never the patient’s fault.

People lead with the easy thing because the hard thing is hard to say. That is human. But it means the most important problem gets the last two minutes instead of the first ten. So here is the single most useful piece of advice in this book: say the thing you are worried about first. Before the rash, before the refill. Say it in the first sentence, even if your voice shakes.

Your doctor has heard it before. Whatever it is, I promise, we have heard it before.