“Silence is more eloquent than words.”
He was a stoic guy who had spent his entire life on a farm. The skin draping over his lanky frame was weathered, but his clothes were clean and his boots were freshly polished. His feed cap hung on the hook behind the door.
He had been free of cancer for a few years, begrudgingly returning for follow-up visits with the same enthusiasm that he probably reserved for trips to the dentist, the fabric store, or the shopping mall. As I entered the room, he tensed briefly like a cornered animal. “Good afternoon, Mr. Anderson. Anything new?” “Nope,”
he answered. He looked at the floor just in front of his feet.
I reviewed my last note, updating his history and trying to coax answers from him. He responded to each question with a barely perceptible gesture and “Nope,” “Yep,”
Fortunately, everything appeared to be stable. I examined his throat, finding no new areas of concern. He shifted in the exam chair, sensing that the appointment would soon be finished. As he stood to leave, I glanced at the tooled leather belt and large buckle that he had worn to each appointment. “You’ve been out to your workbench, haven’t you?”
He stared at me blankly. “Hmmm?”
I pointed at his belt. “You got out your awl to make some new holes, I suspect.”
He shrugged and sank back into his chair as though I had caught him pilfering cookies. “Yep.” “How much weight have you lost?” “Dunno.”
I checked back in his record and found that he had dropped 20 pounds since the previous year. He allowed that he had been having increasing problems with swallowing for several months. I explained that patients who survived one cancer are at risk for side effects and even more tumors. “Cancer?”
he asked. “We don’t know that yet. We’ll work on this together,”
I said. I began the process of ordering tests and setting up visits. “We will find out what is going on, and do everything we can to solve this for you,”
He stood, preparing to leave. He stared at the list of appointments that I had handed to him. As he retrieved his hat, he shook his head, gripped my hand, and said “Hmmm-hmmm."
I looked at him. “I know."
I said. "You’re welcome."