Once when I was a resident, I rotated with a brilliant specialist for a month. He was funny, didn’t suffer fools gladly, and he was very good to his patients.

One day we walked briskly to the door of one of his exam rooms. He pulled the patient chart from the holder on the door, glanced down at the name on the chart, looked at me and said, “She’s screwed.”

We walked in and the specialist had a frank conversation with this patient about her medical problems and he explained succinctly why she could no longer drive.

The patient was very upset by the news that she could no longer drive. She told him she would only drive during the day and only to church and to the grocery store, never long distances.

There was a long pause while the doctor looked at his patient and she stared pleadingly back at him.

“Okay,” the doctor said, “but only short distances and only during the day.”

“I promise!” the patient said gratefully.

After we left the room, the doctor turned to me and said, “You think I caved, don’t you?”

(I don’t have a poker face.)

“Yes,” I said. “You did. What if she has a cardiac event and kills someone, never mind herself?”

“I know, I know,” he said. But he didn’t go back in the room to talk to the patient again.

I’ve thought of that encounter many times over the years. That specialist was very smart and could think very logically. Why did he give in to his patient’s emotional demands?

I’ve come to the conclusion that he didn’t keep his primary goal in mind. With his, “She’s screwed,” statement outside the exam room, he focused on how hard this patient had it. He ignored the fact that his primary goal is the health and safety of his patient. On that day, in that exam room, his patient’s comfort (and his own) was more important than her  health and safety (never mind the health and safety of other people on the road!)

One of the reasons this happens, I believe, is because we don’t take any time to think about our overarching goals for our patients.

One way to keep this in mind in a busy, over-scheduled patient care day is to stop and take a deep breath.

With your hand on the doorknob of the exam room–before you knock–just stop.

Take one deep breath to breathe in wisdom and breathe out the rest of the world.

One deep breath to focus on this patient in this moment and let everything else go.

Try it the next time you see patients.