here's looking at you kid

I'm not sure if every young doctor experiences this sort of thing, but I certainly do, mainly because I'm petite and have young face i guess. I recently interviewed a patient who is 71 years old, lives in a motor home, alone, and eats once a day at the salvation army. He suffered a stroke about three years ago and since then has weakness on his left side as well as short term memory loss. He said he was luck that he was even at the appointment since he usually can't remember. This man was clearly frustrated at the world, at his situation, at life. He was pissed at his brothers for not supporting him even though he had for them. And I think he even had pissed himself, in reality. Maybe there is no shower in his mobile home. maybe he couldn't remember to change his clothes? regardless he was a grumpy old man to say the least. I tried to do a SIGECAPS assesment for depression. I got to suicadility and he said, "Listen carefully before you start writing any of this down. I want to die. I'm dying means I will be in heaven and not here then I want to die. I still take my pills, excercise, watch my weight and do as I am told, but I want to die." I comisserated with his sentiment and told him I didn't blame him for being pissed off and grumpy, not in those words of course. I asked him what we could do for him, physical therapy? counseling? start an antidepressant? All of which he turned down, and said, "Thanks for trying, sweetie." and Pinched my cheek the way my uncle would. He pinched my fatty little cheeks. He went into my space. I wasn't mad but I did feel belittled. For a second I thought i was sitting with my grandpa and not as a doctor sitting with her patient. I know he didn't mean anything by it but it was a strange feeling. As physicians we frequently push our hands into the space of others but remain untouched ourselves, with an imaginary shield that protects our space. When my shield was broken I felt strange.