Sometimes, you have to keep it real

Doctors are pretty good at acting - especially acting like we know what we're doing.

Think about it: if you go to your doctor with a strange lump and he looks at you startled and says, "Eeew, what the hell is THAT?" well, you'd be pretty upset.

Sometimes acting can become so good, it's actually lying. Like when someone once recognized me and said: "You remember me, right? You took care of my father."

"Oh yes, yes. How is he?"

"Don't you remember? He died!"

During my residency training, I had a primary care clinic at the Denver VA. I loved my patients-old vets sitting with their beer bellies hanging out and telling me about hunting, woodworking or the wars they fought with the same ease they'd tell me about their gout, prostate or hemorrhoids. Then I was sent for a few weeks to a women's clinic to get more exposure to women's health issues. The first woman I saw was a 25-year-old aerobics instructor. As soon as I walked into the room, she lifted off her shirt and sportsbra.

"I want to be checked for any breast lumps," she said.

My jaw dropped. It's one thing to talk to a half-naked vet with a beer gut about shooting skeet; it's quite another to chat with a topless aerobics instructor.

I tried as best as I could to look only into her eyes as she talked, and to act nonchalant. In truth, I was afraid my hands would shake from nervousness. I excused myself and got a nurse to assist, did the breast exam and finished the visit in record time. No small talk, no pleasantries. It took about two weeks before I became as casual around female patients as I was with the old vets.

Computers are another thing altogether. It's not that I don't like computers, but switching to an electronic medical record is changing the way I practice. The computer becomes a distraction with absolutely no soul. I talk to my patients but look at a computer screen. So you have a strange, ugly mass on your back? Let me look for it in my computer drop-down menu. Need a breast exam? Sorry, it's not in the computer, so get your shirt back on. Your father just died? OK great, I know just where to put that in the "Family History" field of your file.

They say I will get used to it, that soon it will be second nature. For now, someone may be able to talk to me with a strange ugly mass on their back, have a big ol' beer belly, or even be a topless aerobics instructor and I won't blink. But talk to me in my office while there's a blinking cursor on and no amount of acting will make it seem like a normal thing.