The physician author is puzzled about what he can do to help a young woman who comes to him for treatment of her chronic abdominal pain. She has had every test, seen every specialist, and has no clear diagnosis. Only on the third visit, which she has initiated, does he discover that she was sexually assaulted at age 14. He is the only person she has told.

He immediately feels out of his element, and asks her to see a psychiatrist. She refuses, and insists he handle her care. He sets up open-ended visits to allow her time to talk, and looks for help in the medical literature and from a psychiatrist colleague.

Over time, as they explore her feelings and experiences, his patient gains self esteem and transforms herself into a confident, beautiful woman, planning on travel, school, and career. After her last visit with him, he realizes, "I had been chosen to receive a gift of trust, and of all the gifts I had ever received, none seemed as precious."


While students are told that psychological and social issues will commonly arise in medical practice, many feel overwhelmed and under prepared for this prospect. This well written and moving essay demonstrates how all physicians, no matter what the specialty, can better serve patients by being attentive to psychological issues in their practice, and how simply being there for patients can facilitate their healing.

Primary Source

Annals of Internal Medicine 123 (10): 804-805 (1995)

Page Count