Knees and Trust

On My Knees


“There’s no art

To find the mind’s construction in the face;

He was a gentleman on whom I built

An absolute trust.”

-William Shakespeare


He was a very successful professional.  Well-known; excellent reputation for his work in his chosen field and with charitable endeavors.  The kind of person that we refer to as a rock of stability and good will.  His wife and children loved and admired him.

There was a lot wrong with him, although you’d never be able to tell from looking at him.  He took his medicine on time; he showed up for his appointments; he ate well; he exercised.  I was able to find appropriate treatments for his many ailments, so he continued to work way past “normal” retirement age.  He even helped me with some problems that I had at home.

We developed a bond.  I took his advice when I needed it; he took mine.  Of course there were always questions, but they were fueled by curiosity and the desire to learn more about whatever we were dealing with.  We became student and professor to each other.  I looked forward to his office visits, although I knew that they would be lengthy and complicated.

One day he looked concerned; something unusual for him.

What’s wrong?

“I have a lump on my right knee.  I think that it’s getting bigger.”

Older person; new growing lump.  I understood why he was worried.

Let me take a look.

He had a fairly large growth on his knee. Soft; I would describe it as squishy.  Not red or tender.  Easily movable.  I smiled.

This is a bursitis.  There’s normally a small sac of fluid in this spot.  It has swollen.

He wanted to know why this had happened.

We call it “housemaid’s knee.”  This is almost always a result of trauma or repeated use, like when maids get on their knees to wash the floor.

I smiled as I leaned back on my chair.

So do you get on your knees to wash the floor?

He did not get that I was teasing him.

“No; I don’t.”

Maybe at church.  Some services are long…

“We don’t kneel at my church.”

It’s usually due to trauma.  I could try to drain it, but the fluid will come back if we don’t eliminate the cause.

He looked to the floor.  Obviously uncomfortable.  He thought for a second, then he blurted it out.

“I think I know what it is.  I urinate on my knees.”

Talk about unexpected responses.  I had to keep quiet and think for a few seconds.  When you run a busy medical practice time management is a major priority.  There had been many times in the past when I had regretted asking patients why they had done some of the very odd things that they do.  Like the elderly heart patient who thought it was a good idea to mow his lawn at noon on a day when the temperature exceeded a hundred degrees.  Or the woman who climbed on a chair with wheels to change a light bulb.  The explanations ran into why they didn’t want to call the children because three weeks ago one of them had baked a pie, and they had used a different recipe than what had been handed to them, and this caused a rift, which was no surprise to the patient because of the no-good man or woman that the child had married…  I have learned that 99% of the time it’s best to nod and proceed with the treatment.

But not today.  This I had to know.

Why do you urinate on your knees?

Another moment of hesitation.  Here’s where the trust comes in.  He decides that he can tell me.

“My urine stream is not strong.  Sometimes it splits in two; I end up getting the toilet seat or the floor dirty.  My wife gets angry with me; she makes me clean it up.  This way it all goes in the right place.”

My first thought, I’m sure also yours, is to ask why he doesn’t sit to urinate.  I decide not to get into that.  I don’t have time.

If you want to continue to urinate on your knees, you have to get a cushion.  Keep it in the bathroom.  Use it every time you kneel; the bursitis should clear in a few weeks.

He thanked me and walked out of the exam room visibly relieved.

It was a busy day.  I gave the kneeling man no further thought.  Until I drove home in the afternoon.  Then it occurs to me.

There’s no way.  The distance between the floor and the rim of the toilet has to be greater than…  The math major in me can’t let this go.  I have to find out.

When I get home I don’t bother to greet my wife, or take my jacket and tie off.  I go straight to the bathroom.  I kneel in front of the toilet.  I undo my pants zipper.  At the same time that my wife walks in, ready to give me my coming home hug.

“What are you doing?”

A sheepish smile from me.

You see, I have this patient who likes to urinate on his knees…

“No; seriously.  What are you doing?”

I am serious.  He has this fluid on his knee…

I really want to get on with my experiment; she’s delaying my scientific endeavor.

“Is this one of those kinky things they show on the Internet?”

I swear that Mr. ___ came in today with…

She walked away without bothering to hear my explanation.  To this day I don’t know if she has bought it or not.

My patient came back two months later.  His knee fluid was gone.

I will not tell you the results of my research.  You need to find out for yourself.

Many men share an aversion to sitting on the toilet to urinate.  Probably because it’s something women must do.  More evidence of the sexism that plagues society.

Every day, at every hour, I am impressed by the degree of trust that my patients show in me.  They bare the deepest, sometimes darkest part of their souls with little hesitation.  I am extremely proud that they are able to do so.  I never forget that I must renew that bond on a constant basis.

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This Post Has 7 Comments

  1. Lois Allen

    I have often wondered how doctor’s process the amount of strange things they have to listen to. I’m sure some are humorous and some are heartbreaking. Some probably fall under of the category of Too Much Information. I still remember the first time I met you. I had recently been added to your patient list but hadn’t seen you yet. I had been going through extended stress and was in the throes of being overwhelmed. I was in such bad shape a friend brought me in after insisting I needed medical help. When I burst into tears and admitted “I think I’m having a nervous breakdown” you didn’t bother with anything but to tell me “you need a hug” and proceeded to give me one. I was so shocked it snapped me right out of the tears. You gave me the medical help I needed and never wavered. I have always appreciated your desire to get to the root of the problem rather than just address symptoms. You created a bond of trust in that first visit that I have counted on for many years. Thank you so very much.

    1. franciscogarrigamd

      Nothing wrong with needing a hug; it just means that someone is listening and understands.

      1. Denise Bauman

        I hope u went in and read about the surgery I had. Not without events, ICU, fever, and 5 day stay. No wonder u were concerned. I was clueless. Feeling great right now except exhausted.

  2. Denise Bauman

    That is why I will miss you so much because you are so easy to talk to

    1. franciscogarrigamd

      One of my professors taught me that by the time the patient finished talking you should know what’s wrong with him/her 95% of the time. He was right. But you must learn to listen.

  3. Cordell Webb

    Dr. G, you should write a “sit-com” on this one. I am sure you realize all of us men will be trying this out on our knees. Just hope I don’t get caught.

  4. Betty Townsend

    Interesting story. I learn something everyday. Listening is an art and many of us do not know how. We seem to be always too ready to interject our take before we know the whole story.