Illustration by Catherine Chan
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I made the life-changing decision to have a double mastectomy when I was standing in a parking lot outside Sports Experts in Saint-Sauveur, Que., during my kids’ spring break.
The location was less than ideal. My surgical oncologist had called unexpectedly while I was shopping with family, so I rushed outside to hear him share the not-so-great results of my MRI. After listening and writing notes on a page pressed against the car hood, I replied: “Given this new information, I guess the bigger surgery is necessary.” In that moment, the dusty parking lot, framed by melting snow, became a medical space.
As a professor who researches the history and visual culture of medicine, I often think about how medical spaces alter physician-patient encounters and experiences. Face-to-face meetings have long characterized how doctors share medical news. Cell phones, however, have transformed everyday places into makeshift medical spaces. A physician can call us anywhere, converting wherever we answer our phones into medical spheres. All sites are potential locations for diagnostic discussion. Nowhere is protected from good or bad medical news.
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Generations before us have adjusted to the changing locales of receiving medical results. Physicians used to visit patients in the privacy of their homes, then these encounters moved to hospitals, clinics and offices, and now, they can take place almost anywhere over the phone or virtually.
Taking a call from a health care provider in one’s own abode is comfortable enough but being caught off guard in public is another experience all together. Doctors may be adhering to privacy rules by closing a door or speaking in hushed tones, but what of the patient’s privacy when answering questions about bowel movements while at the grocery store?
I took a call from my surgeon in the bathroom of a busy Montreal bistro just days before my surgery. The ink of my pen bled across the scrap paper, damp from the water pooled along the sink’s edge, as I scribbled, “Radiation unlikely but no crystal ball.” This place that I once associated with joy and the best salmon tartare in town was now a medical space, whether I liked it or not.
I recently complained to a GP friend about how waiting to receive medical results over the phone made the waiting time worse because I never knew where I’d be when I got the call. As I waited, I’d be tethered to my phone in a state of distraction: Vibration mode on, volume up, the call can’t be missed (there is rarely a call-back number). Waiting for medical news is torturous and one of the most existential forms of experiencing time. This isn’t waiting for a bus or a package to arrive. Medical waiting is a temporality that reminds us of the frailty of our bodies and our inevitable wait for death. The call could be nothing, or it could be everything. Where we receive it matters.
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My doctor friend shared her perspective: Is it better to wait for an administrator to schedule a call, thus prolonging the sharing of results? Should we waste our medical system’s resources by requiring in-person meetings for all patients if updates are brief? Of course not, I replied. We all want our medical news fast. But we also know that “in person” is becoming code for bad news. Furthermore, is fast always good? One of my Toronto friends got her breast cancer diagnosis through Ontario’s speedy online system. She sent the report to her retired physician father who advised that she wait to speak to a specialist. She plunked the info into ChatGPT. Who can resist the lure of the fastest “doctor” of all?
I think of my GP friend calling patients from her home office. Perhaps she makes herself a cup of coffee or empties the dishwasher as she works her way through the long list of names and numbers. Medicine – for better and for worse – has infiltrated her domestic sphere too. I got my cancer diagnosis over the phone while sitting at my kitchen table, its marble surface reminding me of how Victorian hospitals used this polished stone for entrance halls, heroic sculptures and dissection tabletops.
We need to think more about how communication technology has changed where medical news is given and received as well as the effect these impromptu medical spaces have on patients, doctors and their relationship. We all want speed and convenience, but it shouldn’t be at the detriment of the physician-patient connection. Today, “bedside manner” refers to a doctor’s ability to be comforting, clear and respectful, but the term is historically rooted in a physician’s close physical presence to a patient.
It turns out that when my surgeon called me in Saint-Sauveur, he was on vacation. Was he phoning from the Caribbean, the corner of an airport lounge, his rental car? I know nothing of his personal life, but I have imagined how the medical space infiltrated his holiday, as it did mine. Were his kids or partner or friends annoyed that medicine infiltrated their vacation location? Was I relieved or upset that the medical news he shared altered mine?
I’m currently waiting for more test results. I’ve opted for the longer wait time to get the news face to face.
Mary Hunter lives in Montreal.