My heart is racing...

Seeking a new doctor or therapist feels like exam fear to me. Standing at the door just before an oral exam is about to start - remember that feeling? I suffer from exam fear. My heart is racing, my stomach is restless and I have a strong urge to escape. Especially when the receptionist is of the draconian kind.

I have a hard time building trust. When I find a doctor I trust, having to change this doctor, is like tearing off a limb - painful!

Cost cutting has cut out trust building

On this long journey to diagnosis, I have met many doctors and therapists. Always, but especially when you are chronically ill, you need a lot of trust in your doctor. In return, the doctor also needs trust in the patient. Unfortunately, trust has been "saved" over many years, because there is very little time for a conversation with the doctor.

A conversation is what I often needed. I have also met doctors who take time for their patients. They are under many economic constraints. That's thanks to the health system, which since the 1970s has taken more and more focus away from the patient and towards economic efficiency. Sometimes I even have a guilty conscience when a doctor takes time for me. How paradoxical is that? On the other hand, I sometimes have the feeling that I'm interrupting here, my illness is taking up too much time and it's going nowhere, so I drop the appointment again. All not fertile ground for trust. Being ashamed

The cause

The cause is largely to be found in the system,

A system that "paradoxically, on the one hand, offers financial incentives for an excess of medical services and, on the other hand, prevents all patients from receiving meaningful and necessary treatment through budgeting",

Prof. Robert Jütte, Director of the Institute for the History of Medicine of the Robert Bosch Foundation

Ankowitsch, E. (2013). Doctor-patient-relationship: trust saved away for decades. Retrieved May 16, 2020, from

I assume that most doctors choose this profession because they want to heal people and save lives. Healing definitely involves conversation.

Trust alleviates pain

Studies have shown that trust and closeness to the doctor can reduce pain. This is called the "social placebo effect". The greater the trust and the feeling that the doctor understands you and thinks alike in some ways, the less pain we seem to feel. This means that when we believe that the doctor can help us, because of trust, the brain sends signals that reduce pain. The University of Heidelberg has conducted a study to find out whether improving the doctor-patient relationship reduces pain, and whether patients who find it more difficult than others to establish a new relationship benefit more from it. For such people in particular, going to the doctor can cause something like exam anxiety. Improving the doctor-patient relationship

How do we come to trust?

  • by feeling as a patient that the doctor is taking me seriously.
  • by conducting the conversation at eye level and not condescendingly.
  • by letting me talk (not endlessly) and not interrupting at the first opportunity to end the conversation quickly.
  • by the doctor asking questions and not just whether I have understood him.
  • by the doctor talking to me in a way that I can understand him and encouraging me to ask questions.
  • by the docotor giving me the feeling he has time for me and trying to understand my point of view.
  • by looking at my individual situation and not stubbornly insisting on the textbook case.
  • by having the doctor include me in his treatment plan and let me have my say in it.

Of course, this is not a one-way street. As a patient, I can also contribute by

  • preparing myself for the conversation, writing down what I want to say, writing down everything that comes to mind about my symptoms. Since when have I had them? What do they feel like etc....
  • Going into the conversation with an open mind not with preset negative expectations
  • saying when I'm feeling anxious (palpitations!)
  • if possible, completing my notes with keywords about what the doctor said, so that I don't forget it right away and have an incorrect memory.

What do you think about this, when do you have confidence, and what do you to get it? Feel free to write something in the comment area.

I wrote this poem for a project. Of course, it doesn't apply to every doctor and every practice, but I have had this experience, it shouldn't be like this:

Hello, can you see me?

I am sitting here on this chair in your consulting room.

Before that I sat on the chair in the waiting room - for a long time.

I can't sit for long - it hurts...

Hello can you see me? Can you see me?

You can't not see me, I've gained 20 kilos since I got this disease.

No, I don't eat chocolate all the time.

Yes, I'm trying to do sports and keep moving.

Hello, can you see me?

Somehow I seem to be speaking Swahili, because nobody is listening to me.

I do not fit with the diseases described in the textbooks.

Hello can you see me?

Are you listening to me? Me, here I am. In the chair in front of you.

I am not a disease. I'm a human being.

I am not vegetative dystonia, psychosomatic functional imbalance, irritable bowel syndrome, irritable stomach, allodynia ... I am a human being, I am trying to tell you what is wrong.

You're on the phone, you're writing, you're scrolling, you are not listening to me.

You don't believe me.

I'm sitting here again.

I get up and go.


©Dawn Garroch


K, N. (2017, May 8). Trust and closeness to the doctor reduce pain . Retrieved May 19, 2020, from

Coachman, P. (2013). The doctor-patient-relationship: Seven tips on how to improve communication with patients. Retrieved May 20, 2020, from

Albat, D. A. (2019, October 22). Therapy: What the doctor's attitude causes.

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