Couldn't Find the Words

I walked into the room to see a new patient from Guatemala. She was sitting in a chair next to the door with her head in her hands. I looked at her and said “Hola”.

She took a few moments, took a deep breath, and looked up. I could see she had been crying so I sat not too close and not too far, not too direct and not too indirect. She spoke only a little Spanish, and I didn’t know the language of her indigenous community. So, in the first few seconds getting to know her, I could tell that we would need more than my 8 allotted minutes to introduce myself, understand her needs, build rapport, and figure out a plan to help her get from where she is to where she wants to be. I knew that if my wife, my daughter, my son, my mother, my father needed help in a place where they have trouble communicating, had to take time off work and take public transportation to a clinic, I would be grateful if someone would take time and make the effort to listen.

She didn’t look at me very much, and I sensed aspects of vulnerability, shyness, embarrassment. I got the feeling she couldn't quite say the things she wanted to say, and I knew that I couldn't quite ask the questions I wanted to ask.

So I drew a diagram. A simple line drawing of a vulva on a piece of paper. And I held it toward her and asked her to point to where she felt the pain. She pointed. That was the conversation we could have—not in words, but in gesture. In her finger finding the place where the pain lived. In the small, brave act of showing me where it hurt.

I made a tentative diagnosis of interstitial cystitis. We talked about diet. I gave her medication. And to be honest, I felt unprepared. I didn't know enough about IC to be the doctor she needed. But I also knew that she didn’t have anyone else she could turn to, so I was willing to better myself to be able to help her better. We would work through it together.

Six months later, I came back to that same room.

She was sitting in the same chair. And when she saw me, she stood up. Her face changed completely. She smiled—a smile that reached her whole body—and she came toward me and hugged me.

That moment still lives with me. I can still feel it.

Because she got better. Or better enough. Or the care mattered in a way that went beyond the medicine. And in that moment, I understood something about what it means to show up for someone even when you don't have all the answers.

But the story doesn't end there.

I wanted to learn more about IC, so I searched for more. I wanted to understand what I had missed, what I could learn, what else was possible. And in that search, I found something new to me: an entire field I had never encountered before—pelvic floor physical therapy.

That discovery led me to a classroom in Athens, Georgia, where I walked in as a student to Pelvic Floor Level 1 with physical therapists who had been trained in things I had not. I was intimidated and felt out of place, but I also wanted to learn, and I was ok being the newbie in the room, along with all the 77 women and two other men.

That single step—that decision to become a beginner in a field I knew nothing about—changed my life. It changed how I understood women's health. It changed how I understood patient care. It gave me colleagues who went on to became friends. It gave me a future for a fulfilling practice, it gave me the work that makes me excited to wake up in the morning…in moment when I thought I might be lost.

So I am grateful that I met the woman from Guatemala who couldn't find her words, but who could point to where it hurt, who entrusted me with personal details that she had never shared with anyone, and who came back six months later and hugged me.

She is one of the reasons I am who I am today.

This is the first story in a series exploring how listening, courage, cycles, and village shape my approach to medicine and life. More stories coming soon. If you'd like to be notified when new stories are published, subscribe below.