There are things patients say that you forget almost immediately.

And then there are the ones that stay.

Not because they’re medically important – but because they’re unexpected, revealing, and occasionally surreal.

One patient came in for a routine appointment.

We went through everything: a cervical screening test, a breast examination, a review of her medications. I wrote her scripts, answered her questions, and explained the plan – a fairly standard consultation.

At the end, she paused, looked at me, and said:

“You did well. Now, when do I see the real doctor?”

It was one of those moments where your brain briefly stops.

She had just allowed me to perform quite personal examinations, accepted prescriptions, and discussed her care – but somehow, in her mind, I didn’t quite qualify.

You run through possible responses.

Nothing seems quite right. You reassure her, show her your framed qualifications on the wall and move on.

But the moment stays.

It’s not always a one-off.

Another patient once insisted I couldn’t possibly be the doctor she’d seen the week before.

“That’s not possible,” she insisted. “The doctor I saw last week was shorter and much blonder.”

I had, in fact, seen her the week before.

You take a moment to reflect on what, exactly, has changed in the intervening seven days.

Then realise that, once again, you’re up against expectation rather than memory.

And then there are the moments that shift things in a different way.

When I was eight months pregnant, I looked less ‘slightly expecting” and more ‘full term, possibly with triplets,’ waddling and having to heave myself out of the chair.

As I finished consultations, I explained that I wouldn’t be there to follow up results and suggested other doctors in the practice.

The responses were … unexpected.

Some asked if I was moving practices.

Others assumed I was going on holiday.

When I said I was having a baby, I was met with genuine surprise.

A number of patients hadn’t noticed. For some the news came as a shock.

One even asked if I was “Sure it’s a pregnancy?”. He thought I had just “packed on some pounds”. This was despite the baby making its presence very clear during consultations, stretching and kicking through my clothes.

Not to mention that you’d hope a doctor would know when they are that pregnant.

It was a useful reminder.

Most people are focused – understandably – on their own concerns. Their symptoms. Their worries and expectations.

My appearance, however obvious it seemed to me, wasn’t what they were noticing.

What mattered more was how I listened, what I said, and how I made them feel.

Which made me think back to that earlier patient.

The one who asked when she would be seeing the “real doctor.”

She had trusted me enough to undergo personal examinations. She had accepted my advice and prescriptions.

And yet something hadn’t quite landed. She later told me I didn’t look old enough to be a doctor. I was 30 years old at the time.

Maybe I should have been flattered she thought I was more youthful. People expect doctors to be authoritative, experienced with accumulated knowledge. Appearing younger was a professional hindrance.

Patients often say things that make perfect sense to them, but land differently on the other side of the desk.

“I’ve got a high pain tolerance,” usually just before wincing. I’ve never met anyone who said they have ‘a low pain threshold’.

“It’s probably nothing” means they’re more than likely concerned it’s something serious.

These aren’t misunderstandings.

They’re glimpses into how people see their health – and the person sitting in front of them.

For doctors, these moments accumulate. Not as diagnoses, but as reminders.

That medicine isn’t just about knowledge or tests. It’s about bridging the gap between what we understand clinically and what patients perceive in the consult.

In reality, patients don’t always say what we expect.

And they don’t always mean what we hear.

But those moments – the odd, the surprising, the slightly surreal – are often the ones that stay.

Dr Kathryn Fox is an Australian medical doctor and bestselling crime writer, best known for her forensic thrillers featuring pathologist Dr Anya Crichton. Drawing on her medical expertise, she crafts gripping, authentic crime fiction and is also a passionate advocate for forensic medicine education and public engagement. 
 

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.