I have a collection of rocks. I have a rock in my office from a lake in Minnesota where my brother, my Dad and I built a cabin. At home, my wife and I have a collection from vacations and hikes we have taken over the years. But I keep one special rock on my desk to remind me how to be a better doctor.

It is a small oblong green rock worn smooth by rubbing. It’s about the size of a half dollar and it reminds me that sometimes the most important thing I can do as a doctor is to listen. The rock and the lesson came from a patient I met on a day that did not have a particularly promising start.

I was working at the Maine Medical Center Emergency Department. It was a busy shift and I was unusually tired. Just when my energy was at its lowest ebb, I looked down at the chart of my next patient and saw that she suffered from chronic fibromyalgia and depression and had been admitted to the hospital several times for chest pain. She was in the emergency room that day suffering from chest pain.

Fibromyalgia is one of those medical conditions that defies easy description or treatment. People who suffer from fibromyalgia are in pain for no obvious reason. The condition can be triggered by surgery, infection or psychological stress. Sometimes there is no known cause, and although some medications can help control symptoms, there is no cure.

Doctors hate fibromyalgia because we are not very good at treating it. Often, it seems there is little we can do except prescribe medications, which can be addictive and may do patients more harm than good. Meanwhile, to rule out other causes of pain, doctors may order tests that can be costly or even harmful.

All of this costs money, wastes time, and makes patients incredibly frustrated.

As I walk into the room, however, one of the first things I noticed is that my patient did not seem antagonistic. She was in her mid-60’s with grayish hair, and seemed pleasant, even grandmotherly.

I begin to take her medical history, but suddenly I felt not just tired, but weak all over and dizzy. I grabbed a stool to sit down and continued to take her history but I realized that I needed to slow down.

I leaned on the bed railing and I listened to her story, her entire story, and only after she was done did I start to feel a little better. I gave her a brief exam and then told her what I normally tell patients with fibromyalgia.

I told her that her symptoms didn’t sound dangerous but we would do a simple test (an EKG )to rule out the possibility of a heart attack. If that test was OK, I told her I thought she could safely go home although she may want to talk to her primary care doctor about adjusting her medications.

By the time I left, I felt pretty good. The interaction had gone well and she seemed happy with what we had discussed.

Then, as I was writing up her discharge paperwork, I looked up and she was staring at me from the doorway of her room.

That’s usually not a good sign. Often that means a patient is not happy with how things have gone. They may have something to tell you that they didn’t mention the first time around, or they may want to complain.

I thought to myself that she probably wanted a prescription for Oxycodone, or that she thought she really needed to be admitted to the hospital.

I walked back to the exam room with her and she said, “You know, you look tired.”

She held out her hand which held a small smooth green rock and said, “I use this when I worry and it really helps a lot. You were so good to sit down and talk with me. I want to give this to you because you seem to have a lot on your mind.”

It is hard to describe how good that made me feel. Not only did she not complain, she thanked me for listening to her, and I realized that she had also paid attention to me.

She went home happy and I kept the rock. I rallied a bit as my shift went on but by the time I got home, I was beat. My muscles ached and I went to bed early. The next day I had a fever and my wife developed the same symptoms.

I realize now that I had been sick throughout my shift. But ironically, I would not have been successful with that patient if I had not been feeling ill enough to sit down and have that conversation, and I am convinced that conversation not only made my patient feel better, it made me feel better and it saved the healthcare system a huge amount of money.

My patient didn’t have to go into the hospital and most importantly, she didn’t end up with any prescription or other form of treatment that could have eventually done her more harm than good.

Now I have this rock which I leave on my desk. Every now and again I look at it and I am reminded that I need to sit down and listen to the patient even when I am busy and there are patients waiting in the hallway. It is not only important for the patient; it is good, efficient medicine.

Dr. Mark Fourre is an emergency physician and Chief Medical Officer of Lincoln County HealthCare, the parent company of Miles Memorial Hospital and St. Andrews Hospital. He also serves on Lincoln County Healthcare’s Board of Trustees. Prior to joining Lincoln County Healthcare, Fourre was an attending faculty at Maine Medical Center where he developed the Emergency Medicine Residency Program and served as Residency Director.