A young Marine sat in the exam room waiting for his final physical. He had failed multiple physical fitness tests and would receive an administrative discharge (general under honorable conditions) for falling below standards. He would not rate his G.I. Bill.

“How are you doing? I’m doc Hardman, good to meet you.”

“Good to meet you too, sir.”

“Before we start, I’d like to thank you for signing up for the Marine Corps. Most Americans don’t do that. So, thank you.”

“Thank you, sir. That means a lot.”

“But tell me, I’m curious, why are you getting separated?”

“Sir, I failed my last two physical fitness tests.”

“Why?”

“I couldn’t run fast enough.”

“Why not? Have you always struggled on the run?”

“No, I used to be a decent runner. But then my leg started hurting too much.”

“Did you ever come to medical for it?”

“Yeah, I did. They told me there was nothing wrong with it.”

“Did you have any imaging?”

“I had an x-ray.”

“Let me go take a look at it in my office. Hold on a second.” (I walked to my office confident the x-ray wouldn’t show anything relevant.)

On return from the office, I asked, “Do you know anything about your xray?”

“Other than it was normal, no.”

“Let me go back and check again.”… after checking again, “You know you have a big hole in your femur – a cyst or a tumor?”

“They told me there was a small cyst.”

“Well, it’s not small. And I don’t know what it was. The radiology read said that it lacked aggressive features, but I am going to call ortho to set up a consult.”

30 minutes later, “Ortho tells me that we are going to get a CT of your leg, but we need to get you in to see ortho-oncology so they can get a biopsy. We are going to give you crutches and make you non-weight bearing. We are concerned that your leg could break if you apply too much force to it.”

“Am I going to get the biopsy before I am separated from the military?”

“Nobody is separating you from the military without my signature. And I’m not giving anyone my signature until you are done with surgery. Here’s what we’ll do. I’ll be in touch with your command to set up a meeting with your commanding officer. This is crazy that you are being separated for having a hole in your femur and not running fast enough. I don’t know what to say, other than I’m sorry, and we are going to take care of you medically and try to make this right.”

Three months later, Marine walks into my office after a negative biopsy and a surgery to fill the cyst and install a bone plate, “hey sir, I just wanted to say thank you. Thank you for paying attention. I’m getting medically retired.”

Every patient has a story. It is up to physicians to make the time to listen.