You pull out your spiral notebook of meticulously recorded blood pressures and my heart sinks.  You go through the numbers with me, focusing on the sporadic readings that seem particularly high.  I see you searching my face, looking for evidence of the shock or dismay or panic that I surely must be feeling from seeing this objective evidence of your impending doom.

But I don’t feel any of that, just marked indifference and a sense of wanting to move on to the next patient since your disposition has been made.  Now it’s my turn and I counter with my high blood pressure speech, offering reassurance in a flowing polished manner, a byproduct of giving this same talk hundreds of times before.

When I finish I ask indirectly if you feel better about things and you almost always do which is good, partly because I want to relieve you of your anxiety and partly because I want you to leave the ER without a fuss.  I tell you bye and start the discharge process, wishing for a world without home blood pressure monitors.