The question I forgot to ask

He mentioned it like it was something he'd already grieved.

Dance. He used to dance regularly, freely, without thinking about it. And somewhere in the years of managing a chronic illness, it had quietly disappeared. Not just because his body stopped cooperating. Because the hesitancy had crept in. The second-guessing mid-movement. The not-quite-trusting his body anymore.

Truth be told, I didn't even write it down in my SOAP notes. It was just a passing comment. But for some reason it really stuck with me. I think it was the tone of his voice. Maybe a hint of longing? Or grief? Maybe both. But from that session forward, that was the real goal.

Not the symptom list. Not the lab markers. The dance floor.

It sounds simple when I say it like that. Almost obvious in hindsight. But nothing in six years of clinical training had ever pointed me toward that question. The symptom was on the intake form. The goal wasn't.

So much of what we learn is clinical. Structured, thorough, evidence-informed. Which matters. I'm not arguing against any of it. But there's no field on the intake form for "what do you actually love doing with this body." And in my experience, the answer to that question is often the most important thing in the room.

Most people don't volunteer it. Why would they? They've learned to speak the language of symptoms because that's what gets taken seriously. So they lead with the shoulder. The low back. The tension that's been there for two weeks. And you treat what they give you.

But underneath almost every chief complaint is something more specific. A garden they can't get to. A kid they can't pick up without bracing. A sport they've quietly stopped showing up for. Something that used to feel like theirs.

When you find that thing, and sometimes it takes a few sessions to get there, the whole dynamic shifts. You stop being someone who manages a complaint and start being someone who helps them get back to something they care about. That's a different relationship. And honestly, way more interesting work.

People are more motivated by joy than by symptom reduction. They'll do their homecare if it means getting back on the dance floor. They'll show up, they'll engage, they'll trust the process because the process has a destination they actually want to reach.

The last time I saw him he told me he'd been dancing again. No hesitancy. He said it like he was reporting something small.

It wasn't small.

It's just a question. Something like: "What does this stop you from doing?" Or even more simply: "What do you want to get back to?"

Try it once and see what happens. And if something comes up when you do -- a patient who surprised you, or a moment where the whole treatment shifted because of one answer -- I'd genuinely love to hear about it. Just hit reply.

Best, Dr. Jess

P.S. I'm building out a treatment philosophy framework that puts this kind of thing at the center -- understanding the why beneath the complaint, client empowerment, motivation-informed care. If that's something you'd want to hear more about, hit reply and let me know.