The Exam Room Reset: Cole in the middle (#398)

On that morning in 1996, the exam room at the UC Davis Veterinary Medical Teaching Hospital was already full before the black Labrador arrived.

White coats along the wall. Clipboards at attention. That particular hush of eager students trying not to sound eager.

Our patient was a friendly black Labrador named Cole, referred for seizures. Cole entered the room with the careful dignity only a well-loved dog can manage.

I began my usual cadence. Brief history. Timeline. Questions meant to loosen memory and tighten detail.

Lisa Hartman Black answered crisply. Clear, organized, eyes on her dog.

I was halfway through the neurologic checklist when I realized Clint Black was with us but not with us.

His gaze kept sliding past the room, not in distraction but in engagement. Engagement with someone who wasn’t there!

Then I saw it. A small microphone at the end of a device on his ear. He was on the phone. In our packed exam room.

This is where the competing currents of clinical medicine and teaching meet. We tell students that a good neurologic exam is structured, patient, and attentive. That you learn as much from the pauses as from the reflexes. But here we were trying to thread a seizure history through someone else’s conversation.

So, I stopped. Not dramatic. Just still. I looked at the students and said, “Thank you. Please give us the room for a moment.” I'd heard that on so many TV shows and movies, and I finally got to use it!

The students filed out, surprised but professional. Then I turned to Clint and said, “I’ll step out as well and come back when you’ve finished your call.”

No irritation. No lecture. Just a boundary stated plainly.

In the corridor, I could feel twenty eyes on me. A teachable silence never lasts long, so I broke it. “We don’t compete for attention,” I told them. “Attention is a clinical instrument. If I can’t have the room’s attention, I can’t examine properly, and I can’t teach you properly. The dog deserves focus. The owners deserve focus. If we don’t have it, we pause until we do.”

A few nodded; one scribbled as if I’d just revealed the brachial plexus’ last secret. Another asked whether we risked offending a high-profile client. “We risk more by pretending divided attention is acceptable,” I said. “The standard you walk past is the standard you teach.”

When we re-entered, the room felt different. Quieter. Aligned. The phone was away. We started again, and now the small details had room to be heard: the subtle asymmetry in menace response, the fleeting head tremor that might have been dismissed as a shake, the cadence of Lisa’s answers when she described the first event at home.

We talked through rule-outs, why episodic collapse isn’t always seizure, why “normal between events’”can be both reassuring and misleading. We discussed triggers, safety, and the plan for diagnostics and management. The Labrador breathed easier. So did everyone else.

Afterwards, I told the students that medicine is full of heroics that look like procedures, but some of the most important interventions are quiet. Closing a door. Resetting a room. Protecting a conversation. You can sedate a dog for a procedure, but you cannot sedate a distracted clinic into good medicine.

You set the conditions for clarity, or you don’t get clarity.

I think about that day often, not because of the celebrity sheen. Dogs don’t care about platinum records. But because it distilled something we say all the time and too rarely practice:

Presence is part of the work.

If we mean it when we say the animal comes first, then our attention must arrive before our hands do.

It was, in the end, a simple moment. I asked the students to leave. I told Clint I’d return when he was ready. We reclaimed the room, and the medicine followed. A valuable teaching moment made more valuable because we taught it by doing it.

Postscript

The Labrador, Cole, was ultimately diagnosed with a brain tumor. He underwent surgery. The tumor was benign – a brain base meningioma. Cole rallied like a champion, and a few days later boarded a private jet back to his home.

When I spoke with Lisa before discharge, we talked not just about medications and rechecks, but about life after a scare like this.

She asked whether adding another dog would be wise, how to pace a household’s energy around a recovering patient, and the quiet gifts that routine can give a healing brain.

Lisa was gracious, attentive, and deeply grateful for the outcome.

Two years later a letter arrived. Inside was the Christmas photo for a calendar prepared for the Clint Black Fan Club. There sat Cole, bright-eyed in the middle, flanked by his proud owners. And, to my delight, an additional dog adopted from the Nashville Humane Society, and two more Humane Society adoptees!

The picture said more than any progress note: recovery, gratitude, and a household that had chosen to widen the circle.

For the students who were there that day, I often add this coda: the point of insisting on full attention isn’t merely etiquette. It’s clinical.

Attention begets accuracy, accuracy begets trust, and trust makes room for outcomes like Cole’s.

And for Christmas cards filled with second chances.

CLINT BLACK & LISA HARTMAN

“Our Country Love Story”

It sounds too beautiful to be for real – but it’s all true!

A unique aura surrounds country singer Clint Black and actress Lisa Hartman; it’s as if they were playing a love scene from a romantic 1930s movie. Lisa, 37, and Clint, 31, have been married for two-and-a half years, yet they bring to mind a couple whose eyes have just looked across the proverbial crowded room.

When one speaks, the other listens raptly. Often when they’re talking to a third party, they’re still looking into each other’s eyes, as if a blink might interrupt some shared telepathy. They speak of love and marriage with the fervor of newlyweds.

When they met little more than three years ago, both were hardworking individuals whose careers left little room for romance, much less commitment. Lisa had just finished reeled off a string of six TV movies. Clint had burst onto the country music scene as a superstar with his first album Killin’ Time.

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