Hello. This is Doctor Bean. Psychotoddler has kindly allowed me to share a guest post with you, his dear readers.
About a dozen times throughout my career patients have come to me worried about their xiphoid process. The following is a fictionalized amalgam of those encounters.
Mr. Jones: Good to see you Doctor Bean.
Me: Nice to see you too, Mr. Jones. What brings you in today?
Mr. Jones: I noticed a lump on my chest two weeks ago and it hasn’t gone away. I’m worried it’s a tumor.
Me: Oh. Well I’m glad you came in to get it checked out. Does the lump hurt?
Mr. Jones: No.
Me: And has it gotten bigger since you first noticed it?
Mr. Jones: I don’t think so, but I’m not sure.
Me: Where is it?
[Mr. Jones points to the bottom of his chest in the midline.]
Me: [Thinking: Good Lord! Not another one.] Alright. Take your shirt off and let me take a look. [Palpating with my right hand.] Is that it, right there?
Mr. Jones: Yeah! That’s it. Is it serious?
Me: No. That’s your xiphoid process. It’s a pointy tip at the end of your sternum.
Mr. Jones: Oh, no! Do I need surgery?
Me: No. It’s fine. You don’t need anything.
Mr. Jones: Is it normal?
Me: It’s not just normal. It’s universal. Everybody’s got one. It’s standard anatomy.
Mr. Jones: Weird how I just got mine two weeks ago.
Me: No. It’s always been there. It’s part of your skeleton. You’ve had it all your life.
Mr. Jones: So why did I just notice it two weeks ago?
Me: What do you mean?
Mr. Jones: I mean if it’s always been there how come I didn’t notice it all this time?
Me: Wait a second. You came here worried that you had cancer. I reassured you that you’re healthy. But now you’re saying that that’s not satisfactory and you also need me to sort out why it’s taken you 42 years to stumble across an irrelevant protuberance of your normal anatomy? I really don’t know.
Mr. Jones: So you’re saying I shouldn’t worry about it.
Mr. Jones: What if it gets bigger?
Me: It’s cartilage. It can’t get bigger.
Mr. Jones: Should I keep an eye on it?
Me: You mean just in case it gets bigger?
Mr. Jones: Yeah.
Mr. Jones: Can I call you if it changes?
Me: Have you ever suppressed even the most fleeting desire to call me?
Mr. Jones: Tom, my buddy at work, never mentioned feeling a lump there.
Me: Hmmm. I wonder why he’s holding out on you. [Sprinting from the examination room.] Well, take care. I’ll see you soon.