Recently, I conducted a low back pain evaluation that took me by surprise with just how deep and emotional it became within the first few minutes of talking with the patient. My initial feelings regarding this evaluation were more on the side of frustration since this was the third attempt at rescheduling this evaluation and that she was currently 15 minutes late to the appointment. After she arrives and I bring her back, I very quickly understand that this is much deeper than just low back pain and essentially push my computer to the side only referencing it occasionally to ask brief follow up questions. It became very apparent that this is years of emotional trauma from many different aspects of this person’s life. Her injury started off with a simple flare up of low back pain after helping a friend garden 15+ years ago but was then layered with being a caretaker to a spouse who had a spinal cord injury. She also noted one of her daughters was severely ill several years ago that resulted in an amputation, as well as the passing of her other daughter a couple years after that – which I will leave out the heavy details of that situation. Through the patients breaks in tears, she has shared with me her struggle with PTSD, the current separation/divorce she is going through with her spouse, and how she hasn’t taken care of herself for years. She was once an active individual and body builder, who has a fairly good understanding of exercise and healthy living and has the current desire to get back to being happy and active. Several times during this evaluation, I could feel my eyes starting to burn and my throat get tight, just wanting to cry with her as I could see on her face the emotional pain she had been through, and it broke my heart. I kept repeating in my mind, “Hold it together Sarah” but all I wanted to do was give this patient a hug. This evaluation was a clear example on how the subjective interview can be leveraged to help the patient. My time spent with this patient was mostly just listening to her story. I did a couple objective measurements to establish a baseline at the end, but mostly focused on understanding her, her story, and what she wanted to accomplish with physical therapy. She shared that she really likes her new PCP, is seeing a mental health therapist for her PTSD, and is beginning Physical Therapy, all in attempt to start taking care of herself. Her demeanor by the end of the evaluation had changed, and she left our clinic saying she felt encouraged and excited to begin treatment with us. If I have a similar encounter to this one in the future, I hope to be able to provide more education in the moment to the patient. While I was able to provide some education to the patient, I felt slightly blindsided by the heaviness of her story and the details she was sharing, that I was also processing that information and felt very overwhelmed too. I knew with this patient, the follow up visit would be my time to get more objective testing completed as well as tie up any loose ends I had with my questioning that I didn’t feel was appropriate to ask in the moment. Overall, I think the evaluation went as well as it could’ve given the context of it, and that I have the opportunity to help guide this patient back to the healthy and active life she desires to have.