“What did you have for breakfast today?”

This phrase is a crucial part of my morning rounds.

While interacting with the patient, the greeting is very important. I believe doctors who approach the bedside without introducing themselves and who immediately ask about the patient’s active complaint tend to come across as less compassionate (whatever their actual intentions might be). This can hinder the development of the bond necessary for obtaining a complete medical history and for making patients feel comfortable around them. Feeling at home in the hospital and sensing that there are caring people nearby are vital factors in a patient’s recovery.

Feeling at home does not necessarily mean that a patient has a large room, an LCD TV, an air conditioner, or a refrigerator. What is the use of all these amenities if no one engages with them, asks about their day, shares their interests, or provides relatable conversation? Experiencing loneliness or lacking sufficient moral or emotional support can make a patient more vulnerable, lower their morale, and reduce their chances of a swift recovery. Patients are often more sensitive to changes in the moods of those around them and their environment compared to healthy individuals, whose coping mechanisms may be more robust.

This phrase has been very helpful for me in starting conversations with patients. After the usual greetings and introductions, I like to ask for the patient’s permission to sit down on a nearby sofa, couch, or bench at their bedside. Typically, detailed rounds occur in the mornings at most hospitals, and this may be the only opportunity for an in-depth conversation that day. Keeping this in mind, I believe that the doctor on duty in the morning should make a little extra effort to ensure that the conversation is interesting and engaging.

While active issues, new complaints, and the patient’s progress over the previous 24 to 48 hours are crucial, I also make it a point to ask questions like, “What did you have for breakfast today?”

Discussing a meal with a patient helps them feel more like a person than just a medical case.

This approach encourages them to open up about other concerns as well. Asking such questions can serve as a starting point for important conversations. For instance, it may lead to questions about symptoms such as bleeding, fatigue, changes in bowel habits, nausea or vomiting, fever, swelling, mouth sores, rashes, and shortness of breath—common issues among cancer patients.

Assessing a patient’s morale and nutritional status is crucial. I find it to be a more cost-effective approach than consulting a nutritionist, especially in a lower-middle-income country like ours. When patients share what they’ve eaten—such as a boiled egg, an omelet, a fried egg, tea, paratha, or a bread slice—it often indicates they are less likely to feel depressed or gloomy. Responses like “Shabash!” (bravo!), “Zabardast!” (That’s amazing!), “Yay!”, “MashaAllah!”, or even a simple thumbs up can brighten their day and make them smile.

If a patient hasn’t had breakfast, I can inquire about the reasons. This can reveal whether they are feeling nauseous, have an altered taste, are experiencing diarrhea or constipation, or simply do not like the food provided at the hospital. I can then offer alternative options and guide them on various ways to improve their appetite and overall well-being.

Sometimes, the reasons patients struggle with their eating habits can provide insight into their mental health, such as signs of depression, anxiety, tearfulness, sadness, or feelings of isolation. I try to comfort them and let them know that I am there to support them on this challenging journey of battling a serious illness, and I am cheering them on.

Many times, this simple question can spark a detailed conversation in which patients share their stories about what has been troubling them. They may discuss inner conflicts, family problems, financial issues, or the emotional turmoil they are experiencing. I find human interactions endlessly fascinating, and often, just having a listening ear can make a big difference. Feeling heard and acknowledged is crucial in releasing emotions, and ultimately, after a good catharsis, patients might find their appetite returning.

An interesting fact is that after adopting the habit of asking this question, I find myself repeating it effortlessly throughout the day. Many days, I ask my siblings and parents this question, and in return, I get an idea about how their day went and what’s on their mind that has been bothering them.

When I ask this question in the morning and listen to the various food items mentioned by my patients, I start to feel hungry, especially on days when I haven’t had breakfast. It’s amusing how a simple mention of an egg, a slice of bread, paratha, or tea can trigger cravings and remind me to take care of myself, too.

I would say I have received a great deal of appreciation and love from my patients, largely due to this phrase. That love and admiration from my patients motivates me to keep going, no matter how much work I have on my mind.

Yesterday, I met a 23-year-old patient who had acute lymphoblastic leukemia (ALL). He came from a very poor background and was struggling to find a hospital where he could receive treatment through a support program. He had visited many hospitals but had not found a suitable opportunity, as all the beds in the hematology department were already occupied. Finally, he was admitted to our hospital, and this was his first day.

When I spoke with him, he was accompanied by his very young father and mother, both of whom appeared anxious. After greeting them and taking a thorough medical history and exam, I sat beside his bed and asked what he had eaten for breakfast. He was hesitant to respond. However, after a bit of small talk, his parents opened up about how much they had suffered during the search for a hospital due to their limited resources and financial struggles that delayed his treatment. As we continued our conversation, the boy felt more at ease and shared that he had not been able to eat for the past few weeks because of a loss of appetite and a persistent low-grade fever.

I asked him what his favorite foods were and what he wanted to eat at that moment. We can arrange something he likes. My reassurance seemed to help him relax, and his father remarked, “Kisi doctor ne hum se kabhi itne pyar se baat nahi ki.” (Never has a doctor spoken to us with such kindness.) I felt sad and ashamed of our overburdened health care system and the overworked, burnt-out doctors, but his heartfelt compliment truly made my day.

If you’re curious to experience the magic of this simple question for yourself, I really encourage you to give it a try. You might be pleasantly surprised by what you discover.

Damane Zehra is a radiation oncology resident in Pakistan.