A lesson in empathy from a young patient

Anyone close to me knows orthopedics has never been my cup of tea. I rarely studied it properly; somehow, my enthusiasm always remained low. No offence to the subject, but maybe it started the day I saw my best friend’s forearm break. Fractures have always made me uncomfortable. During one of our postings, we were asked to do a case presentation. A patient was assigned to us, and it happened to be a busy day in the unit. Seniors, juniors, around 15 of us, were huddled around the same patient.

“Shidu, he’s a Malayali.”

“Oh no, not again.”

“I’ll take the history; someone else can present.”

I walked over. He was a fifteen-year-old boy, casually scrolling through his phone. No visible casts or splints. His mother sat beside him, calm, composed. He didn’t seem to be in pain. After some light small talk about football, school, and Instagram, I told him, “I know there are a lot of us here. But we want to learn something important from you; something that will help us become better doctors, hopefully.”

We took the history. A trivial fall while playing football. A slip at home. Even a straining movement (too much effort) could lead to fractures. “Pathological fractures,” I thought. And once they healed, swellings would form. “Malunion?” I didn’t want to think tumors. I prayed it wasn’t. Maybe some inherited disorder? But to him, we were just a bunch of students joking about his style, his glasses. Still, I pressed on. “Anyone in your family had similar complaints?”

“I had an elder son,” his mother replied quietly. “He passed away a few years ago.” Her face was unreadable, but her eyes carried the weight of years: of patience, pain, and resilience. I looked back at the boy; his smile had faded. The mood shifted. I had no more questions left. I turned to my batchmates and said, “You guys go ahead and do the examination.”

Then I walked over to the junior batch, who were standing a little away, and began explaining the history to them. Maybe I wanted them to learn something; or maybe I just needed a moment to process what I had heard.

“So,” one of them asked, “Diagnosis from history?”

“Shidu, look at his eyes.” He had taken off his glasses. Blue sclera. Eureka. A Doctor House moment. “Osteogenesis imperfecta,” I said with a quiet smile. “Even I’m diagnosing orthopedics now,” I thought.

But the tables turned again. We began examining his limbs more carefully. We found multiple small bony swellings, likely the result of previous fractures healing with malunion. Then we asked him to stand. That’s when we noticed the varus deformities of the lower limbs, legs bowed outward, confirming the suspicion. Someone suggested we examine his heart for associated valvular defects; so we auscultated. I placed my stethoscope on his chest. No murmurs. But as I lifted it away, my eyes met his mother’s. Her gaze, silent but piercing, struck something deeper than any sound. A murmur rose within me. What were we really doing with this young boy? We were excited, witnessing a rare condition. But in that moment, I wondered: Did we forget he’s a person first?

I think all of us felt that internal murmur, together. In silence, we turned to write our notes. Before leaving, I bent down and thanked the young man. “You know, because of you, we learned a lot today. You might not realise it, but this means so much to us. This will help us be better doctors.” He smiled. So did his mother. And that’s when the murmur in me finally stopped beating.

I’m not sure if it was us or him who truly made the impact that day; but it reminded me of a Hadith: