It was past 7 p.m. when I finally reached home after another long day in the outpatient oncology clinic. My mind still echoed with the day’s stories: patients fighting pain, families clinging to hope, and the small victories that made the exhaustion feel almost worthwhile. There was emotional fatigue, but also peace.
Then I opened WhatsApp. The headline jolted me: “Doctor in Chennai stabbed by patient’s son after mother’s death.” He believed the “wrong drug” had been given. The faint smile I had brought home faded into heaviness. Sadness loomed over me, a reminder that our profession, built on healing, now seems to require armor.
Every few months, another such story circulates: a doctor assaulted, a ward vandalized, another family’s grief turning violent. Outrage floods social media, colleagues demand justice, and then the storm settles, until it rises again. Why does this keep happening? And what can we do about it?
There are no simple answers, but many of us know the familiar triggers: inadequate communication, financial strain, denial of prognosis, and overwhelming emotional overload. Violence is never justified. Yet I find myself asking what we, as clinicians, might do differently. As we often remind our patients: Prevention remains better than cure.
The quiet power of honest communication
In my experience, anger seldom arises from malice alone. It often grows from misunderstanding. Families feel blindsided by sudden deterioration, unspoken realities, or the loaded language of medicine. Documentation may protect us legally, but it does not shield us from instant violence or abuse. A progress note cannot defuse an angry relative the way a sincere conversation can.
A few extra minutes spent explaining what lies ahead, the likely complications, the limits of medicine, can turn confrontation into collaboration. I once asked my teacher, Dr. Sachin Hingmire, how to discuss the permanent side effects of chemotherapy without scaring patients away from treatment. He said, “Your demeanor and words make all the difference. The patient should leave the room believing you can handle the side effects, even if they happen.” That wisdom has stayed with me. Communication is not merely the transfer of information; it’s the transfer of confidence and care.
The work that goes unseen
Much of a doctor’s labor happens silently: tracing reports, revisiting pathology, weighing treatment plans in conference hallways or messaging groups. Families rarely see this effort, and sometimes our silence is mistaken for indifference. Over time, I have learned to gently mention, “We discussed your case in the tumor board meeting today,” or “I spoke with the pathologist again this morning.” Not for praise, but to show that their loved one is not forgotten after clinic hours. Revealing this invisible work builds trust, and trust protects both sides.
Teaching the art, not just the science
Medical education still prizes scientific precision over human connection. Students master guidelines yet stumble when breaking bad news. Skills in communication and emotional intelligence are treated as optional, not essential. And yet, the ability to deliver difficult truths gently is what sustains the bond between physician and patient. I see communication as a clinical skill, as necessary as prescribing the right drug. Teaching young doctors how to navigate fear, hope, and uncertainty may prevent not only misunderstandings but also tragedies.
The weight of money
Cancer care carries an enormous financial burden, especially in low- and middle-income countries. Emotional turmoil deepens when families exhaust savings only to face worsening disease. Financial distress can fuel resentment, especially when expectations collide with reality. Understanding a patient’s socioeconomic background is not bureaucratic formality; it is clinical necessity. If an expensive therapy is unlikely to deliver proportionate benefit, I steer families toward realistic choices. Clarity about cost and outcome early in the journey helps prevent bitterness later.
Guiding, not deciding
Families often urge, “You decide for us, doctor.” It feels noble to take charge, but it can be dangerous. When outcomes disappoint, that same trust can transform into blame. I once heard my mentor, Dr. Padmaj Kulkarni, say, “The doctor’s role is to guide, not decide.” I often share with my residents a lesson from the Mahabharata, an Indian epic in which Krishna guides the warrior Arjuna in making difficult choices. Likewise, the doctor’s role is to support and counsel, but the final decision must belong to the patient. Empowering patients to choose fosters ownership, not dependency.
The healing power of small gestures
Not every encounter needs to stay strictly formal. A kind joke, a question about a daughter’s wedding, a smile during a tense moment, these gestures humanize medicine. For patients who know their illness may not be curable, such moments offer something precious: dignity. One of my teachers, Dr. Chetan Deshmukh, embodied this lesson. He talked to patients about local food, hometowns, or even told those with oral mucositis to enjoy ice cream. His warmth dissolved fear faster than most drugs. Being informal does not weaken professionalism; it reinforces humanity. In a world where medicine feels increasingly transactional, these moments of connection can be our strongest shield.
Compassion with boundaries
Compassion, however, should not blind us to risk. Occasionally we encounter families whose anger simmers from the beginning: voices raised, suspicion at every turn, multiple second opinions. With time, one learns to recognize such patterns, and it is prudent to involve hospital administration, call security quietly, or invite another clinician into the room. Protecting oneself is not cowardice. It is a professional responsibility.
Violence against physicians cannot be solved by outrage on social media alone. The real protection lies in everyday acts: clearer explanations, honest prognoses, acknowledgment of effort, and emotional presence. We cannot eliminate grief or anger, but we can soften their expression through empathy. Compassion, far from being a weakness, is often our most potent defense.
Medicine will always be about more than disease and diagnoses. It is about human beings. The gentlest words we speak become the most powerful shield we have.
R.N. Supreeth is an oncologist in India.
