As a second-year internal medicine resident, I had an unexpected epiphany during my geriatrics rotation, not amid the chaos of a bustling hospital, but within the reflective calm of a rehabilitation facility.
As I walked into the room of a long-term care patient recovering after a stroke, there was a man in front of me who was wheelchair-bound and visibly distressed. His speech was difficult to understand, but as I listened carefully, one message came through clearly: He was frustrated that no one from the physical therapy department had been coming to work with him. He sounded defeated, as if he had been forgotten. When I reached out to my preceptor and the director of physical therapy, I learned that the stroke had impaired his short-term memory, leaving him unable to recall the daily sessions he had been having. I had already begun to think of him simply as the “frustrated stroke patient,” when my eyes wandered to the photographs on the wall. There he was, smiling and beaming in a sharply tailored black suit at his daughter’s wedding. In another picture, he stood surrounded by his family, joyful and full of life. These images weren’t just decoration; they were evidence that the person I was seeing was someone who was celebrated, belonged, and mattered deeply to others.
That moment changed how I saw him and made me reflect on how we see our patients. We speak in the language of numbers: length of stay, bed availability, readmissions, risk scores, discharge barriers. We talk about “disposition.” The term sounds practical, but when you pause to really hear it, the word itself is unsettlingly close to “disposing” of a body, treating the human as a logistical problem to be moved along. Though we don’t intend it this way, language has power and a deep impact on the way we think and care for our patients.
Why has medicine moved in this direction? The root causes are less about moral failings and more about systemic pressures. We practice in an environment optimized for throughput, documentation, and measurable outcomes. Electronic records reward what can be coded and counted. Quality metrics prioritize what fits on a dashboard. Time scarcity pushes us toward checklists and away from narratives. Defensive medicine favors “actionable” numbers. Burnout blunts the emotional bandwidth required to stay fully present with suffering. Even when clinicians remain deeply compassionate, the system trains our attention toward what can be completed, audited, and billed.
And yet this rotation taught me that what matters most is often the least measurable: function, dignity, meaning, relationships, and goals. Change doesn’t require grand reinvention. It can begin with small acts of re-humanization built into daily work. We can ask, “Who is this person on a good day?” We can document one “personal sentence” alongside the problem list: what they loved, what they valued, and what independence looked like before illness. We can replace “disposition” with “transition plan” or “care-setting plan” and link it to our patient’s goals and needs, not just hospital metrics. It takes only a few words to restore identity.
The wedding photo in that rehabilitation room vividly reminded me of something my father taught me when I first dreamed of becoming a doctor: Medicine is a privilege because it allows us to serve people at their most vulnerable. If we want to protect that privilege, we have to practice in a way that keeps the person visible, even when the system nudges us to see only the patient.
Aditya Singh is an internal medicine resident.
