I never considered myself dismissive or noncaring. I entered medicine with a genuine desire to help, to make a difference, to care and to change outcomes. Like so many of my colleagues, my “why” had the same core message, rooted in the same simple truth: I love science and I care about people.
But somewhere between the first day of medical school and the years that followed, something changed. Not the shift that makes you stop caring. Rather, my focus shifted toward efficiency. The curiosity and idealism that first drew me to medicine slowly gave way to the demands of documentation, meeting metrics, productivity and clinical decision-making. We are taught to present patients as cases. Cases become diagnoses. Diagnoses become treatment plans. Somewhere in that progression, the human being can quietly disappear.
It’s within that reality that fatigue seeps in. The pressures that now dominate modern health care threaten to consume the very reason why many of us entered medicine in the first place: the connection with our patients.
It is within this context that my own unlearning began about thirteen years ago.
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Before that, I considered myself empathetic and compassionate. I believe I cared for patients the best way I knew how. Yet I had unknowingly adopted many of the routines and assumptions that had become part of the medical culture.
Everything changed when I met a young woman whose chart had already told me who she was.
“Noncompliant.” “Difficult.” “Uncooperative.”
At first glance, the descriptions seemed accurate. She showed little interest in answering my questions and neither did she make an attempt to acknowledge my presence. For days I was met with the same detached and guarded reception.
Still, I had data I needed to formulate a treatment plan. I was a nephrologist. Laboratory values, imaging studies, vital signs and physical exam gave me enough information to make sound medical decisions. I found myself writing the same narrative of labeling: noncompliant, difficult and so on.
Then one evening, after leaving the hospital, I found myself thinking about her. Not the patient, not the diagnosis. Her. The human being.
She had been diagnosed with a devastating autoimmune disease as a toddler and had spent the majority of her childhood in hospitals. She had recently transitioned from pediatric to adult care, and here I was, a part of her journey in health care.
What made me pause even more was that one of my daughters was the same age as her when her illness began. Around that time, I had been enrolling my daughter in ballet and soccer leagues. She was discovering childhood and social skills through play, friendships and what we considered ordinary milestones.
My patient never had those opportunities. She spent her childhood surviving. She likely learned medication names before rhymes. She probably knew more nurses and physicians than children her own age. While her peers were worrying about birthday parties and playdates, she was likely learning to navigate the hospital halls, procedures and medication schedules. Her disease had not only shaped her physical appearance but also shaped her emotional development. The physical manifestations of years of chronic illness were evident, and so were the invisible scars.
Life had been unfair to her. In that moment, I realized that expecting her to meet me where I was, was profoundly unfair. Rather, I had to meet her where she was. She did not need another physician to remind her another organ was failing, a new medication had been added to her regimen and her disease was not going to disappear.
She needed a human being. Someone who would be present without demanding.
So, my posture changed; not because I cared more, but because I learned to care differently. I wanted her to know that I was on her team, that I would walk alongside her and do the best I can to help. But most importantly, listen.
She did not transform overnight, nor did she suddenly become warm and conversive. But something changed between us. Our conversations became easier. Our encounters became more meaningful. I realized she was not refusing care. She was afraid of what this relentless disease will take away from her next. And she was exhausted.
That single encounter forever changed my approach to medicine. Since then, I have made a conscious effort to minimize anchoring myself to what is already written in the chart. Instead, I ask why. I look for the person behind the diagnosis. The social history has become just as important as the medical history.
I have learned that the patient refusing physical therapy after surgery may not be “noncompliant” at all. Perhaps their pain has not been adequately controlled. Perhaps they feel exposed walking through hospital hallways in a hospital gown and are simply trying to preserve a sense of dignity.
The patient who becomes defensive when asked about medication adherence may not be careless. They may be too embarrassed to admit they cannot read and do not understand the written instructions they have been given.
That elderly patient refusing transfer to a skilled nursing facility after hospitalization may not be being unreasonable. They may simply fear that accepting rehabilitation means they may never again return home and have the independence they so cherished.
Every chart tells a medical story. Every patient carries a human story. The two are rarely the same.
As I learned to humanize patients beyond the diagnosis, empathy and compassion naturally followed. It was not rehearsed or something I had to be intentional about.
Only then did I begin to truly understand what it meant to practice the art of medicine. The art is not separate from the science, but rather the bridge that allows the science to reach the person who needs it. It is applying evidence-based medicine while never losing sight of the individual sitting in front of us, remembering that healing sometimes starts before the prescription.
It is the extraordinary privilege of standing beside patients at the defining crossroads of their lives: the intersection of their “before” and “after.”
Stella Awua-Larbi is a nephrologist with more than 15 years of experience in private practice at Kidney Care Center in the Chicagoland area, where she also holds a hospital affiliation with Silver Cross Hospital in New Lenox, Illinois. She earned her undergraduate degree from the University of Wisconsin-Madison and her medical degree from the Medical College of Wisconsin, completing her internal medicine residency at Loyola University Medical Center and her fellowship at Northwestern Feinberg School of Medicine.
A 2023 recipient of the Physician Leadership Excellence Award, Awua-Larbi is known for her ability to listen deeply and connect with patients as they navigate the complexities of their illness. She is passionate about mentoring the next generation of physicians.
Her debut book, The Other Side of the Bed: A Physician’s Journey Into the Human Side of Medicine, explores humanizing patients beyond the chart. Part reflective narrative, it advocates for patient-centered care while reminding health care workers of the sacred, rewarding nature of walking alongside patients at life’s crossroads. She shares her writing on Facebook, Instagram, LinkedIn, and TikTok.
