Medical school had trained me to move quickly; there was always another exam to prepare for, another deadline to meet, another task to attend to as I worked toward the next milestone. When I learned that I would need to remediate, what initially felt like an academic setback gradually became something else: an opportunity to notice habits I had carried into both medicine and my relationships.
Without the familiar rhythm of coursework and with a lighter academic schedule than I had previously carried, I had fewer places to direct my attention outward. In that quieter season, I became aware of patterns I had rarely questioned: how quickly I moved toward reassurance, how often I listened with an answer already forming or a story of my own ready to share, and how uncomfortable I was simply sitting with another person’s distress. These habits did not come from a lack of concern for others. If anything, they reflected my discomfort with uncertainty and my tendency to move too quickly toward solutions. Remediation humbled me by forcing me to confront those habits and examine them more honestly. The lessons did not arrive all at once. They emerged gradually, as a result of being slowed down long enough to pay attention.
The shift was subtle, but it changed the way I approached other people. I found myself asking questions without trying to steer conversations toward a particular outcome, becoming more comfortable with pauses and less eager to fill silence with advice. I also became more thoughtful about which questions to ask and more willing to let another person’s experience remain the focus of the conversation. Before remediation, I often assumed that helping meant reassuring, advising, or finding a solution. Over time, through conversations with people facing difficult circumstances, I began to appreciate how important it could be simply to listen. I had no reason to believe those changes would later influence how I responded in a moment of crisis.
Those lessons felt personal at first. I did not realize how relevant they would become until one night while volunteering with Crisis Text Line.
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While volunteering with Crisis Text Line, I connected with a texter in acute psychiatric crisis. The details have been altered to protect confidentiality. From her first messages, she spoke with a quiet certainty that she did not deserve relief from her pain. She told me she lived with serious mental illness and polysubstance use and that she planned to die that night. As we spoke via text, she told me she had already begun her attempt.
She described years of encounters with health care professionals that had left her feeling judged and unseen, shaping how she approached future interactions with the health care system. She worried that seeking help would only lead to another experience of being dismissed or misunderstood. Over time, those experiences had reinforced a belief that she was unworthy of help and, ultimately, unworthy of life.
When she told me what she had done, she begged me not to call emergency services. I knew what protocol required, but knowing the steps did not make the moment easier to hold. The slowing down and self-examination that came with remediation had taught me to stay focused on the person in front of me and resist the urge to rush toward a solution. I typed carefully, keeping my messages deliberate and clear. I offered genuine reassurance, asked questions that kept her engaged, and quietly coordinated with my supervisor as emergency services were arranged. As the conversation continued, her messages became increasingly disorganized. She told me she was continuing to mix alcohol with prescription medications despite my encouragement to stop. I remember staring at my laptop, worried that a wrong word, or even a pause, might feel like abandonment.
Instead of relying solely on advice or directives, I asked open-ended questions and reflected her feelings back to her, listening for what still mattered to her. She spoke about fear. Eventually, she mentioned her daughter, who lived in a group home and loved to dance.
When I asked about her, the tone of the conversation began to change. I continued asking about her daughter and the moments they had shared together. She described the dance performances she had attended and the sacrifices she had made to keep her daughter enrolled in lessons. She spoke about wanting her daughter to feel supported, proud, and safe.
For the first time in the conversation, her messages seemed less focused on her desire to die and more focused on someone she loved. She gradually became more willing to separate herself from the substances she had been taking and more accepting of emergency services arriving.
The conversation shifted at that point, not because the crisis had passed, but because she had reconnected with something that still mattered to her. I helped create the space for that conversation by continuing to follow the thread that seemed most meaningful to her. She stayed with me as emergency services made their way to her location, and when they arrived, she agreed to accept help.
Despite the urgency of the situation, the interaction itself unfolded quietly. Looking back, I do not think I said anything remarkable. The conversation reminded me that people do not always need perfect words or immediate solutions. Sometimes they need someone willing to remain with them in the face of uncertainty.
As I continue my medical training, I return often to that night. Remediation, once a source of shame, became an experience I came to understand differently over time. In this case, emergency intervention was necessary, but what sustained the conversation was the opportunity to talk about something that still mattered to her.
I still think about that conversation when I feel pressure to have the right answer. More often than not, I remember that what mattered most that night was not what I said, but what I was willing to hear.
Scarlett Saitta is an osteopathic medical student.
