It was all over his face. I couldn’t help but notice Mr. P’s unspoken disappointment in missing the target goal weight for his anticipated bariatric (weight loss) surgery, the recommended treatment for his obesity. The number on the scale this day had trended slightly upward from what was documented at his last appointment. The physician was displeased at his noncompliance in picking up the medicine that was prescribed to him, and he allowed me the opportunity to work with Mr. P on my own before he and I would later revisit this patient together.

His general appearance was distressed and disheveled. The many holes in his clothes and large tears in his worn shoes told a story. It was clear that he suffered financial hardship. I listened intently as he responded to the standard patient interview questions. After only a few questions, I realized there was an undertone of sadness in Mr. P’s voice. I couldn’t ignore the serious nature of his responses.

His higher weight that day and medication non-compliance were just the tip of the iceberg. He had expressed how, in the aftermath of his wife leaving him due to his weight, it had been challenging for him to exercise the healthy habits he had once carried out. I paused our interview to express empathy, validation, and compassion for his story.

Mr. P is an example that each person deserves empathy and respect to be heard, not just seen. It all begins with the choice to look beyond the room number, patient chart, and sometimes even the diagnosis. Regarding each person we serve as human, and not just another hospital tag or billing code, ultimately means that we see value in the faces of those who come to us earnestly seeking to be healed. Having the opportunity for someone who cared to listen to what was happening beneath the surface made all the difference in Mr. P’s openness in the remainder of our interview, which flowed with empathy and compassion.

During my one-on-one encounter with Mr. P, he privately expressed the reason he had not been taking his medication. He told me that this appointment had unexpectedly been moved up due to the physician’s upcoming time off. He hadn’t anticipated having to pay for his required monthly check-in more than once this month. It turned out he had to make a challenging choice. He could spend the forty dollars he knew that he needed for transit and appointment fees, or he could purchase his medication. Trying his best to be responsible in his decision-making, he had chosen the former.

This example demonstrates the importance of providing holistic care and avoiding making potentially harmful assumptions regarding one’s willingness to comply with medical treatment. Approaching the patient instead with dignity and respect, asking open-ended questions in place of assumptions, can positively impact patient rapport. It may also have a ripple effect on a patient’s esteem in seeking future treatment for their illness and promote a collaborative effort in attaining lasting solutions to issues of access.

In the office, Mr. P looked defeated. He confided in me that he felt like his life had fallen apart. I replied offering words of encouragement to him in his capacity to heal emotionally and still meet his personal weight-loss goals, despite this temporary setback. Calmly and assuredly, I offered him three honest words that have potential to lift anyone from a low place, no matter their circumstances.

“There’s still hope.”

This simple phrase caught Mr. P off guard. There was a subtle shift in the atmosphere of our conversation. I could tell it lifted his spirits to have someone see him not as a “failure” for not meeting his weight goal that day, but as a human who is hurting, and more than capable of success. From the edge of his lips, I saw a smile appear where there was once a frown. For just a moment, his eyes found a glimmer of light. There was hope.

“Hope is a key ingredient to survival.”

While I did not say this statement aloud to Mr. P, I had heard it said in a documentary once with regards to how a resilient community miraculously endured and survived the HIV epidemic in Uganda, and it has stuck with me ever since. Where there is a listening ear, there is hope. Where there is hope, there is a way.

To my surprise, Mr. P opted not to later share with his doctor what he had shared with me privately. My physician had a very busy clinic, which unfortunately did not lend him much time in the group encounter to sympathize with Mr. P beyond his poor numbers that day. The scheduled appointment proceeded as usual, without any discussion about Mr. P’s personal circumstances.

As health care providers and trainees, we may never see the impact of our actions, but that doesn’t mean they aren’t there. I don’t take lightly the privilege I have as a medical student to speak with patients and listen to their deeply personal stories which often accompany their illnesses. To me, this is a gift worth unwrapping with each patient encounter and is an immensely humbling experience.

I may never know the outcome of how our earlier one-on-one discussion impacted Mr. P, but if I hadn’t listened to his story, I would also never know why he didn’t make his target weight that day. Communication was a gateway for the unknown to be released, compassion to lend its comfort, and empathy to embrace someone in need of being seen, heard, and cared for.

For me, the gentle smile on Mr. P’s face after hearing that there was still hope for his weight-loss journey, even for a brief moment, was a silver lining in the patient’s encounter that brought me unexpected joy. In reflection, perhaps hope works both ways and is a key ingredient for survival for patients and providers alike. It gives us all the strength to keep going.

Ashley McCray is a medical student.