C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

The power of small gestures

Takeaway

Actions speak louder than words. Small gestures like listening closely to patients, getting tissues, adjusting the lights, and helping them get comfortable in bed is part of giving holistic care.

Connecting with Patients | March 3, 2025 | 2 min read

By Sanjana Nelogal MBBS, India (no affiliated facility), with Amy Yu MD, MS, Johns Hopkins Medicine

 

As an international medical graduate from India, I had the opportunity to observe an elderly woman being cared for while shadowing Dr. O at Johns Hopkins.

 

An 88-year-old woman was brought to the ED after a fall at home. I read her chart and mentally prepared a set of question to ask her and investigate the cause of her fall. On entering the room, Dr. O and I saw the frail woman crying in bed. Having read her chart, I assumed it was because of the pain from the fractures.

 

“Everything hurts: my arm, back, and hips. I had just learned to walk again after the stroke. All those efforts are now worthless. I don’t know if I’ll be able to walk again. I don’t want to be a burden on my cousin. She takes care of me but I need to do these things on my own.”

 

I realized her pain wasn’t just physical, but also emotional. We listened to her patiently as she shared her fear of nobody visiting her at the hospital and of being abandoned.

 

Dr. O responded compassionately, “All of this can be very terrifying. I’m so sorry that you had the stroke and now the fall.” She reassured and encouraged her, “You’ve endured stroke and its after effects, and you succeeded in overcoming it. That’s very commendable and you should be proud of yourself. I believe in your strength to recover through this as well. You’re not alone; we’re in this together. With therapy and support, you’ll be able to walk again. Do you want to give a family member a call?”

 

And then the patient’s phone rang; it was her sister. She smiled. When we returned later, the patient was in much better spirits. We discussed her labs and management plan moving forward and she was receptive to our suggestions.

 

What I learned:

 

1. Patients need someone to listen; be that person. Listen patiently, and acknowledge and address their fears and worries.

 

2. As William Osler said, “The good physician treats the disease; the great physician treats the patient who has the disease.” Listen and try to understand their emotional and psychological pain. While discussing the care plan, ask for their suggestions, ideas, opinions, and how they feel about it.

 

3. Encourage and reassure.

 

4. Actions speak louder than words. Small gestures like listening closely to patients, getting tissues, adjusting the lights, and helping them get comfortable in bed is part of giving holistic care.

 

 

 

 

 

 

 

 

 

 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.