Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Beyond Language—Closing the Gaps 


Caring for a patient who didn’t speak English showed me that all patients can benefit from a compassionate facial expression, eye contact, and a soothing tone.

“She’s in distress,” the nurse said to me in the hallway outside the patient’s room. I was a fourth-year medical student on an away rotation at Hopkins in the oncology pediatric department. I entered the patient’s room and saw her head moving wildly looking around the room, her eyes wide with fear and desperation. Her mother had left a moment ago to find food and the patient was alone. She quickly told me something, but she was speaking Arabic. Instinctually, I asked where it hurt. She shook her head. The bedside nurse reassured me that they were reaching out to language service on an iPad and started to give me information about the vital signs and blood work. My heart missed a beat. My first thought was to sprint out of the door and find my fellow. My patient’s eyes held fear. I felt calmer, realizing that my anxiety as a med student couldn’t compare with her fears as a patient.


I texted my fellow an SOS. I then asked myself how I could show my patient that I cared. I approached her and gently squeezed her shoulder. I spoke softly and slowly to her, using facial expressions and and hand gestures as well. She gripped my hand and looked into my eyes and nodded. We were together standing in the eye of the storm. The interpreter connected and a couple of seconds later my fellow rushed into the room.


What I learned from this experience is when interpreters are necessary we can still show our empathy and compassion to patients. We must be comfortable with other types of language such as gestures, facial expressions, and body language. We need to be able to comfort and make connect with patients even in the absence of interpreters. Being able to foster a connection bypassing speech helps strengthen the patient-physician relationship.


1. Show compassion nonverbally.

Give your patient comfort through speech alternatives such as gestures, body language, eye contact, and when appropriate, physical contact.


2. Small gestures of caring make a big difference.

Even spending a minute comforting your patient can reassure them a great deal.





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