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

Connecting in Silence


Sometimes the best way for a clinician to convey empathy is through non-verbal communication. 

I was 16 years old when I pursued my first clinical observership. The patient we were seeing was young, immaculately dressed, and had her hair up high in a perky ponytail. “Good news or bad news, doc?” she asked. 


I had a feeling she wasn’t expecting the disappointing diagnosis that followed. As the doctor sat down next to her patient and explained that it was cancer, I watched as a poised woman crumbled and started crying. The physician simply sat quietly, leaned forward, and placed her hand gently on the woman’s shoulder. They sat there for a long time together in silence.


Later, the patient’s first question wasn’t about treatment. Instead, she asked, “Will I lose my hair?” That’s when it occurred to me that breast cancer may threaten a woman’s sense of identity, sometimes prohibiting them from feeling comfortable and confident in their own skin. 


As I reflect on this patient encounter, I realize that I learned one key lesson: silence sometimes speaks louder than words. Listening to a patient and conveying understanding through non-verbal communication may help patients absorb the diagnosis. 







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