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

I Wonder…


“I wonder . . .” is a phrase that triggers curiosity and empathy. It can help us support patients instead of labeling them as “difficult.” 

I recently overheard two of our phone triage employees discussing a call from a patient who they described as “rude.” The patient was trying to get pre-approval for a CT scan to follow up on an incidental lung nodule. Many of their comments began with “I can’t believe that . . .” or “I can’t stand when . . .” followed by some frustrating behaviors they have witnessed or been on the receiving end of. We’ve all been there, or will be at some point. People are often not their best selves when interacting with medical care professionals and office staff. We must always try to maintain a high standard for how we respond to patients’ emotional disinhibition in a care setting.  


When I want to verbally strike back in these situations, the phrase “I wonder . . .” helps me consider what the patient might be feeling. Shifting from reactive to curious diffuses my outrage and points me toward compassion and support. Genuine responses like, “This must be so difficult for you,” and, “I can hear you’re frustrated and I’m here to help,” are then so much easier to retrieve.  


Medical care teams often bear witness to profound suffering and vulnerability in its most raw forms. Wonder can be a portal to empathy, and the antidote to some of our own emotional exhaustion. 


When a patient is rude or abrupt, first: 

1. Pause and take a deep breath. 

2. Ask yourself, “I wonder what difficult circumstance he/she may be going through.” 

3. Respond with support and compassion. This can be disarming for the patient, and rewarding for you. 





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