Lessons from quiet care

By Peng-Jhen Wu, MD, Johns Hopkins Observership Program, with Carolina Musri, MD, Johns Hopkins Medicine

I’ve always admired people, in particular healthcare professionals, who don’t need to raise their voices to be heard. Their presence alone carries weight—the way they listen, observe, and respond with calm precision. As a physician-in-training, I try to emulate this quiet steadiness. But it wasn’t until I met a patient with metastatic lung cancer that I understood the true meaning of bedside presence.

His daughter was deeply devoted and never missed a visit. She sat by his side during every appointment, listened closely, and held her father’s hands. Over the years, their family had weathered both hopeful and heartbreaking news. There was a time when chemotherapy gave them a few more precious years—an unexpected grace that allowed the family to catch their breath under the strain of illness.

When I met him, the disease had already progressed and the prognosis was clear. He was a reserved man—hesitant to burden those he loved and unwilling to show his vulnerability. But in the presence of the doctor he trusted, and whom he had known for over 20 years, I saw how he let his fatigue show because of the deep relationship they had.

The first time I entered the room, I felt like an outsider. The patient greeted me kindly, almost like he knew what it meant for a young trainee to witness someone at the end of life. We talked sometimes, but mostly we didn’t. I learned to sit with his silence. He didn’t need another summary of his lab results. He needed to not be alone. And in those long, silent moments, I began to notice things I usually overlooked—the shift in his breathing, the weight in his eyes, the way my attending would pause at the door before walking in, composing himself before stepping into a space that held both professional duty and personal grief.

The day he died, the room was silent again. No code. No rush. Just a quiet goodbye. With grace, his daughter allowed us to accompany her father in his final minutes. My attending stood by the bed for a moment, his hand resting on the railing. I stood behind him, unsure if I was intruding. The doctor didn’t speak. But somehow, I felt I was witnessing one of the most important lessons of my training.

In that stillness, I learned what kind of physician I want to become. One who is present, even when there’s nothing left to say.

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