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

A lesson on spider angiomata 

Takeaway

As a first-year medical student, I spent time with a patient who had alcohol-related liver disease. He taught me the importance of always knowing the patient’s personhood in addition to their medical condition. 

“He should be dead in two years,”
at least that’s what the doctor told
me before I entered and met you,
lost in loose-fitting sweats, then listened
to you reminisce about the forty years
of Cuba Libres with breakfast in Key West
that left your liver shipwrecked, belly
swollen, and skin studded with starbursts.

“He’s handled all this with phenomenal 
grace,” the doctor remarked, yet the faraway 
look in your honey eyes reflected a yearning 
for the road trips and ripe tomatoes of a warmer 
place—where you were more than a constellation 
and nowhere near the island you’re 

 
stranded on now, down the list, waiting
for a match and a miracle. 

 

Dr. William Osler famously said, “It is much more important to know what sort of patient has a disease than what sort of disease a patient has.” I recognized the value of this patient-centered approach to care as a first-year medical student while seeing a patient with alcoholic liver disease—the subject of this poem. Investing time in learning about the rich and unique details of patients’ lives and not just their medical symptoms is something I plan to do throughout my career. 

 

 

 

 

 

 

 

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