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

Both sides 


I realized that I didn’t truly understand my patients’ pain until I experienced pain myself. This has allowed me to give even better care. 

I recently watched Joni Mitchell on TV performing “Both Sides Now” at the 2024 Grammy Awards. I cried. I remembered being mesmerized by the beauty of her words and music when I was a preteen. Back then I too thought of the clouds up above and watched their weightless beauty from my window. I’d learned about all kinds of clouds in school. When I looked out at the sky, I wondered which clouds would produce raindrops. I wondered where my clouds were headed next.  


So why my tears? My childhood friend Joni Mitchell has aged. Her voice is less resonant, but her words remain strong. My voice is changing too, but I hope that my words still count.  


I thought that I knew about pain. I’ve treated pain in children for over 30 years. I’m familiar with bone pain, muscle spasms, neuropathic pain, emotional pain, burn pain nociceptive pain, nociplastic pain, acute pain, chronic pain, and inflammatory pain. Lots of types of pain and pain pathways. I’ve prescribed many medications to target different receptors and performed nerve blocks to numb the pain. I’ve encouraged patients to get out of bed and work with physical therapy. I’ve cheered for small accomplishments as if they were ascents to the highest mountaintops. I’ve done guided imagery and asked what my young patients and their families hope for. I’ve done it all. But I learned that I didn’t really know pain at all. 


Recently, I had two knee replacement surgeries. I’ve experienced pain and it was awful. I wondered if I was ever going to get well. A few days after my second surgery, my husband had to leave for a few hours to go to work. I suspect he just needed a break. My childhood friend came to visit and cooked me the most magical linguini with olive oil and Parmesan cheese I’ve ever had. She reminded me that this recovery was the beginning of my new self. We talked about fear and hope. She tucked me in for a nap before she left. I felt loved and cared for. 


I’ve been thinking about my patients, and how I never really knew all their fears and hopes. As a doctor, I try to be present and listen. I’ve been trained to ask the right questions. But now I want to open my heart and dig deeper and let my patients know that I care deeply. I now find beauty in my clouds, just like Joni Mitchell.  










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