By Priyanshi Joshi, MBBS, Johns Hopkins Observership Program, with M. Carolina Musri, MD, Johns Hopkins Medicine
When I was nine, my mother zipped me into my first swimsuit and walked me to the pool. I stepped in clutching a kickboard, kicked my legs, and kept my eyes down on the tiled line. I didn’t know that the rhythm I found in the water—steady breath and consistent strokes—would one day shape the way I show up at the bedside.
Swimming taught me more than stamina. It taught me how to move forward when things feel stressful or uncertain: breathe first, then act. Notice small changes early—a breath held too long, a stroke that shortens—and adjust before fatigue sets in. I also learned that calm is cultivated through steady breath. In medicine, I try to carry that calm into rooms where fear and breathlessness live.
I cared for a man with end-stage renal cell carcinoma who heard “code status” and “hospice” for the first time. He was shocked when he heard those words. His family looked to the medical team; the room grew quiet. He whispered, “I just need time to think.”
In swimming, when your lungs tug and your rhythm falters, you don’t splash harder. You let the breath return, and then take your next stroke. That day at the bedside, the best care was a quiet pause, not an explanation of options for next steps. We stopped talking and let silence do its work. We gave him space to breathe and gather emotional strength. The next day, he was ready to share what mattered most, and we could align his care with his values.
Here are two lessons I learned from the pool that have improved communication with my patients and their families:
1. Breath becomes pacing.
I slow down my speech, make room for silence, and check my own breathing so I don’t rush.
