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

Unshackle The Mind


When caring for a man in handcuffs, I was reminded that every patient must be shown empathy and compassion.

I approached the bedside with trepidation. I was never at ease approaching a patient who was wearing handcuffs. I felt fear of the unknown. Visible from the door were handcuffs on one wrist and the other end hooked to the bedrail. The police officer sat next to the bed, staring at his phone. It was hard to take my eyes off his firearm and stay focused on what I needed to do.


I gathered myself and approached the patient and asked as casually as possible, “Hi, how are you feeling today?” He’d been admitted the night before with vomiting and coffee ground emesis. He also had a pneumonia. As I gathered more details of his history, his answers made me feel more comfortable. During the physical exam, both of us tried to ignore the handcuffs. It made listening to his back particularly challenging, but he did his best to roll over and cooperated with the exam as best as he could. I told him that while things appeared to be improving, he would likely need to stay another day in the hospital for IV antibiotics and other medications. He nodded. I felt sad as I turned around and walked toward the door. “Poor guy has to be in shackles all the time,” I thought.


I hadn’t taken more than a few steps when I heard the police officer calling someone and saying, “He’s gonna stay another day.” I shook my head wondering whatever happened to HIPPA. Do incarcerated patients lose all their rights? I had no idea. Should I have insisted on his handcuffs coming off so that I could examine him in a proper and dignified manner? What if he’s an innocent man and wrongly accused of a crime?


It’s not unusual for healthcare professionals to encounter patients who are either currently under arrest or their chart says, “History of multiple incarcerations.” This information may create a bias in our minds. These biases can lead to unfounded fears and create false stereotypes, which can prevent us from serving these patients to the best of our abilities. I walked into that patient encounter with many fears, but I left feeling reassured that the patient I met was just like any other person, and that my fears weren’t justified.


This experience reminded me to approach all patients with empathy, compassion, and humanism. The patient wasn’t the only one in shackles that day; my mind was too, and I resolved to unshackle it.





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