No matter how much I learn, some things cannot be taught. There was no prepared script and no checklist to follow when my father tersely told me, “Your uncle in India passed.” Five solemn words and a pregnant silence. His eyes, rung with the blue of cataracts, did not shed a tear. Instead, they were fixed on an empty corner of our worn sectional couch.
My lack of words stretched across the silence. I could think back to the routine lines I had learned in the past year when delivering bad news to a patient: “I’m sorry for your loss” or “I know it can be hard to hear that.” And yet, they all crumbled in my mouth. These rote words, meant to console, would only dilute my intentions.
There was no balm for this grief; no pill to alleviate his suffering. No words passed between us, yet I remembered how he would comfort me as a child when I would skin my knee. This hurt stung deeper than skin on pavement, but I put my hand on his shoulder to remind him I was here when words would not suffice. His shoulder remained tense and I dared not speak. We sat in this vigil for what seemed like countless hours, where only silence could meet his profound loss.
I remembered this encounter two years later, as I shuffled back and forth in the primary care clinic and watched Dr. V interact with his patients. Many of his patients spoke Spanish, and most understood the limits of my own Spanish within minutes of meeting me.
Parsing through patient encounters in the weeks I was there, I observed patterns in body language, informing me of the nuances of each interaction. Dr. V often raised his eyebrows when he pointed to a patient’s blood pressure cuff and said, “alta.” When they saw me shifting my weight from foot to foot in the back of the room, some patients got up from their chairs and motioned insistently with two arms for me to sit. The phrase “analysis de sangre” was coupled with Dr. V’s parting handshake, signaling that the phlebotomist would soon be on their way. Gestures and movement were integral to my clinical understanding.
On this particular afternoon, Dr. V abruptly stopped me in the hallway as I reached for the door handle of a patient room. He quietly warned me, “Mr. J might cry. Just be prepared for that.” The chart stated that an 85-year-old man with a past medical history of stroke and prostate cancer was behind that door.
I walked in to see a stooped, wrinkled patient with his arms outstretched towards Dr. V. Leathery skin bordered a fond smile, welcoming the physician in with a hug. Dr. V rolled his stool towards Mr. J, asking about his routine medications and his health as of late. Mr. J pounded his thigh with one hand for good measure and proudly claimed, “soy robusto.”
Dr. V motioned me forward as Mr. J pulled out his phone and flipped through pictures of meat dishes. “He still cooks for himself every day, even now.”
As the visit progressed, even without the context of the exact conversation, I was able to see the familiarity and warmth Mr. J had for Dr. V. His hand clutched around two of Dr. V’s fingers while he asked about Dr. V’s daughter and what she would be doing after completing her undergraduate degree. I smiled behind my surgical mask. I did not frequently see such intimacy in patient rooms.
Sliding his chair to the side, Dr. V asked me to step forward and cross my fingers while Mr. J loosely squeezed them. “Notice the deficit on his left side after the stroke.” At the mention of the word stroke, Mr. J’s eyes began to glisten. He buried his head in Dr. V’s arms and wailed. The doctor looked at me knowingly as he patted Mr. J’s back.
“Tuve un derrame cerebral hace veinte años. Él ha estado conmigo todo el tiempo,” Mr. J explained through his sniffles. Even in the few words I knew of Spanish, I could hear his pain. Dr. V did not have much to say. Instead, he embraced his patient when words could not suffice.
I thought of a similar embrace: my arm bracketing my father’s grief-wracked frame. We continued to sit in heavy silence, but eventually my father turned inwards to me and sobbed. While I could not make presumptions about the extent of anguish my father felt, I wanted to show him he was not alone.
The power of physical touch is nothing short of universal. A hug or a hand on the shoulder can go a long way especially when words fall short. A silent gesture can remind both people that, no matter how difficult or isolating tragedy can be, neither is alone. As I continue with my medical education, I am excited to learn how I can make the practice of medicine more personal, particularly when words do not suffice.
Image credit: Silence (CC BY-SA 2.0) by kooikkari
Contributing Writer
Florida International University Herbert Wertheim College of Medicine
Agrata is a medical student at Florida International University Herbert Wertheim College of Medicine in Miami, Florida, Class of 2025. In 2021, she graduated from the University of South Florida with a Bachelor of Science in biomedical sciences and a minor in psychology. She enjoys reading books, painting, and trying out new coffee shops in her free time. After graduating medical school, Agrata would like to pursue a career in psychiatry.