An intern in internal medicine is frustrated by his weekly clinics; he seems unable to understand why most of his patients come to see him, why they seem happy when they leave, and wonders when he is going to have the chance to do "real" medicine, such as ordering tests and making sophisticated diagnoses. One day, he sees an elderly woman who had been worked up over the years for "heart pain" without finding a diagnosis. In the past she had seen other residents for no discernible reasons.

At this visit, the author recognizes that she seems upset, encourages her to talk, realizes that she reminds him of his grandmother. The woman reluctantly admits she has fallen in love with a younger man. The resident is respectful towards her, and recognizes the beautiful woman she had once been. He begins to realize that she has experienced much that he hasn't, and that she has much to teach him about life and about being human.


This intern's frustration with the psychosocial aspects of care may be quite typical of traditionally trained Western physicians. The essay illustrates to the reader how the physician can value this aspect of care--an aspect that truly helps patients in ways that biomedicine alone cannot.


This essay is from the "A piece of my mind" section of the journal.

Primary Source

J. Amer. Med. Assoc. 271 (24): 1902 (1994)