The 20th subject of Medical School: A medical student’s reflection on empathy
I didn’t know it then, but the first person I’d ever learn medicine from would already be dead. On the first day of the first year of medical college, we entered the dissection hall. The pungent formalin made our eyes water and noses sting but curiosity had a stronger grip. We elbowed our way to the front, clutching our Cunninghams’ dissector and instruments. And then, someone lifted the sheet. A strange stillness settled in the room. There lay a man in front of us. Pale and unnamed. Someone who once walked, laughed, smiled and cried; now lying in complete surrender to science.
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Where is his family now? Did someone hold his hand when he passed? What dreams did he carry? Did he live a full life, or did it end too soon? Was he loved by someone? Or did he leave without goodbyes? In that moment, we did not see a cadaver. We saw a story.
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Medicine moves faster than grief and reflection. Class after class, we cut off the skin, stripped fat and traced nerves. We climbed on chairs to catch glimpses of structures we couldn’t see properly through the crowds. We took pictures with hearts and brains in our palms like they were trophies. Slowly and unknowingly, we stopped seeing our cadaver as a person. He became a tool for learning. And that was our first lesson: detachment. How to see life, and then very quickly look away. Everyone said that it was a necessary skill.
In the second and third year of medical school, we took a leap. From the comfort of textbooks and air-conditioned lecture-halls into the unpredictable cacophony of hospital wards, from PowerPoints to actual patients. And one might imagine that this is when our empathy would deepen. After all we were no longer studying diseases in theory but were witnessing it in flesh and bones, in breath and heartbeats. But strangely, research tells a different story.
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We raced through wards, chasing clinical signs and murmurs. We crowded the patient`s bed to be the first one to hear a lung crackle, and palpate a liver. We followed residents, not wanting to miss a rare finding. We fought for scrubs in the changing rooms, hoping to secure a good spot in the Operation Theatre. Surgery became a grand theatre we were desperate to enter. Along with our daily lectures, our clinical postings began and with them came a revelation- patients do not arrive with diagrams. The hospital doesn’t follow a timetable, grief doesn’t knock before entering and the patient is not a checklist. And in this dizzying shift, something inside us hardens- not out of cruelty but out of survival.
As medical students, we enter the hospital each day with two intentions. To learn and to help. Armed with half-baked knowledge, we walk into the wards. There is an unspoken childlike urge to be useful. To somehow ease the load of residents who teach us. To say something meaningful to the patients. To belong. But hospitals are busy places and the constant pressure to prove ourselves, something within us begins to shift. We start focusing more on ‘sounding smart’. The very ideals that once brought us to medicine, somewhere start to dissolve in this turbulence. Not because we intend to forget, but because the system forgets to hold space for them.
Empathy, unlike physiology, cannot be slid into a lecture, memorised the night before, or ticked off a checklist. And the drift from seeing a patient as a person to seeing him as a puzzle happens so gently, so gradually, disguised so well as competence, that by the time we notice it, we have already stopped noticing.
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If we read this on our first day of medical school, it sounds meaningless. We stand beside the patient, just as lost, just as unsure. Their confusion is ours too. And in that very moment, we are kind. We speak softly and explain a little longer. We sit by their bedside and translate the foreign tongue of medicine into the words that feel human. When we are more like them, we listen not for symptoms but for stories.
As years go by, we cross the bridge from not knowing to knowing. On the other side, we are fluent. It rolls off our tongue like a reflex. We speak only in abbreviations and forget that just across from us, sits someone still hearing and digesting it all for the first time.
Where do we relearn this lost language of care? The beauty of it is, we don’t need to look anywhere else. It was inside us all along. It lies in that twelve year old who wrote in her exam essay that she wanted to make people feel better. It lies in the first year student who stayed back in the ward just to hold an old woman`s hand a little longer. We have to protect that part of us more fiercely.
In a curriculum of nineteen subjects from anatomy to medicine, we are taught everything about the body. But there is a twentieth subject of empathy, with no ICD code of its own, never reflected in a lab report, and has no entry in any pharmacopoeia, is almost always, what the patient came looking for. But it reveals itself in the way we pause before delivering bad news. It reveals itself in the way we look a patient in the eye and not just at their charts. It reveals itself in the silence we are willing to share when there is nothing left to say but everything left to feel.
Medicine never demands brilliance. It demands presence. Years later, when students become clinicians, and are standing next to a dying patient, they may realise: the most extraordinary thing about medicine is not its power to delay death, but the courage to stand beside life as it bleeds, heals, and hopes again.
Edited by Aaradhana Vaghela
Dhruvi Joshi is a recent medical graduate from Narendra Modi Medical College, Ahmedabad. Outside of medicine, she loves storytelling, writing, playing sitar and trekking. She sees writing not a separate pursuit but an extension of the same curiosity that drew her to medicine. She aspires to become a cardiologist.
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Charles Holland
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Aiden Moore
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