First Principles in Medicine: Finding the Patient’s Story

Fourteen years ago, I began my clinical rotations fresh out of the classroom, bright-eyed and, frankly, clueless. Two years of medical school had filled my brain with the foundational sciences - anatomy, physiology, pathology, pharmacology. I could recite pathways, recognize slides of disease processes, and rattle off mechanisms of action. But stepping into the real world of patient care, I quickly realized how little I knew about what truly mattered.

My very first rotation was geriatrics at the VA hospital. I still remember walking into the facility that first day—the hum of medical equipment, the quiet chatter of nurses, the unmistakable smell of institutional floors polished to a shine. Within an hour of arriving, I met Dr. Morris, the attending physician who would introduce me not only to geriatrics but to something much deeper.

She welcomed me warmly and gave me a quick tour. Then, without much fanfare, she handed me two assignments. One was to read the book Water for Elephants. The other was to watch the documentary Young@Heart. At the time, I thought it was an odd initiation into the world of medicine. Weren’t there charts to review or clinical guidelines to memorize? But Dr. Morris had her reasons, and they became clear soon enough.

Water for Elephants tells the story of Jacob, a young man who endures personal tragedy and finds himself as a veterinarian for a traveling circus. His tale, full of twists and turns, is narrated by his 93-year-old self from the confines of a long-term care facility. Young@Heart is a documentary about a choir of older adults in England who perform rock songs. It’s a joyful, poignant glimpse into the lives of people whose spirits refuse to be defined by their years.

Dr. Morris’s intent wasn’t for me to focus on the plots of these stories. Instead, she wanted me to grasp a simple but profound truth: We are all, at our core, the same people throughout our lives. Our bodies age, but inside, we remain the young, vibrant individuals we’ve always been — full of dreams, plans, doubts, fears, goals, love, and emotions. Her challenge to me was to see beyond the lab results, imaging studies, and physical limitations of my patients. My job, she said, was to find the person within. To uncover their story. To honor who they were and who they are.

I’ve carried that lesson with me since. It’s easy, especially in medicine, to get caught up in the churn—the problem lists, the treatment plans, the constant push for efficiency. But whenever I find myself frustrated or disconnected, I return to Dr. Morris’s words and those two assignments. They’ve become my first principles: Find the story. If I’m struggling to connect with a patient or feeling stuck in the process of building a plan, it’s usually because I’ve forgotten to do that.

Medicine is often described as a science, but Dr. Morris reminded me remains very much an art. Behind every lab value is a person with a history and a future. Behind every diagnostic image is someone’s parent, sibling, or child. And while treatments and interventions are important, the most meaningful thing we can do for our patients is to help them be the person they are on the inside—to help them live their story as fully as possible.

When I think back to that first rotation, I’m struck by how pivotal it was in shaping who I’ve become as a physician. It wasn’t just about learning geriatrics or palliative care. It was about understanding what it means to care for someone—not just their body but their whole being. I’m grateful for that early lesson, and I’m grateful to Dr. Morris for giving me the kind of education you don’t find in textbooks.

So, if you’re reading this and you’re a healthcare provider, or even if you’re not, here’s what I’ll leave you with: Take the time to find the story. Whether it’s a patient, a colleague, or someone in your personal life, remember that we’re all walking around with an inner narrative. It’s a gift to uncover it. And it’s an even greater gift to honor it.