Settling into the consultation chair, she felt the cool vinyl through her thin trousers, a sensation that usually preceded the rhythmic interrogation of a cold stethoscope or the scratch of a pen against a clipboard. Mrs. Chan, a retired teacher from a secondary school in Sai Wan, adjusted her glasses.
She had prepared her identity card, her previous blood pressure readings, and a mental list of her 13 distinct aches. She was ready to be a patient-which is to say, she was ready to be an object of study. But the practitioner didn’t look at her ID card first. Instead, the question that hung in the air was one she hadn’t been asked in at least of navigating the public and private medical systems of the city.
“What do you miss being able to do, Mrs. Chan?”
The question caused a physical stutter in her posture. She had spent decades being asked what hurt, where it hurt, and when it started hurting. She was used to being a collection of symptoms categorized by a database. To be asked about her life-the actual, lived texture of her mornings-felt almost like an intrusion.
It was disorienting. She realized, with a sudden pang of grief she hadn’t expected, that she had become accustomed to being treated as a body in a queue, a billing identifier, a data point to be processed before the next began.
The Replacement of Person with Profile
This is the hidden crisis of modern medicine. In our pursuit of standardized protocols and digital efficiency, we have replaced the “person” with the “profile.” We have built magnificent systems that can track a blood glucose level across 103 different variables but cannot remember that the human being attached to that blood is currently grieving a spouse or struggling to climb the stairs to their favorite dim sum parlor.
The Modern Clinical Imbalance: Tracking 103 variables while missing the lived intention of the patient.
Personalization has become a buzzword, but it has been hollowed out. In most clinics, personalization is a CRM feature-a computer program that reminds the receptionist to say “Happy Birthday” because a field in the database triggered an alert.
That isn’t personalization; it’s automated politeness. Real personalization is a clinical posture. It is the recognition that a migraine in a programmer is a fundamentally different biological and psychological event than a migraine in a retiree.
The Telemetry of Intent
I think about Avery N.S., a friend of mine who works as a video game difficulty balancer. It’s a strange, highly specific job. Avery spends staring at spreadsheets and player telemetry, trying to figure out exactly when a game becomes too hard for the average person to enjoy, but not so easy that they lose interest.
Avery recently went through a phase of organizing every file on their computer by color-red for urgent mechanics, blue for narrative flow, green for economy. It was an attempt to find order in a sea of data.
“You have to look at *how* they are dying. Are they panicked? Are they bored? Are they trying a strategy that the game hasn’t accounted for? If you don’t understand the player’s intent, your data is just noise.”
– Avery N.S., Game Balancer
The same is true in the exam room. If a practitioner doesn’t understand the “intent” of the patient’s life, the medical data is just noise. When Mrs. Chan says her knees ache, she isn’t just reporting mechanical wear. She is reporting the loss of her morning walks through the banyan-shaded streets of Sai Wan. She is reporting a shrinking world.
I’ve made the mistake of over-valuing efficiency myself. I used to think that the faster I could categorize a problem, the more “expert” I was. I would color-code my tasks, much like Avery’s files, thinking that the organization of the information was the same as the resolution of the problem.
It was a lie. You can have the most organized files in the world and still miss the fact that the person standing in front of you is terrified. The professionalization of medicine has created a distance that we mistake for “objectivity.” We think that by stripping away the biographical details, we can get to the “pure” science of the body.
But the body is not a machine that exists in a vacuum. It is a biological record of everything we have ever felt, eaten, and survived. When we ignore the person to focus on the body, we lose the very context that makes healing possible.
The Radical Simplicity of the Story
In the realm of traditional practice, there is a concept of “constitutional consultation” that feels almost radical in its simplicity. It’s the idea that you cannot treat the symptom without understanding the constitution of the person. This isn’t just about whether they are “hot” or “cold” in the TCM sense; it’s about who they are in the world.
It’s a return to biographical inquiry as a clinical tool, not just a hospitality flourish. This is where places like
find their relevance.
They operate on the premise that the patient’s story is not an obstacle to the diagnosis, but the foundation of it. When a practitioner asks about your sleep, your stressors, and your desires, they aren’t being “nice”-they are being precise. They are gathering the necessary telemetry to balance the “difficulty” of your recovery.
The Decommissioning of Humanity
I remember a specific afternoon, around , when I was sitting in a waiting room that smelled faintly of antiseptic and old magazines. I watched a man receive a diagnosis. The doctor spoke to him for exactly .
The doctor was technically correct, I’m sure. The information was accurate. But the man left the room looking more broken than when he entered. Not because the news was bad, but because he had been delivered the news as if he were a faulty piece of machinery being told it was slated for decommissioning. There was no space for his humanity in that 3-minute window.
We have reached a point where being treated as a person feels like a luxury. We are so used to the “patient-as-product” model that when someone looks us in the eye and asks how we are actually doing, we suspect they are trying to sell us something. It’s a cynical way to live, and an even more cynical way to heal.
A Better Onboarding Process
Avery N.S. often talks about the “onboarding” process in games-the first where a player decides if they trust the system. If the game treats them like an idiot, they leave. If it treats them like a god, they get bored. The “sweet spot” is being treated like a capable human being who is on a journey.
Medicine needs a better onboarding process. We need to stop asking patients to fill out 13-page forms that ask for their insurance details three different times but never ask if they have someone at home to help them cook. We need to stop treating the clinical encounter as a transaction and start treating it as a calibration.
“Sign here. Next slot in 23 minutes. Here is the code for your symptoms.”
“What do you miss doing? Let’s adjust the treatment to fit your mornings.”
Mrs. Chan eventually answered the question. She talked about the tea house she hadn’t visited in . She talked about the stairs in the MTR station that felt like a mountain. As she spoke, her posture changed.
The “patient” mask dropped, and the teacher returned. She became the authority on her own life again. And in that moment, the healing had already begun, long before any herbs were prescribed or any needles were placed.
Reclaiming the Biography
We often think that “humanizing” healthcare means more comfortable chairs or better art on the walls. It doesn’t. It means changing the clinical posture. It means acknowledging that the “body” in the chair has a name, a history, and a set of fears that are just as real as their blood pressure.
It means admitting that we don’t have all the answers, and that the patient often holds the most important piece of the puzzle. I’ve had my own moments of clinical failure. I once spent explaining a solution to someone, only to realize at the end that I hadn’t listened to their actual problem.
I was so enamored with my own expertise that I had tuned out the person I was supposed to be helping. It’s a mistake I try not to repeat, but the gravity of the “expert” role is strong. It pulls you toward the center, toward the ego, and away from the person.
To truly see someone is a heavy lift. It requires us to set aside our color-coded files and our 103 data points and simply be present. It requires us to accept the “strange dignity” of the person in front of us. It is not an efficient process. It cannot be scaled by an algorithm.
It cannot be automated by a CRM. It is the slow, manual work of one human being looking at another and saying, “I see you, and your life matters as much as your symptoms.”
In the end, Mrs. Chan left the clinic with more than just a prescription. She left with the feeling that she wasn’t just a woman with a knee problem. She was a teacher, a neighbor, a walker of banyan-shaded streets, and a person whose presence in the world was recognized.
That recognition is the missing ingredient in most modern treatments. It is the thing that makes adherence possible, because we are no longer just “taking our medicine”-we are participating in our own restoration.
If we want to fix the “hollowed-out” nature of modern medicine, we have to start by reclaiming the biography. We have to stop being afraid of the “unprofessional” act of caring. Because the price of our current efficiency is too high. The cost is our dignity, and that is a price no one should have to pay for a .
As I look at my own color-coded files today, I’m reminded that the colors are just a map. They aren’t the territory. The territory is messy, unpredictable, and deeply human. And that is exactly where the healing happens. Not in the organized rows of a database, but in the disorienting, dignified space between two people who have decided, for at least , to really look at each other.
