Case of the Month
The Patient Who Stopped Asking Questions
A 58-year-old man with a new diabetes diagnosis leaves three consecutive appointments without asking a single question. His silence is mistaken for acceptance.
The case
Mr. K attended his third diabetes follow-up in four months. Each time, his clinician provided thorough explanations. Each time, Mr. K nodded and said very little.
What was missed
The clinical team interpreted his silence as compliance. In reality, Mr. K had grown up in a culture where questioning a doctor was considered disrespectful.
The turning point
A nurse asked: "Sometimes people have questions they find hard to put into words — is there anything that is still unclear?" Mr. K paused, then said: "All of it, really."
The insight
Clinical empathy requires active curiosity about silence, not just responsiveness to expressed concern.