Finding Hope in the Face-to-Face

Jennifer Y. C. Edgoose, MD, MPH; Julian M. Edgoose, PhD


Ann Fam Med. 2017;15(3):272-274. 

In This Article

Abstract and Introduction


What does it mean to look into the face of a patient who looks back? Face-to-face encounters are at the heart of the patient-clinician relationship but their singular significance is often lost amid the demands of today's high-tech, metric-driven health care systems. Using the framework provided by the philosopher and Holocaust survivor Emmanuel Levinas, the authors explore the unique responsibility and potential for hope found only in face-to-face encounters. Revisiting this most fundamental attribute of medicine is likely our greatest chance to reclaim who we are as clinicians and why we do what we do.


We had nothing in common. She was from a small indigenous tribe in Mexico called the Triqui. We couldn't find a Triqui interpreter and my poor Spanish was no better than hers. Her face belied her age of only 17, due to years of work in the fields and suffering at the hands of an older man. She made the arduous journey north, arriving pregnant and undocumented, and now I was to be her doctor. Our worldviews were so different that even her way of expressing pain confounded me. I reverted to closed-ended questions about where, when, how, and why, but still felt lost gathering only incoherent answers and gestures. We struggled together during her gestation period and, despite being an experienced physician who can usually connect with challenging patients, I came to feel my heart sink every time I saw her name on my schedule. Toward the end of her pregnancy, tired of our inadequate words, I looked into her eyes and tried to give her hand a reassuring squeeze as we parted. Then, in broken Spanish, she asked me what I thought of the name "Edgoose." I was stunned into silence and eventually mumbled that my unusual last name would really not be appropriate for her expected daughter…