The piece “The woman sits opposite me, hands clasped around a list of her prescriptions” by Ryan Nadelson delves into the intricacies of contemporary medical practice, specifically the friction between algorithm-based metrics and patient autonomy. In this account, the author, a doctor, recounts a significant conversation with a patient who refuses cholesterol medication, highlighting the difficulties physicians encounter in reconciling evidence-based guidelines with honoring patient preferences. Nadelson critiques the prevailing healthcare system’s focus on adherence rather than individualized care, advocating for a quality metric approach that respects patient autonomy and compassion. He notes that while quality metrics intend to standardize healthcare, they frequently neglect the vital role of trust and the specific requirements of patients. Through this contemplative article, Nadelson pushes for a healthcare model that integrates scientific precision with empathy, underscoring that genuine quality care cannot be simplified to mere data.