It was after 7 p.m. when I at last arrived home following yet another lengthy day in the outpatient oncology clinic. My thoughts were still filled with the day’s narratives: patients battling pain, families holding onto hope, and the minor triumphs that rendered the fatigue somewhat worthwhile. There was emotional weariness, but also tranquility.

Then I opened WhatsApp. The headline shocked me: “Doctor in Chennai attacked by patient’s son following mother’s death.” He asserted that the “incorrect medication” had been administered. The faint smile I had carried home vanished into a heaviness. Sorrow overshadowed me, a stark reminder that our vocation, rooted in healing, now seems to demand protection.

Every few months, another such tale emerges: a doctor assaulted, a ward destroyed, another family’s sorrow escalating into violence. Outrage floods social networks, colleagues call for justice, and then the tempest calms, only to rise again. Why does this perpetuate? And what can we do to address it?

There are no straightforward solutions, but many of us identify the common triggers: poor communication, financial pressure, denial of prognosis, and overwhelming emotional strain. Violence is never warranted. Yet I find myself contemplating what we, as medical professionals, might approach differently. As we frequently remind our patients: Prevention is always more favorable than a cure.

The understated strength of genuine communication

In my experience, anger rarely emerges purely from malice. It often stems from misunderstanding. Families often feel caught off guard by sudden deterioration, unspoken truths, or the complex terminology of medicine. Although documentation may safeguard us legally, it does not shield us from immediate violence or hostility. A progress note cannot pacify an irate relative in the way a candid conversation can.

A few additional minutes spent clarifying what lies ahead, the probable complications, the limits of medicine, can transform confrontation into collaboration. I once inquired with my mentor, Dr. Sachin Hingmire, about how to convey the lasting side effects of chemotherapy without deterring patients from treatment. He responded, “Your attitude and language have a significant impact. The patient should exit the room believing you can manage the side effects, even should they occur.” That insight has remained with me. Communication is not merely conveying information; it’s transferring assurance and compassion.

The unseen efforts

A significant portion of a physician’s work occurs quietly: analyzing reports, reviewing pathology, weighing treatment strategies in conference corridors or group chats. Families seldom witness this dedication, and sometimes our quietness is interpreted as apathy. Over time, I have learned to gently mention, “We discussed your situation in the tumor board meeting today,” or “I spoke with the pathologist again this morning.” Not for accolades, but to demonstrate that their loved one is not overlooked after clinic hours. Highlighting this invisible labor builds trust, and trust safeguards both parties.

Imparting the craft, not just the science

Medical education continues to prioritize scientific accuracy over interpersonal connection. Students excel in guidelines yet falter when delivering bad news. Communication and emotional intelligence skills are considered optional, rather than vital. Yet, the ability to gently deliver difficult truths is what sustains the bond between doctor and patient. I view communication as a clinical skill, as essential as prescribing the appropriate medication. Training young doctors to navigate fear, hope, and uncertainty can avert not only misunderstandings but also calamities.

The burden of finance

Cancer treatment comes with a tremendous financial strain, particularly in lower- and middle-income nations. Emotional distress amplifies when families deplete savings only to confront worsening illness. Financial strain can breed resentment, especially when expectations clash with reality. Understanding a patient’s economic background is not just bureaucratic procedure; it is a clinical essential. If an expensive treatment is unlikely to yield suitable benefits, I guide families toward more realistic alternatives. Transparency about cost and outcome early in the process helps avert bitterness later.

Guiding, not deciding

Families frequently implore, “You decide for us, doctor.” It seems noble to take control, but it can be perilous. When results disappoint, that same trust can shift into blame. I once heard my mentor, Dr. Padmaj Kulkarni, state, “A doctor’s role is to guide, not to decide.” I often share with my residents a lesson from the Mahabharata, an Indian epic where Krishna instructs the warrior Arjuna in making difficult decisions. Similarly, a doctor’s role is to support and advise, but the final decision must reside with the patient. Empowering patients to choose fosters ownership, not reliance.

The healing touch of small gestures

Not every interaction needs to remain strictly formal. A light-hearted joke, a question about a daughter’s wedding, a smile during a stressful moment—these actions humanize medicine. For patients aware that their illness may be incurable, such instances offer something invaluable: dignity. One of my instructors, Dr. Chetan Deshmukh, embodied this principle. He conversed with patients about local cuisine, hometowns, or even shared stories with those enduring oral muc…