The "Ungrateful" Patient
for whom I am grateful
You are reading Ask The Patient by Dr. Zed Zha, a doctor’s love letter that gives patients their voices back. If you enjoy it, please comment, like, share, and/or subscribe!
As doctors, we don’t exactly have a “thankless job.”
Literally, every patient thanks us before leaving our offices —even the 11-year-old who screamed bloody murder while getting vaccinated says, "Thank you, doctor," through sniffles and tears.
So, when I encountered an “ungrateful” patient, I knew something was very wrong.
Ok. I know that sounds entitled.
But readers, hear me out.
Jenny was a quiet 15-year-old girl who looked like she had just woken up at first glance. But soon it became obvious that she had endured severe eczema for a long time — her skin was thickened with scratch marks, and her eyes were puffy with a miserable rash. And when I got closer to examine her, I heard her wheezing with each breath. Turned out, she also had severe asthma — a common thing to have with eczema.
“Wow. How long have you had eczema and asthma?” I asked.
“Pretty much all her life.” Jenny’s dad spoke on her behalf.
My heart broke a little (by a little I mean a lot) every time I heard stories like this. “We are going to get you better, Jenny,” I promised.
I prescribed an injectable medication for Jenny’s severe eczema, which should also get her asthma somewhat better. But not “better” enough. So, I called her primary care team. I suggested to the clinician that he add a couple of medications that would actually control Jenny’s asthma so she didn’t have to use her “rescue inhaler” as much.
Let’s take care of this kid like we would our own children, OK? I wanted to say.
The rest of the day, Jenny never left my thoughts. Everything made sense now. She wasn’t another teenager who “just woke up”—she always looked like that. Her eyes were swollen and red, weighed down by the thick rash she fought not to scratch. And her silence, the way she barely spoke — she had to focus, each breath slow and measured, just so she could hold back the cough that threatened to break free.
I’m not a mother. But I’ve been with hundreds of mothers in the most vulnerable moments of their lives, helping them bring new life into the world. I’ve seen the raw, fragile worry in the eyes of parents as they watch their children in pain. And I’ve watched my own mother do anything to hold me close, even if it meant making hard choices (such as thieving, in my case).
I share, intimately, the unspoken wish all parents have: for our children to just be children.
Carefree. Unburdened.
Not fighting for every breath.
Not battling the pain of an itch they’re told not to scratch.
We will get her better, soon. I swore to myself.
But there was one problem: the injectable medication I’d prescribed would likely take days — maybe weeks — to get approved by insurance. And even one day felt like an eternity. Luckily, a team of dedicated people had fought tirelessly to store free samples of this very medication at a nearby clinic. (You can read that story here: How To Save A Life.)
Thank God for them, I thought.
With a sense of urgency, I sent a text to my colleagues there: “Can I send you a 15-year-old to get the injection today or tomorrow?” A few hours later, my phone buzzed with a reply: “Sure! We have an opening tomorrow at 3.”
Yes!! I thanked her profusely and felt a flood of relief. I can’t wait to tell Jenny and her dad the good news. We can finally get that itch under control. Jenny will sleep again. Maybe even breathe better. They’ll be so excited!
When I dialed Jenny’s dad’s number a few minutes later, I felt like Santa Claus climbing down the chimney to deliver a gift —except this one wasn’t wrapped in paper, but in hope.
“K. We’ll be there.” Jenny’s dad’s voice was flat, almost detached, after I told him about the arrangement for the injection.
Wait! That’s it? No excitement? No relief? Usually, this kind of phone call leads to a celebration on the phone. Now, it felt like a child walking into a room where Santa Claus (aka me) had just left a pile of gifts, only to shrug and say, “Meh.”
But it wasn’t just the lack of enthusiasm. There was something else—something hesitant in his tone.
Hmm. Strange.
“Great,” I said, trying to ignore the knot forming in my stomach, and I was about to hang up.
I guess that’s it.
“Umm, Dr. Zha?” His voice stopped me mid-motion, “I need to ask you a question.”
My pulse quickened. Something in his voice had shifted. It wasn’t just a question—there was tension in it now, something more confrontational.
Uh-oh. Have I made a mistake?
“Jenny’s primary care doctor just called me, too.” His words tumbled out. “They gave us an appointment tomorrow to talk about adding medications for her asthma.”
Ok? So far so good, right?
“Because they said in your note, you wrote: ‘audible wheezing’…” He paused, his words hanging in the air.
Oh, god, I did write that. Wait, what’s wrong with that?
“And you asked them to add medications…”
I did that, too. But that’s a good thing, too. No?
“I’m glad you did,” he added quickly.
But…
“But we’ve been coming to the doctors for years and telling you guys over and over that Jenny needed better treatment. How come…” His voice faltered, and I heard him take a deep breath, a forced exhale as if holding himself back from something harsher.
I braced myself.
“How come you wrote down two words and suddenly we’re taken seriously?”
“I…” My lips moved. Yet no word came out, as if my voice had abandoned me.
The silence on the other end of the phone grew heavier with each second, demanding to know the truth.
“I… I don’t know,” I finally muttered.
More silence.
There had been countless questions patients asked me that I didn’t have the answers to. Some pushed the boundaries of my knowledge. Some were once familiar to me but had since slipped from memory. And some, no matter how hard I tried, would forever be beyond my understanding. I’ve never been afraid to say, “I don’t know.”
But the question my patient’s father raised was different: It wasn’t beyond me — I did know the answer. It just stung too deeply to say.
Finally, Jenny’s dad broke the silence. Thank goodness he did.
“I’m sorry, doc. I must sound so ungrateful.”
“No,” I replied, my eyes darting around the office, searching for something—anything—to steady myself. My pink sticky notes. My antique medical book collection. The water bottle covered in silly stickers. I clung to the familiar, but somehow I knew that wasn’t going to help me find the right thing to say.
In that moment, it hit me: this wasn’t a confrontation.
This was a desperate father questioning the failures of a system meant to help them — the failures that had torn at the heart of his family for years. He wasn’t angry—he was devastated.
He needed to know why, despite his every effort, he still felt powerless. He needed to know that he had done everything he could for his baby girl as he promised her he would since the day she was born.
And now, by telling me how he felt and asking the question that had been eating at him for far too long, he was giving me the chance to make it right for him. Even if only a little.
There was only one thing left for me to say — the truth that we owed him and so many patients and parents like him:
“I’m sorry that…we never listened to you.”
If there were ever moments in my career where I felt my world shifted — this was one of them. In constructing the world of medicine, we’ve paved countless new paths. But we’ve also taken many wrong turns, straying further and further from those we vowed to walk alongside. The greatest of these missteps is that somewhere along the journey, we stopped listening to our patients — the very compass that guided us and made us who we are today — forgetting that without them, there is no us.
This so-called “ungrateful” patient taught me something I will be forever grateful for: patients are not looking to return to the path that separated us. They are ready for the one that will bring us back together, as a team.
All we need is the courage to follow their lead.
“Thank you,” said the trembling voice on the other end.
I also want to take this opportunity to thank all my patients, readers, and those whom I interact with on my platforms! You have taught me many things that have made me question the status quo. I hope I’ve listened to you. Thank you for helping me grow.
I no longer see patients but I can’t tell you how many cried in my office simply because I let them tell their whole health story without interrupting, and truly listening. Most of the time I wasn’t even able to provide all the care they needed, but they knew I’d be honest with them and send them in the right direction. I hope your patient is doing much better now 🤍
Dr Zha, please keep sharing your stories, and keep shining your light on the importance of the human and the humane in medicine. Thank you for the gift of your precious time in sharing with us.
My day is made brighter knowing you are doing good in this world