An absence of words

The power of silence in patient care and human connection

“Silence can create an opening for emotions to flow without detours, suppression or blockage,” writes Stephanie Lee, OMS IV. “It is a channel of communication that is understated.”


Silence is a pause, a rest between two notes in a musical piece and a holding space between words spoken aloud. It is a mark that leaves an intensity behind its trail, creating greater emphasis on the words that come before and after. We’ve been told that silence can be uncomfortable. Yet for some, silence can also be healing. In conversation, silence can create an opening for emotions to flow without detours, suppression or blockage. It is a channel of communication that is understated, yet fierce in its expression.

Diving deeper

I once met a patient on a unit—”manic” was how the staff often described him. But to me, he was gripping his emotions from their submerged dungeon, releasing their energy for all of us to see. It was beautiful in expression and taught me more about what it means to be human. On a cold morning, one with crisp air that gripped my skin, I walked into the unit to round and the patient found me and said, “Stephanie, can we talk?”

“Of course,” I said. I looked forward to speaking with him every day, as he showed me how vulnerability is a piece of our human consciousness.

“How was your night?” I asked him. “I heard things didn’t go well for you.”

The patient gave a slight bend to his shoulders and looked down, hunching over.

“I miss my mom,” he said. “She doesn’t visit me like the others do.” He immediately brought his hands to his face and sobbed. I watched the tears fall over the crevices of his nose down to the corners of his lips.

“Your mom loves you very much,” I gently stated, observing his body shaking through his tears.

Now screaming, his voice echoed across the hall, patients walking by and looking in. Moments later, as he caught his breath, he said to me, “please don’t go,” and reached over his dirty laundry to wipe his tears.

I sat there, holding presence and space for someone who seemed to battle the misconceptions the world had of him, and allowed him to express his emotions through broken sentences and intense sobbing. I allowed the silence to take over, inviting him to release the heavy wound many years in the making.

“Thank you for listening—you’ve done more than help me,” he said. I looked over at his flushed face, his eyes looking to the ground after the long war with himself, and I bid my farewell.

Listening as an invitation

A broken heart often needs companionship—this companionship was silence.

Silence as an ease into a conversation asks us to share our truest selves. Some of us deeply wish to be heard and/or seen. Silence allows for the quietness in us to expand and grow as it waits to be released through expression. When we fill the silence with words and thoughts, it can inhibit the free flowing of another’s thoughts. Silence is a warm invitation for these thoughts that have been hidden or buried beneath us to come about and be seen. It is a comforting reassurance that says, “I wish to see you as you are.”

On another unit, there was a woman in her 60s—she had blonde, disheveled hair that looked like it hadn’t been combed for days. As we entered her room, the bright, fluorescent sun was shining through her window, as if reminding her there was a brighter, different future than this. Yet, her guilt shielded her from the prospects of a better future. Pacing around the room, she whispered that she was guilty and had lied many times. As she saw us approach, she froze in her stance and sat down.

“Is everything OK?” we asked.

“No, no they’re not,” she whispered. “I’ve done bad things.” Tears slowly ran down her cheeks and she continued to whisper those same phrases. We stood there in silence as she cried, inviting her to continue pouring into the space of emptiness.

Eventually, her sadness poured into the space and we felt a release in her chest. Moments later in the patient interview, she finally felt OK for us to leave. She looked out the window again, this time feeling a slight hopefulness of a better tomorrow, if only for a moment.

“Goodbye,” she whispered.

Holding space for all

Silence creates a space that holds no borders, yet takes the shape of the confines of the room. In the darkest moments of our human experience, we often share exchanges of whispers, laughter, grieving and hopefulness. Yet, silence can allow us to understand we are not alone. It is an offering to ourselves and another to be in our truest form and create space to process our deepest emotions.

Genuine connection between people is a blessing and a soul-nourishing endeavor. Through silence, we connect deeply with those around us as we reach out our hands in an unwavering fashion and say, “Tell me your story, I wish to know.” With those words lingering in our thoughts, we slowly blossom, discovering more about ourselves each time.

Author’s note: Any cases mentioned in this article are generalized examples or amalgamations of multiple patient encounters and have been de-identified to protect patient privacy.

Editor’s note: The views expressed in this article are the author’s own and do not necessarily represent the views of The DO or the AOA.

Related reading:

The ironic tango of imposter syndrome and a growth mindset

Vulnerability: The path least taken


  1. Omar A.

    Thanks so much for writing this thought-provoking peace. You speak beautifully when you express that with silence “we connect deeply with those around us… inviting the person we are connecting with to “Tell me your story, I wish to know.”
    There’s a great book out there you may find interesting called, “Just Listen” by Mark Goulston. I think you’ll find it interesting! Thanks again.

    1. Stephanie Lee

      Thank you Omar for your kind words. It brings me even more joy hearing our readers’ thoughts and that we can share stories together.

      Thank you for the book recommendation. I look forward to reading it!

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