How I learnt the human side of medicine, one heartbeat at a time

Every profession has its symbols.

For doctors, there are two that every child recognises long before they understand what medicine is: the white apron and the stethoscope. Many professions wear white coats. But the stethoscope belonged to doctors. It was more than an instrument—it was an identity. As a child, I believed that the moment a stethoscope rested around your neck, you somehow became a doctor.

That belief stayed with me until the day I entered medical college. It was not an ordinary beginning. The year I joined MBBS, Kerala was in the middle of one of the largest agitations against the opening of private medical colleges. The strike delayed our admission by nearly six months. By the time counselling finally began, the atmosphere outside the medical college was charged with anxiety.

As my brother and I walked towards the counselling hall, groups of medical students stood outside, distributing pamphlets and urging us not to join. Some warned us that the protests could become violent. Others pleaded with us to support the strike. Inside the hall, the tension continued.

What caught my attention, however, was not the slogans but the stethoscopes. Some students wore them proudly around their necks. Others folded them into their coat pockets. A few carried them in their hands as though they were badges of honour. Then there was one young man who had somehow managed to hang his stethoscope over his head, with the earpieces dangling beside his ears like an oversized pair of spectacles. My brother looked at me and smiled. Even in that tense atmosphere, we shared a quiet laugh. It was probably the first time I realised how powerful a symbol the stethoscope had become. It announced who you were—or at least who you hoped to become.

When classes finally began, reality arrived with surprising force. I had imagined medicine to be about diagnosing diseases, saving lives and understanding people. Instead, it felt like drowning in names. Bones. Muscles. Enzymes. Pathways. Receptors. Latin words. Greek words. Thousands of facts with no obvious connection.

Nothing in my school education had prepared me for learning this way. Many of my classmates seemed to absorb information effortlessly. I watched them memorise pages in the time it took me to understand a paragraph. My mind simply didn’t work that way. The first two years often felt less like education and more like survival. Yet giving up was never really an option.

That lesson had been taught to me long before medicine. Growing up, my siblings and I lived in the city while my parents worked on our farmland, visiting whenever they could. Eight of us shared a rented house. By the time I was still in school, my older brothers and sisters were already navigating college and adulthood. They were far more than siblings. They cooked, corrected, protected, sacrificed quietly. In many ways, they raised me as much as my parents did. When I entered medical college—probably the first in our family to do so—it never felt like an individual achievement. It felt as though many people had carried me to that moment. Whenever studying became overwhelming, I reminded myself that I was not walking alone.

Of all the pre-clinical subjects, anatomy made the most sense to me—not because it was easy to memorise, it wasn’t. But we could see it, dissect it and understand it, rather than simply memorise it. It wasn’t easy for me to remember the attachments of every muscle—their origins, insertions and actions. Then I stopped trying to memorise them. Instead, I began to see anatomy as a puzzle to be solved. If a muscle begins at a particular point on a bone and its job is to produce a particular movement, where must it attach at the other end to make that movement possible? Suddenly anatomy stopped feeling like a list of facts and started behaving like engineering. Every structure had a purpose. Even complex movements followed the same logic, with several muscles working together while nerves carried the electrical signals that activated them at exactly the right time. Function dictated design. The human body was no longer an endless list to memorise but had become a beautifully engineered machine. Dissection confirmed that logic.

Biochemistry appealed to me for the same reason. Molecules followed rules. Reactions had reasons. Pharmacology became interesting only when I understood relationships rather than drug names. Pathology often overwhelmed me. Physiology demanded relentless repetition.

I wasn't enjoying medicine. But I had decided I would stay. I kept telling myself one thing. Maybe clinics will be different. They were. The wards were nothing like the polished illustrations in textbooks. Patients occupied every available space—beds, corridors, verandas, even the gaps between beds. There was noise. Confusion. Families. Fear. Hope.

For the first time, medicine had faces. Every patient carried a mystery waiting to be solved. There was a problem. Hidden within the patient's story were clues. Your job was to ask the right questions without exhausting the patient. Notice what others overlooked. Examine carefully. Separate the relevant from the irrelevant. Build a provisional diagnosis. Then test your own thinking against the clinical signs you discovered with your own hands. It felt less like memorisation and more like detective work.

For the first time in medical school, I was genuinely curious. Medicine had finally become alive. That was when the stethoscope acquired an entirely different meaning. Until then, it had merely been a symbol. Now it became an extension of the examination. It revealed heart sounds. Murmurs. Rhythms. Breath sounds. Hidden clues that no textbook could provide.

But its greatest power was not acoustic. It was human. The moment a patient saw the stethoscope around your neck, something changed. You were no longer just another student interrupting their difficult day. You became a doctor in the making. Patients trusted you. They allowed you to examine them. They answered your questions patiently because they genuinely believed that perhaps this young medical student might notice something that would help the senior doctor care for them better. The stethoscope opened conversations long before it amplified heart sounds.

Among students, a new discussion began. Which stethoscope should we buy? There were many options. Some were expensive—far beyond what most of us could afford. We were legally adults, but financially we still depended entirely on our families. After comparing prices, I quietly decided I would ask for a simple Indian-made stethoscope. It would do what I needed it to do, and that was enough.

That evening, as I was hesitantly trying to bring up the subject at home, my brother walked in carrying a small box. “This is for you,” he said. I opened it. Inside was a Littmann.

To us, Littmann wasn’t just another brand. It was the stethoscope. The one every medical student admired. The one many dreamed of owning. I looked up at my brother. He was not someone who spent money casually. Everything he did was thoughtful, practical and deliberate. If he bought something, it was because he believed it mattered. Yet he had chosen the very best.

As he handed me the stethoscope, my brother smiled and said something that has stayed with me ever since: “The best doctor is not the one who hears a patient’s heartbeat through a stethoscope, but the one who can hear it without one.”