You’re halfway through your vascular surgery and haematology placement. The cases have been intense: critical limb ischaemia, deep vein thrombosis, peripheral arterial disease. Today feels heavier than usual. Your consultant asks you to clerk a new patient before the ward round – a man in his late fifties with severe leg pain, struggling to walk more than a few steps. His scans show significant arterial narrowing. He’s scared. He’s frustrated. He smells strongly of smoke. As you introduce yourself, he folds his arms, defensive. “Let me guess,” he says. “Another doctor here to lecture me about smoking. Everyone does. I know it’s my fault.” You pause. You’ve heard it all week from staff – “It’s always the smokers,” “They bring this on themselves.” You know the physiology, the risk factors, the statistics. But sitting here, looking at him – anxious, ashamed, expecting judgement – none of that feels important. You sit down beside him instead of standing. You ask about his pain, his work, his routine, his worries about surgery. Slowly, he starts to relax. He talks about when he started smoking, why it’s been hard to stop, the guilt he carries every time he lights a cigarette. You listen. Properly listen. Not waiting for your turn to speak. You explain the disease process without blame. You explore options. You discuss support, not criticism. For the first time today, he meets your eyes. Before you leave, he says quietly, “Thanks. You’re the first person who hasn’t made me feel like a lost cause.” After the ward round, the consultant tells you his case will be complex. Surgery may help – but so will trust. And that trust begins long before the operating theatre. Walking home later, you realise something: learning medicine isn’t only about recognising pathology. It’s about recognising people – their fears, their histories, their humanity. And sometimes, the most powerful clinical tool you have is the ability to see someone without judgement.