A Look Back: Radiating with Hope, Compassion & Empathy with Ashley Brown, MD

In November 2023, I sat down with Ashley Brown, MD, a radiation oncologist from New Orleans who was about three years out of residency and finding her footing across multiple clinical sites. We talked about how she found a specialty she had not known existed as a medical student, the work of caring for people with cancer, and the less tidy work of bringing the day home without letting it take over the house.

Her mother’s breast cancer was part of the reason she became interested in oncology. It was also part of the way she practiced. Brown told me that, when she speaks with patients, she often thinks: “How would my mom like to hear this?”

That is not a script. It is a test of attention.

The question asks more than whether the information is accurate. It asks whether the person in front of you is being treated as someone’s mother, father, child, partner, or friend—not as a diagnosis moving through a schedule. It asks whether the clinician has remembered what the room feels like from the other side of the table.

The part no machine can measure

Radiation oncology is technical work. Brown described a field shaped by measurements, anatomy, planning, and precision. Those things matter. But the idea from this episode that still holds up is that precision does not cancel tenderness. A clinician can be exact about the plan and still need to be gentle with the person receiving it.

Brown was frank about the emotional cost. “You cry with patients, you know,” she said. “And I don’t think I have a good way yet of, like, managing that.” I appreciated the unfinished quality of that answer. We often expect experienced clinicians to have a neat method for absorbing grief. Brown offered something truer: she was still learning how to remain open without being consumed.

That learning happened in community. She spoke about a senior partner who had practiced for decades, about colleagues who shared the burden of difficult days, and about the ordinary rituals that help people recover enough to return. Not a grand solution. People. A walk, a meal, a conversation after work, a place where the story can be told by someone who understands why it was heavy.

I keep thinking about the distinction between treating a disease and caring for a patient. The first asks whether we did the technical work correctly. The second asks whether we were present for the human being who had to live through it. Good care needs both.

What a patient should take away

You are allowed to ask how a plan will affect your life, not only what the plan is. You are allowed to say that you are scared, confused, or tired. Those statements are not interruptions to care; they are information about the care you need.

And when a clinician pauses to explain something again, or asks what matters most to you, that is not time wasted. It is part of the work.

For the rest of us, Brown’s example offers a useful standard: before we speak to someone in a frightening moment, ask whether we would want our own family member to hear those words in that tone. Technical competence is essential. So is the manner in which we carry it across the room.

If this episode stays with you, reply and tell me about a clinician whose presence made a difficult day feel less lonely. I read every response.

Dum spiro, spero. — Ugo