There is a particular kind of silence that follows a bad medical consultation. Not the ordinary quiet of a busy clinic, but a thick, heavy stillness that both sides carry away. The doctor feels it walking back to the desk. The patient feels it walking down the corridor. The administrator feels it days later when a complaint appears on their screen. No one collapsed. No code was called. The prescription was written, the test was ordered, the note was completed. And yet everyone leaves worse off than when they arrived. This kind of encounter is not rare. It lives beneath the surface of everyday practice. From the doctor’s side, it often begins long before the specific consultation that finally “goes wrong”. The pressure builds through countless small moments: advice that is ignored, the same complaint repeated again and again, the demand to fix problems rooted in poverty, trauma, or bureaucracy, the constant awareness that any sentence might later be quoted in a complaint or legal case. ...