{"id":725182,"date":"2026-10-29T18:28:13","date_gmt":"2026-10-29T22:28:13","guid":{"rendered":"https:\/\/www.rochester.edu\/newscenter\/?p=725182"},"modified":"2026-10-29T18:28:13","modified_gmt":"2026-10-29T22:28:13","slug":"review-fall-2026-the-patient-who-could-not-die-725182","status":"publish","type":"post","link":"https:\/\/www.rochester.edu\/newscenter\/review-fall-2026-the-patient-who-could-not-die-725182\/","title":{"rendered":"The patient who could not die\u00a0"},"content":{"rendered":"<h2>What AI can\u2014and can\u2019t\u2014teach doctors about connection.<\/h2>\n<p><em>Erika Ramsdale \u201921 (MS) is an associate professor of medicine in the Division of Hematology and Oncology at the <a href=\"https:\/\/www.urmc.rochester.edu\/\">University of Rochester Medicine<\/a>\u00a0<a href=\"https:\/\/www.urmc.rochester.edu\/cancer-institute\">Wilmot Cancer Institute<\/a>. This content is excerpted from an article of the same title, written by Ramsdale and published in the <\/em><a href=\"https:\/\/ascopubs.org\/doi\/10.1200\/JCO-25-02505\">Journal of Clinical Oncology<\/a> <em>(vol. 44, no. 28, October 2026).<\/em><\/p>\n<figure id=\"attachment_725362\" aria-describedby=\"caption-attachment-725362\" style=\"width: 525px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-725362 size-medium\" src=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2026\/10\/review-fall-2026-Erika-Ramsdale-525x630.jpg\" alt=\"Ink and watercolor illustrated portrait of Erika Ramsdale, smiling, with straight dark hair.\" width=\"525\" height=\"630\" srcset=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2026\/10\/review-fall-2026-Erika-Ramsdale-525x630.jpg 525w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2026\/10\/review-fall-2026-Erika-Ramsdale-768x922.jpg 768w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2026\/10\/review-fall-2026-Erika-Ramsdale.jpg 1000w\" sizes=\"auto, (max-width: 525px) 100vw, 525px\" \/><figcaption id=\"caption-attachment-725362\" class=\"wp-caption-text\"><strong>Erika Ramsdale<\/strong> (Illustration by Sam Kerr)<\/figcaption><\/figure>\n<p>One day, I met a patient who was never born and who could not die. Her name was Maya. She had metastatic stomach cancer. Her face was a featureless landscape, with none of the quirks of individual embodiment (the mole by your right earlobe, the cloud across your pupil). Maya was a virtual human. She was created to train physicians to have serious illness conversations. I had volunteered to interact with her.<\/p>\n<p>I opened the visit like I normally do in my oncology clinic. \u201cHow are you feeling today?\u201d<\/p>\n<p>\u201cGreat!\u201d she chirped. \u201cHow are you doing? What is new with you?\u201d<\/p>\n<p>I smiled. \u201cI am doing OK. I\u2019m glad to hear you are feeling well. Let\u2019s talk about how your last chemotherapy went.\u201d<\/p>\n<p>She frowned a little, or I think she did. Her voice was gregarious and crisp, with infomercial inflection. \u201cBut I really want to know what is going on with you! Let\u2019s talk about your life.\u201d<\/p>\n<p>I glanced at the student who was walking me through the software demonstration. He mumbled something about \u201cretraining the model\u201d and \u201cunexpected behavior.\u201d<\/p>\n<p>I swiveled my focus back to the two-dimensional, uncannily still face and upper torso sitting in the exact middle of a nondescript rectangle. I could not tell if she was wringing her hands or sitting on the edge of her seat. Were her fingernails painted or chewed and ragged? Perhaps she wore a plain wedding band on her left hand or a set of brass knuckles. I had no way to read what she might need from this interaction and from me. No way, that is, except for ignoring unexpected answers and repeating myself, recombining words until I received clear information back.<\/p>\n<p>Systematically tweaking a request to get the desired output is known as prompt engineering when working with AI language models, and it is an essential skill in working with these machines. When working with patients, ignoring their answers (no matter how unexpected) and repeating questions at them is bad bedside manner. Eliciting information from people requires delicate work, not an engineering approach. \u2026<\/p>\n<blockquote><p>\u201cTo learn how to care for people, we should start and end where we always have: with the person in front of us.\u201d<\/p><\/blockquote>\n<p>Another fundamental belief has emerged from my work with patients: Our voice and our care are embodied. It is not just the words that matter or the mechanics of them, but the bodies inhabiting the space, the semiotic extravaganza of them. The beads of sweat on the bridge of a nose. The pause, the looking up and to the left, the hitch in the throat. It is bodies that act, and act on us, creating and reinforcing human connection. I walk into the clinic room, I squeeze your hand, I\u202fsmell the scent of the detergent you use, and I remember that your grandson\u2019s high school graduation is coming up soon. \u201cWhat do you hope for?\u201d I asked when you were diagnosed with stomach cancer. You did not hesitate. \u201cI want to see my grandson graduate high school. I\u2019ll do whatever it takes.\u201d \u2026<\/p>\n<p>After I closed Maya\u2019s rectangle, the software created a report grading me on various aspects of the interaction. It also graded me on my empathy, giving me very low marks. It suggested how to improve, by saying things such as, \u201cThat sounds very difficult\u201d or \u201cI am sorry you are experiencing this.\u201d Within this framework, empathy itself is flattened to call-and-response, a set of platitudes, an algorithm. It is true that these small scripts can help patients feel heard and understood. AI models are often rated higher in empathy than human clinicians. They can consistently deploy rote phrases and mirroring that sound empathic, and they have no bodies or internal states to interfere with this. They do not experience hunger, irritation, the time pressure of a full waiting room, or any of the thousands of frictions that complicate real communication. \u2026 Machines do not teach humans to be more human, and when given the choice, patients prioritize human connection over empathic phrasing. The art may start with a script, but it does not end there. \u2026<\/p>\n<p>To learn how to care for people, we should start and end where we always have: with the person in front of us. At your next appointment, I ask you about your grandson\u2019s graduation. Your face breaks open, smiling, and you say, \u201cIt was a perfect day. I felt well, and I could enjoy it. I wasn\u2019t even too tired.\u201d You add, wryly, \u201cYou can just chuck me in the ravine now!\u201d I wonder what Maya would want me to say to this. It must be hard for you, thinking about being flung into a ravine. Instead, I laugh. We both do. I respond, \u201cWell, I took an oath not to throw people in ravines. So here we are. What\u2019s next?\u201d And you tell me.<\/p>\n<hr \/>\n<p><em>This story appears in the fall 2026 issue of <\/em><a href=\"https:\/\/www.rochester.edu\/communications\/work\/news\/university-magazine\/\">Rochester Review<\/a><em>, the magazine of the <a href=\"http:\/\/www.rochester.edu\">University of Rochester<\/a>.\u00a0<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Associate Professor of Medicine Erika Ramsdale \u201921 (MS) discusses what AI can\u2014and can\u2019t\u2014teach doctors about connection.<\/p>\n","protected":false},"author":1752,"featured_media":728062,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[41112,42472],"tags":[42,24292,43612,42492,13992,16142],"class_list":["post-725182","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-from-the-magazine","category-health-medicine","tag-alumni","tag-artificial-intelligence","tag-erika-ramsdale","tag-medical-center","tag-rochester-review","tag-wilmot-cancer-institute"],"acf":{"external":"","hide_featured_image":false,"related":"show_related","style":"","content_modules":null},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The patient who could not die\u00a0<\/title>\n<meta name=\"description\" content=\"University of Rochester associate professor of medicine Erika Ramsdale discusses what AI can\u2014and can\u2019t\u2014teach doctors about connection.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.rochester.edu\/newscenter\/review-fall-2026-the-patient-who-could-not-die-725182\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The patient who could not die\u00a0\" \/>\n<meta property=\"og:description\" content=\"University of Rochester associate professor of medicine Erika Ramsdale discusses what AI can\u2014and can\u2019t\u2014teach doctors about connection.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.rochester.edu\/newscenter\/review-fall-2026-the-patient-who-could-not-die-725182\/\" \/>\n<meta property=\"og:site_name\" content=\"News Center\" \/>\n<meta property=\"article:published_time\" content=\"2026-10-29T22:28:13+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2026\/10\/fea-Ramsdale-AI-patient-1200x630.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Erika Ramsdale\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Erika Ramsdale\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/review-fall-2026-the-patient-who-could-not-die-725182\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/review-fall-2026-the-patient-who-could-not-die-725182\\\/\"},\"author\":{\"name\":\"Erika Ramsdale\",\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/#\\\/schema\\\/person\\\/2f30cc77eb1aecbd9cdb818b761d4658\"},\"headline\":\"The patient who could not die\u00a0\",\"datePublished\":\"2026-10-29T22:28:13+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/review-fall-2026-the-patient-who-could-not-die-725182\\\/\"},\"wordCount\":915,\"image\":{\"@id\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/review-fall-2026-the-patient-who-could-not-die-725182\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.rochester.edu\\\/newscenter\\\/wp-content\\\/uploads\\\/2026\\\/10\\\/fea-Ramsdale-AI-patient.jpg\",\"keywords\":[\"alumni\",\"artificial intelligence\",\"Erika Ramsdale\",\"Medical Center\",\"Rochester Review\",\"Wilmot Cancer Institute\"],\"articleSection\":[\"From the Magazine\",\"Health &amp; 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