Foreword from Between Heartbeats and Algorithms: Reclaiming What Matters in Healthcare

The craft of narrative medicine continues to evolve, highlighting how clinicians of all types grapple with the complexities of their chosen professions in this era of healthcare. Patients allow us the privilege of intimacy with their lives, often followed by a subsequent outpouring of gratitude and appreciation that comes from helping them become healthier. And then, occasionally, there are the contrasting circumstances that must be confronted when the inevitable inadequacies of patient care outcomes occur.

In both circumstances, there is a related emotional component that clinicians may or may not be comfortable recognizing or admitting to themselves, let alone with others.

The paradox of clinical healthcare professions is that the people drawn to these professions are typically kind, caring, and compassionate people who care deeply about helping others; however, this altruistic driving force can become difficult to maintain, given the volume of patients cared for during a career and the often-tragic outcomes or patient circumstances they may witness over time.

We must each learn how best to navigate these personal journeys. And at times, it is a tough path to follow. Between Heartbeats and Algorithms: Reclaiming What Matters in Healthcare is a beautiful example of narrative medicine. Devjit Roy draws deeply from his personal clinical and emotional experiences in a fashion designed to stir the reader’s compassion, empathy, and altruism.

All clinicians have a multitude of clinical stories to tell and memories to share, and Dr. Roy challenges us not to simply bury them within our memory banks. Rather, he dares us to learn from these experiences, to capture their essence of humanity, and to use them to not only help us, but to benefit others as well.

As Dr. Roy describes, “This book is my attempt to … reflect on the spaces where real healing happens … to grow, to learn from story, and to keep myself honest — to preserve our shared humanity in a system that sometimes feels like it’s forgetting it.”

Drawing on his experiences caring for approximately 50,000 patients, he profiles 15 clinical situations that profoundly affected his views toward medicine and life in general. His storytelling is crafted in a way that resonates with all clinicians, and his writing style is both engaging and reflective.

More importantly, his messages at the end of each story are designed to help readers recognize the emotional connection we all share with our patients and create moments of pause that we can use to better manage ourselves moving forward.

The moments of pause created while I read through this book actually took me down a path of reflection on my own clinical journey as a trauma (acute care) surgeon. Over my clinical time, I performed around 20,000–25,000 trauma resuscitations (typical 10% mortality rate), managed more than 100,000 ICU patients (typical 15% mortality rate), and was involved with 10,000–12,000 end-of-life discussions. No, I don’t remember all those cases, but there are a few that still stand out. And I realize now that I should have taken more time to process my own emotions during that time.

Not paying adequate attention to the emotional turmoil and related mental health challenges in the clinical disciplines is now recognized as a contributing factor in compassion fatigue and burnout in the healthcare workforce. Recognizing this insidious erosion of our innate traits of benevolence and compassion is critically important for the betterment of the profession now and for the future.

Fortunately, the topic of burnout has reached a level of general awareness and a multitude of resources are now available as our industry better navigates the complexity of these issues.

But this book does not dwell on the difficult side of clinical care! It is a beautiful collection of poignant, heartfelt stories that anchor the reader back to the reason clinicians choose to devote themselves to the privileged professions of helping others. This book is about helping us to reimagine and recognize the beauty and pleasure of being a healthcare professional. It also challenges us to empower ourselves to ensure none of us forgets about the humanity in healthcare.

This is also a book that clinicians should share with their families and friends, for it will provide patients and the public with deeper insights into how they, themselves, influence physician-patient interactions and how they might better interact with their clinical providers going forward.

The core of every clinical interaction is the deep personal and emotional connections made between the humans who are each trying to make their lives, and the lives of others, better through kindness, caring, and gratitude for one another.

This is a must-read book for anyone involved with healthcare, regardless of whether they are on the giving or the receiving side of the system. You will feel enriched and reassured that humanism is thriving in healthcare, and that many are invested in making sure it is maintained. Enjoy your read and the moments of pause it creates.

Excerpted from Between Heartbeats and Algorithms: Reclaiming What Matters in Healthcare by Devjit Roy, MD, MAS, MSPC, CPE, (American Association for Physician Leadership, 2025).