If Dogs Could Diagnose Us…

If dogs could diagnose us, they'd probably start by tilting their heads, confused, patient, listening harder than most of us do.

Because what Luna, Milo, Zoba, and Maggie teach us is the marvel of understanding someone who doesn't speak your language. And if healthcare, in underserved communities, listened like a dog does, maybe fewer people would leave the clinic feeling unseen.

Four Friends, Four Dogs, One Problem

The room hums with laughter and empathy. Four friends sit in a sunlit living room, dogs curled by their feet. Evelyn leans forward, her voice weary yet affectionate. “The only time I feel Luna understands me,” she says, “is when I fill her breakfast bowl.”

She gestures helplessly. “I take her to the vet, give her meds, follow every rule in the book. But when I say ‘take your pill,’ she just stares. I point, I repeat, I even act it out, but nothing.”

Across the table, Matt nods. “Milo does the same,” he admits. “He flinches when I raise my hands. I rescued him last year, but sometimes it feels like he’s still trapped in the fear of his past.”

Andy joins in, his tone softening. “Zoba’s been labeled ‘aggressive’ by six vets. But at home, he’s gentle. Maybe someone misread him once, and every vet since just followed that label.”

Toby chuckles ruefully. “Try living with Maggie. She spent eighteen months with a Cuban rescuer, trained in a totally different set of commands. I tell her ‘Stay calm,’ and she barks like I’ve insulted her ancestors.”

Their laughter fades. Beneath it lingers an uncomfortable truth: every story is about misunderstanding. 

What the Dogs Teach Us

Each dog, like each patient, lives in their own world of meanings. Luna doesn’t disobey, she just doesn’t speak human. Milo flinches not at Matt’s hand but at what hands once meant. Zoba bears the invisible burden of a mislabeled file. And Maggie, confused by commands foreign to her, embodies what happens when systems assume understanding is universal.

The inability to see others on their own terms is a tragedy common to all. Small misalignments of signal and meaning can change everything and in healthcare, these tiny fractures in communication can decide life or death.

Communication Breakdown in Healthcare

Now, shift the scene from living rooms to clinics. Replace the pets with patients,those who speak in dialects, gestures, and fears that the health system never learned to interpret.

In underserved communities, communication is often the first, and most devastating, barrier to care. Studies have shown that patients with limited health literacy are twice as likely to misunderstand medication instructions or follow-up plans. Another found that culturally mismatched communication contributes to lower treatment adherence and poorer chronic disease outcomes.

Yet, most health delivery systems are designed around a single, rigid “language”, that of institutional medicine. It is a language that assumes comprehension, flattens nuance, and expects trust to exist, even in places it has never been earned.

Patients, like Luna or Milo, respond not to our instructions but to our tone, our body language, our perceived intent. If they do not “take the pill,” perhaps it is because the system never learned how to ask in their language.

What If the Problem Is Design?

Imagine Zoba’s “aggressive” note as a medical file. A single misinterpretation, written once, that travels with the patient. This is how systemic bias sometimes operates: not through malice, but through replication. Once entered, it becomes the truth.

Or picture Maggie,confused by her rescuer’s language. Now imagine a patient handed an English-only prescription in a rural African community, or a Spanish-speaking mother trying to explain her child’s symptoms to an English-speaking clinician. Every expression, gesture, pause becomes a test of survival.

And today, our healthcare systems, like Toby’s frustrated “Stay calm,” often demand compliance before offering comprehension.

Learning the Patient’s Language

At MGH, our work with culturally rooted medical pictograms begins with a simple principle: communication is care. We design not for translation, but for understanding. Each pictogram, drawn from local visual metaphors, familiar colors, and community-tested symbols, acts as a bridge between the clinician’s science and the patient’s lived reality. We believe empathy can be engineered, not as sentiment, but as system architecture.

To improve healthcare, we must first become better listeners, listeners fluent in silence, gesture, and cultural rhythm. The same humility that helps a person earn a rescued dog’s trust is the humility required to reach patients long alienated by systems that never spoke to them.

Evelyn learned to kneel, not command. Matt learned to speak softly, not assume. Andy questioned the record, not the animal. Toby learned that “stay calm” means different things to different ears.

Healthcare must do the same.

Because healing begins not when we are heard, but when we are understood.

Here’s a glimpse into the medical pictogram library we’re building: