For most people, this painting depicts the heart of medicine. Many doctors and patients today may wistfully yearn for this interaction between the doctor and his young patient. But why is that so? What is conveyed in these dark brushstrokes that has spoken to so many for over 100 years? Even as technology and research have dramatically enhanced our ability to heal, many would say that the doctor patient relationship has been severely compromised. As a practicing Emergency Medicine Physician, I want to start a dialogue with my colleagues as well as with patients regarding the practice of medicine. More specifically, I will express some of my frustrations as well as explore potential solutions as we examine the state of medicine together.