April 2026

I’d lost my glasses. They were replaceable, yet I struggled more than I expected. The struggle was invisible—quiet, constant, easily overlooked. I found myself apologizing often. But amid the blur, I started to see the world in unexpected ways.

I had previously recognized my coworkers by their faces, their bright smiles across the hallway. Without my glasses, I relied on their essence—the way they laughed, walked, and carried themselves. I couldn’t make out their features, but I could recognize their energy: a familiar skip, a distinctive sway of a white coat, a certain laugh echoing down the hall; these became my cues.

When people talk about “guts” in medicine, they often mean the dramatic moments. The resuscitation. The difficult diagnosis. The decision that carries obvious weight.

But the moments that stay with me look different. I think of patients who return after a period of absence. They sit down, hesitant, unsure where to begin, and say something simple: “I didn’t think I would make it here today.”

His naked, dirt-caked foot draws closer, each step accompanied by strained, raspy breathing. He’s missing a shoe, and his ragged clothes offer little to no protection from the elements. His face is gaunt and hollow, his cheeks hardened by the passage of years.

His eyes appear drawn to our black van, painted with bold red lettering: Chi-Care, Serving Humanity on Our Streets. Onboard the van, among other volunteers, I watch him approaching.

The rat-infested underpass the van is parked in reeks of mold and rot and is littered with makeshift tents. As he comes closer, his eyes remain downcast.

“Water,” he croaks.

It takes guts to show up for your medical appointment and meet a new provider about whom you know nothing. Perhaps this one will stay longer than the last three primary care providers you have been assigned. Perhaps this provider will use your correct name and pronouns and will not deadname or misgender you. Perhaps this PCP will not dwell on the fact that you are trans when gender identity is irrelevant to your chief complaint. Perhaps you will not be asked the dates of your last menstrual period when you were born without a uterus. Or, perhaps support staff will think twice before asking about menses, as the word “menstrual” triggers dysphoric feelings, and you have had breakthrough bleeding when you’ve been unable to obtain a testosterone prescription.

My son is at the sink washing wet, sticky tissue paper off his hands (a four-year-old’s experiment).

I flash back to his surgeon’s voice saying that a preemie’s intestines are like wet tissue paper.

The surgeon repeats this phrase as she explains the exploratory intestinal surgery she would be performing. She describes the process with confidence, as I sit there thinking it might be easy to sew wet tissue paper back together.

While most 16-year-olds have parties to celebrate turning “Sweet Sixteen,” my memories of that birthday are of a disinfectant-varnished hospital.

One morning while I was studying physics, my observant surgeon-dad said, “Let’s look at your neck.” I thought it an odd request. “You have a thyroid mass,” he said. Within moments, I was weighing treatment options. Ironically, my dad’s thesis during his surgical residency was on thyroid disease: one of life’s wry twists.

My first thought was “Is this cancer? Will I be dead by 17?”

As I think back on that morning over 40 years ago, I’m pretty sure he was a medical student. I had come to the clinic weeks before after experiencing a sharp, intermittent pain in my stomach; I’d felt sure it was something that needed to be fixed. In part because I was attending a university with a well-known medical school, I’d been offered several tests to try to figure out what was wrong. All of the results were negative.

So now I found myself sitting across a table from a medical student who still had all of his curiosity and empathy intact. “Tell me a little about your life,” he said.