I fell, and I didn’t think I’d be able to get back up.
I’m not even sure I wanted to. But I did. Bruised. Broken. Not done.
Outside, I was rough—scarred, dented, not the kind of thing anyone wanted to look at, much less carry home. I wasn’t shiny or firm. I wasn’t fresh. I was a rotten apple.
When we moved to this house, the outdoor space excited us the most, and we were constantly there. It was a first for us, and a luxury where we live. The garden provided an escape that I never had before: the illusion of leaving something behind.
Like everything in life, the novelty of the garden wore off. The gardeners we hired often spent more time there than we did. Perpetually manicured, it remained beautiful, but undisturbed and underappreciated.
This week, our resident clinic was decimated. The interns were out on a “personal week”-the week between first and second year of residency. One of our senior residents was on maternity leave, and the three remaining residents were all taking a “personal day” here and there to a attend a funeral, visit a sick grandmother, etc. My co-preceptor, realizing we would not need two preceptors this week, had taken a few days of vacation. Which left me with two new interns, eager and enthusiastic to learn, and my senior resident on her last day of clinic.
Though I hadn’t been paged and had plenty to do as the hospital’s palliative care attending physician on a busy weekend, I felt drawn to Harold’s room. His daughter was outside, locked in a nurse’s embrace, barely able to speak through her tears; her father had just taken his last breath.
“Don’t go in there right now,” she said to me. “My mom needs to be alone with my dad.”
My computer chimed a familiar DING, and my patient’s face flashed up on the screen. They were seated in their car, parked in the driveway of their grandchildren’s home, before they went inside for a visit. My patient eagerly declared, “Today is the day!” A broad smile graced their face. “I’m ready,” they said.
Susanna came into the U.S. fighting the mosquito-borne viral disease chikungunya. Her thin body, wracked with fever, shivered and fought off the infection; her family back in her home country called around for a PCP who would see her. They found me and scheduled an appointment. I knew the signs and symptoms of chikungunya, and I knew the hard mass I felt in her belly was something else.
She was diagnosed with cancer two days later and started chemotherapy as soon as she recovered from her infection.
In September, I was called back for dermatological surgery after a biopsy on my left calf revealed a severely dysplastic nevus—a result of the hours I spent tanning in the 1990s.
I canceled my morning clinic while I had the procedure. The surgeon took what she needed and stitched me up. The medical assistant put on a bandage and told me to keep the leg elevated for 12 hours.
Five years have passed since the morning of November 8, 2018. As I headed out that day, an unusual cloud formation was developing in the eastern sky, over the foothills of the Sierra Nevada range. My colleagues and I would soon learn a wildfire had been sparked and was engulfing the neighboring communities of Concow and Paradise, California. It would become the state’s most destructive and deadly wildfire, killing eighty-five residents, many of whom died in their cars while attempting to flee.
It starts as a dull sensation just below my rib cage, as if someone is trying to blow up a balloon inside me. Despite the expanding discomfort, I try to focus on my breathing. Without the ability to fully exhale, it’s difficult to calm my nervous system and avoid the dark places my thoughts are taking me: It’s an abdominal aortic aneurysm, gallstone pancreatitis, a perforated ulcer!
Due to the war in the Middle East, my family and I had to cancel a much-anticipated visit to Israel this holiday season. Instead, we decided to fly to Bogota. My late father grew up in Colombia, but I’ve never been there; we hope to visit my great-grandmother’s grave and my father’s old neighborhood.
Given constantly evolving infectious risks, we made an appointment before our departure for my older daughter to visit an infectious diseases specialist. The physician sent prescriptions for acetazolamide (for altitude sickness) and azithromycin (for traveler’s diarrhea) to a local pharmacy—part of the country’s largest chain.
The year 2020 was epic for me—not because of COVID-19, but because my health was being challenged big-time. I’d had a mastectomy in 2017, and a CT scan had revealed a tiny spot on my right lung; my surgeon ordered annual scans to track it—and two and a half years later it had doubled in size. Coincidentally, my gynecologist had been following what she’d diagnosed as fibroids; we talked about a hysterectomy, but it wasn’t urgent.
I tend to be a “cup is half-empty” person. The current situation in the world has deepened my darkness. At night, I hear the traffic from the main street outside my window. I imagine the sound of bombs heightening the noise, and I pull the quilt over my head. My heart aches for all the children, no matter their background, who are suffering—personal injury, loss of relatives, the trauma of separation and the unknown. With each passing day and each new “breaking news” announcement, my despair intensifies.
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