2023

Having a purpose in life is as critical to one’s well-being as food and shelter. I’ve learned, over my 25 years of doctoring, that a sense of purpose both helps us develop our identity—our sense of self—and connects us to something greater than ourselves.

I knew the private room at the busy teaching hospital was a rare luxury.

I had spent the entire day having invasive and uncomfortable tests; I was in the hospital because my left kidney had been partially destroyed by an interventional radiologist who had failed to distinguish between a renal cyst and a renal diverticulum. Thus my left kidney had been ablated with alcohol—twice. I was in pain, infected, and bleeding internally.

“From dust we came, and to dust we shall return,” she whispered to me. Her face brightened up her compact 80-square-foot room. I held her hand, decorated with jewels from all around the world. She had just been transferred here from another memory care facility, and I’d decided to sit down with her every Sunday. Stacked in her lap were a Bible, a devotional book, and a journal. “What do you write in there?” I asked, pointing to the beaded journal.

I feel like a salmon swimming upstream, constantly fighting the current: the current of a system designed to dehumanize students, residents, and patients—a system in which “health” and “care” are often afterthoughts, while profits and media image take precedence.

“Are you going to leave me?” my ninety-year-old patient asks me during our home visit. I was summoned because she’s been pressing the call button on her wrist every hour. An overworked nurse in her assisted living sent an exasperated fax, mentioning that all vital signs are stable, no physical symptoms, but the patient complains of “being uncomfortable.” Anxiety is a diagnosis of exclusion I’ve come to exclude.

Lights from the city shade the stars as he awaits the dark. When the maze of stars appears, the distraction and solace eases his pain. Life outside with all of its hazards suits him, feels safer, closer to who he is than any homeless shelter.

After all, he is a survivor, and solitude is a comfort and a path. Flashbacks of Vietnam he can’t shake. It’s easier alone, less shame. The struggle a way of life now.

He was a spy, or so we thought. He had traveled the world, spoke eight languages fluently, and knew much more about world affairs than your average Joe. He was a typical COVID patient—jolly, no apparent breathing difficulties, just a slight fever three days ago and a positive test. He came to the emergency department (ED) because he had a blood oxygen saturation reading of 88% at home, later determined to be 90% in the ED. We also saw the much-feared blurry white patches on his chest X-ray.

Dear Pulse readers,

One autumn evening when I was twenty-two years old, I boarded a bus in New York’s Port Authority bus terminal and headed off with my guitar. Dreams of musical success swirled in my head–new songs I would write, places I would perform–and beckoned me forward.

Over the next several months, I pulled into towns where I knew no one (Columbus, Indianapolis, Cincinnati) and took up a solitary existence. I’d find a cheap place to stay and spend my days alone, waiting for inspiration to strike, practicing the guitar and scoping out places I might play.