It was, perhaps, an unlikely place to begin my clinical career.

Shortly after starting medical school, I began volunteering in the hospice unit of my academic medical center. 

The first few visits, I relegated myself to fairly banal activities. I shredded old medical records or did a load of laundry for a family unable to carry out such basic tasks as they waited anxiously by a loved one’s side. 

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Over time, as I became more familiar with hospice procedures, I engaged with families, sat with the dying and comforted the staff—such as one time when I helped a nurse prepare a newly deceased body. When we zipped the bag closed, she crouched in a corner and started to cry.

Caring for people in a medical setting was new to me. Everything seemed so fresh and pure.  I was eager for the chance to graduate from the hospice unit and tackle my first home patient. Unfortunately, the day before this was to happen, my prospective patient fell and was brought to the unit. I visited him briefly before he died, and bought him a bottle of white wine for his last meal.

A few weeks later, another home patient requested a volunteer. I walked through a brisk winter day, passed crowded city sidewalks and stopped short of his building. My first home patient!

Ralph was an octogenarian dying of prostate cancer.  His wife had passed years before, and he had no children or close family. Addressing his daily needs fell to a handful of caretakers who worked in shifts feeding and bathing him, arranging his personal affairs and keeping him company.  My shift was Thursday afternoons.  Usually, we would talk for an hour before he tired.  Then, as he settled in for a nap, I would run across the street and buy groceries to stock his pantry.

Sometimes, we walked down the hallway towards the elevator.  He was a poet, and we talked about a wide range of topics above the rattle of his walker and tentative footsteps.

My class schedule was brisk and I had begun my clinical responsibilities.  I was worried that the hectic, high-pressure process of medical education was somehow diminishing my humanity.  I feared that so much focus on academic knowledge and the depersonalization of doctoring, while smoothing out the rough edges of my youth and inexperience, was making me bland and less in touch with both my future patients and myself.  But Ralph, trampling me with his walker, gradually replaced my rough edges with something just as valuable as what I was learning in my classes.

One morning I woke to the realization that I would no longer hear Ralph’s shuffling footsteps or that creaky old walker. Ralph had died.

I still think of him occasionally and marvel at how inspiring it felt to be engaged in taking care of each other.

Now, decades into my career as a physician and after all the hurt and pain I have both witnessed and felt, it saddens me  to reflect that I no longer know how to return to that place of awe.

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