When I was first paged about Mr. P, I braced myself for the worst. He had already had three “code greys” called—the hospital code for aggressive behavior. When we met him on his hospital bed, he was bound by restraints on his wrists and ankles to protect the staff. He was admitted to the intensive care unit (ICU) for alcohol withdrawal, though the medications used to treat his condition had no effect. Every time I went to his room, he would curse at me. His nurses repeatedly told me how sexist and racist he was. His blood pressure was high, his heart rate fast, and there was concern for how sick he was. Finally, when we gave the patient a powerful anesthetic sedative, he became calm.
Later, when Mr. P awoke at the end of his withdrawal, I found myself facing a man with a subdued smile. I noticed a Calvin and Hobbes tattoo on his arm and asked him about it. He began to tear up. “My childhood friend died. We both grew up loving Calvin and Hobbes. This was our favorite cartoon. It’s when Calvin and Hobbes are looking into the clear blue sky and reflecting on how perfect the view seemed, but Calvin runs out and grabs a red balloon to bring it into view. The point was that everything is better with a little color… thank you for helping me.”
We admitted another man, Mr. A, who came in bleeding from his colon. He was quite somnolent as we sought to stabilize him. A few days later, when he had been stabilized and his mental status had improved, I found Mr. A in tears. I asked him what was wrong, but they were tears of joy. “I’ve had a spiritual experience,” he said. “I never before realized how life is a miracle.”
Mr. A shared with me that he had previously been imprisoned earlier in his life but felt a sudden connection with God to live a new life. There were local community organizations that he now felt a calling to volunteer at.
“I made many mistakes before earlier in my life… but it’s clear to me now. I know why I am alive and why I was placed on this earth.” He continued to sob, but now more uncontrollably than before. “I am here to help other people.”
It was quite moving to bear witness to such an emotional catharsis in a patient.
“I know why I was allowed to live now and given a second chance at life,” he paused, taking a breath. “I just hope my body can still support me; it’s so weak. I still have a lot to offer to this world.”
Medical residency has shown me the power of the medicines we can offer to people, how we can stabilize and resuscitate even the sickest of patients. It is a joy as a physician to witness the human body recover after such a shock.
At the same time, at these critical moments when life can hang in its precipice, a window opens to parts of the human soul we may have never recognized before. At our best, we not only have the chance to save someone’s life but also live up to the ideals of our profession by potentially changing the trajectory of another human being’s life, and in some sense, truly making the world a better place.
I always wondered since my pediatrics rotation, how do children, who can be so sincere, genuine, selfless, and courageous in their expressions of joy and love, evolve over time to become adults who become hardened and stoic—and at their worst, so cruel and selfish? I always wondered if that element of humanity, which we see itself manifested so evidently in children, disappears as an indifferent fate, and as the realities of survival and competition come into play.
But maybe, after witnessing such intensely dramatic patient encounters, that side is not fully gone; rather, it remains dormant and needs something as drastic as a near-death experience to bring it back out—as a reminder of what life and living are really about.
Johnathan Yao is an internal medicine resident.