February 24, 1991, and I wait. I wait on the edge of my cot under the pitched canopy of my far-away canvas home; its sides pulsating from the ever-present wind; sand somehow traversing the walls, everything inside airbrushed a pastel tan; outside the surrounding Saudi Arabian desert limitless in all directions. The winds of war have been blowing, and the time has come. There are 10 of us ...

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I am a veteran. My father and all three of my brothers are veterans. I have been to war, separated from my family, with the danger real, living in the desert, in a tent with the sand blowing through the walls, sleeping on a cot with cardboard boxes for furniture. I know how it feels to lay on that cot, in the darkness, missing your family so badly ...

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He reminded me of a pit bull, this sometimes cantankerous but always fascinating World War II veteran. We first met in 1992, shortly after I arrived in Burlington following my years in the Army. Chronologically he was in his early 70s, but physiologically he was years younger. Square-jawed, short and stocky with broad shoulders, and muscular, tattooed arms, I easily envisioned a once physically imposing, rakishly handsome, young man. For ...

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He was in his 30s, strikingly handsome with the short-cropped hair of a soldier. This was Ukraine, and it was at war with Russia. He was now part of that war, a war the rest of the world has forgotten or no longer cares about, even as its’ young men continued to fight and die in the horror that is the front-line. His unit’s chaplain asked me to see him ...

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The cab driver pulled up to a small house, typical of the post – WWII era. He honked his horn and waited. He honked a second time, but no one came. He contemplated leaving, as it was near the end of his shift, but decided to go knock on the door. Through the door, he heard a voice and something scraping across the floor. The door slowly opened ...

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“How long have you been married?” The question came from a young woman kneeling down by the elevator in the hotel where my wife and I were staying while in Seattle. We were there to celebrate our 40th wedding anniversary with an Alaskan cruise. I hadn’t even noticed her as my wife and I were busy talking about the day. She appeared to be in her twenties. Her appearance was that of ...

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“The only end to pain is the graveyard.” Those words are etched forever in my mind. They underscore the hopelessness of so many throughout the world. She was 90 years old, crippled by arthritis, no family, and lived alone in a dirt floor hovel with no electricity or running water. She lived in a tiny village of 2000 people in the poorest country in Europe, Moldova. She lived every day without ...

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 In today’s increasingly technological, data-driven, depersonalized world of health care, I wonder if the concept of “a good death” is even possible. The COVID-19 pandemic, in particular, has caused me to reflect on this. What does it look like? How do you define it? As I did, a patient came to mind. He was a retired minister in his 80s. I had cared for his wife as well ...

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I recently saw a powerful video about an amazing nurse who is a foster mother to children dying of cancer. She lovingly cared for them no matter the circumstance, the difficulties, or the heartbreak that came with each and every death of one of these precious children. It broke my heart to see and hear. It caused me to reflect on how fortunate we are to have people with hearts ...

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“Will I ever get better, Andrew?” my mother asked. She laid in bed, too weak to sit up, unable to eat, her myelofibrosis in the final stages of its relentless course. Her question stunned me – did she not know she was dying? How could she not? Was she in complete denial? Was she simply grasping for a final chance at hope when all seemed hopeless? Reality quickly set in, ...

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Have you ever found yourself with a patient not knowing what to say or do? Maybe you just told them they had cancer or that the last treatment option had failed or a loved one had died. I have, many times, and I always felt helpless, inept, and alone while doubting my abilities as a physician. Medical school had not prepared me for this. I learned firsthand, one difficult, and ...

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It was a beautiful Spring day. My wife and I were returning from UNC-Chapel Hill after visiting our oldest son. Driving on Highway 54, I suddenly saw a young woman on the left side of the road frantically waving her arms and screaming. Behind her, a pickup truck had crashed into a tree. I immediately stopped the car. That's when I saw him. Lying, unmoving, on his back was a ...

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I rounded recently on a 100-year-old veteran of the Battle of the Bulge. It was a terrible and costly battle fought in Belgium during the winter of 1945, the coldest and snowiest in memory at that time. The German army made a desperate last stand against an increasingly overwhelming US force. Hundreds of thousands of lives were lost. He was there. He lived it. It is not a forgotten memory ...

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Abraham Verghese’s must-read book, Cutting for Stone, addresses powerfully the human side of medicine. It is a poignant reminder of the sacredness within medicine created by the unique bond that is the doctor-patient relationship. We are allowed into that most intimate space, the life of a person at their most vulnerable and frightened time. In the book, a prominent surgeon reads a letter to the house staff from a grieving mother. ...

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She reached for my hand, her hands gnarled, the skin fragile, translucent, road mapped by bluish veins: Hands that had done much in her 87 years. She looked at me from her hospital bed and with voice trembling, her eyes tearing, spoke words that penetrated my heart: “Can I stay here? Everyone is so kind. I am all alone now. I have no family or friends left. I have no ...

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His breathing was rapid and shallow; O2 in place, his eyes stared at the ceiling of the hospital room. He was a soldier in his late 20s, his once strong body now emaciated, a shell of its former self. His arms rested on top of the bedsheet, bluish nodular lesions of Kaposi’s sarcoma landscaping them as they did the rest of his body. His lungs a “white-out” on X-ray as ...

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I have cared for them both, husband and wife, now in their 80s, for almost 20 years. She is a retired nurse and him from his business. They are so typical of this “greatest generation”: tough, enduring, hard-working, deeply faithful, fervently independent, those characteristics that allowed them to survive the Great Depression, World War II, and the many challenges that come with life. They have seen their share of joy ...

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Three straws held in hand, each a different length, a decision to be made. It was September 1990. The hospital commander held them, so they appeared equal in length. The instructions were simple: The long one wins. The consequences, though, were not: separation from family, physical and emotional hardship, possible injury, and even death. There were three of us, Army physicians assigned to the hospital at Fort Campbell, Kentucky. We ...

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I have had the privilege to serve alongside hundreds of nurses in the nearly 40 years since I started medical school. This includes inpatient and outpatient settings and 20 years of leading medical missions around the world. There are five amazing nurses in my family as well. I have learned from every nurse with whom I have served. This has made me a more compassionate, caring, and empathetic person, and ...

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