I sat with my sparkling water, watching the thin slice of lime rise and fall through the effervescence. Outside the small brunch café, I saw Alex pull up: we hadn’t seen each other since graduating medical school nearly a decade ago. He was in town for a surgery conference. As he walked toward me, his long, deliberate stride unchanged, he broke into his warm smile — the old crow’s feet deepening as he said how good it was to see me.
Some friendships bring you back to an earlier version of yourself, even if you’ve both changed along the way. We bonded over aching joints. I admitted I sometimes wanted an X-ray of my knees, just to confirm the osteophytes I imagined. We promised each other we’d start running again before the new year.
Over burnt coffee, Alex told me, somewhat sheepishly, that he had recently been promoted to assistant professor. He described his new office: quiet, unfamiliar, a retreat from the chaos beyond its door. He had bought a burgundy leather armchair on sale, with a footrest already showing fine, branching cracks. I suggested he add a plant or a picture – something alive. He shook his head sarcastically. “Who would believe I’m a serial plant killer?”
A young woman suddenly appeared beside our table, wide-eyed, as though she’d spotted a celebrity. One of Alex’s interns, she thanked him profusely for the book he’d given the week before, for her birthday. I watched Alex light up, even as he deflected every compliment with a soft, reflexive “No, no.” I told her to make the most of this rotation – Alex had a way of making medicine easy to understand. I could still remember the three-minute pharmacology lecture on proton pump inhibitors he’d given me before an exam. I fist bumped her good luck before she hurried away.
I asked about his mom, Donna. She’d visit us on campus, carrying a container of warm chocolate chip cookies – chewy in a way I could never replicate. He told me he needed to call her back, that she didn’t reach out as much anymore – odd I thought, recalling how close they were. “Last time she asked how I was doing, I changed the subject.” He stared at his plate. “I should visit soon. I should do a lot of things.” I wasn’t sure how to respond, so I nudged us into lighter territory and asked what he’d been doing for fun. He shrugged. A new director role had him working late most nights. Thin Mints had become his closest companions: he bragged how he’d eat them by the sleeve, then fall asleep mid-movie. “Maybe that counts as a hobby,” he said.
He told me his cases had been going smoothly – no surprise – but then he stopped himself. “I missed an Ancef allergy,” he said. “Turns out allergies are real.” He tried to laugh, but it didn’t land. “Thankfully, she was kind. Forgiving, even. She likes me and probably won’t sue.” He shifted the focus back to me, asking about my life. I vented about my ever-expanding Inbasket – like a bad case of nec fasc. That made him smile; he clearly appreciated the analogy. I mentioned a recent trip to Honduras, rich with wildlife: scarlet macaws perched in the trees, like something out of a storybook. I brought it up because he had always wanted kids. Now, he didn’t feel that desire anymore. Not good or bad. Just different. He leaned back, thumb stroking his jaw. “Plus, I’m too old anyway,” he said. “My beard is almost white.”
“It’s salt and pepper,” I corrected him.
He laughed. “Maybe I should color it. I’ve never done anything like that before.”
“If it would make you feel better,” I said, “you should.”
The next day, it was 2:21 p.m. when I swiped my badge and the boom barrier lifted like magic. A few shreds of lettuce fell from my scrub pants as I stepped out of the car – remnants of a hard-shell taco meant to fuel the long shift ahead. I told myself it was fine; at least it was biodegradable. A secure chat message greeted me as I logged in: a new admission, eleven minutes ago. Seeing Ms. Rosa’s name brought a familiar mix of relief and disappointment – because I knew her and what it meant: missed dialysis, not by choice, living alone with no reliable ride.
We had bonded during her month-long admission just weeks earlier, marked by multiple ICU upgrades and several near misses. Even when I was rushed and manic, she greeted me with a smile. She worried about the nurses working late and always wished them a safe return home. One day, she wondered aloud what school might have changed for her, then spoke with pride about the life she had built anyway. The Heberden nodes scattered across her fingers told the story of decades in a garment factory. She raised eight children and had lost her partner of 50-plus years only a few months ago. “I feel more numb from losing him than from losing the leg,” she told me. She kept a marigold by her bedside, tending to it carefully, and proudly showing me each new bud as it appeared. Her son, Roberto, visited often, bringing her grandchildren on weekends or during Thanksgiving break, introducing each one with obvious delight. She would tell me that Roberto carried his father in the way he stood.
When I walked into the ED, there she was – gray hair neatly pulled into a loose bun, somehow always cheerful, her left eye lost to diabetes, yet her vivacious personality made me want to linger. She beamed as she told me she’d been doing her home exercises. The therapist had taught her how to slide onto the bedside commode. “Not exactly an ocean view,” she joked, “but it’s something.” She told me she’d changed her own bed sheets that morning as well. I nearly shrieked. “Ah, let me feel a little useful. I’ve lost my leg, not my manners,” she said. When I complimented her healing stump, she placed her hand over her heart. “Doctora, healing isn’t just the wound. It’s here, too.”
Later that night, the winter wind bit through my bones in the parking lot. The ground was clean – no lettuce left behind. As I drove home on the empty street, I saw only the reflection of my driving arms on the unforgiving glass beside me. For a moment, it almost fooled me – I appeared in control, but my mind told a different story. I thought of Alex: outwardly accomplished, yet quietly unmoored. Rosa – outwardly weakened, yet steady in herself. I made a mental note to call Alex over the weekend. A Rumi quote came to mind: “Where there is ruin, there is hope for a treasure.” Sometimes what medicine builds on the outside costs us on the inside, and it is our patients who show us where that treasure lives.
Patient name and identifying details have been modified to protect privacy.
Dr. Naila Khan is an internal medicine physician practicing in both inpatient and outpatient settings in Southern California. She is passionate about lifelong learning and teaching – from patients as much as from students. She loves the ocean, croissants, soft Urdu music, and finds joy in hearing her loved ones laugh. Dr. Khan is a 2025-2026 Doximity Op-Med Fellow.
Illustration by Diana Connolly
