Just One More Day

“See this dark, black area around the left ventricle.”

He plucked his heart from his chest once again and pointed to an area of prominent discoloration.

“Yea, I see it now.”

“Well you don’t suppose that just happens to everyone, do you?”

“No, you’re right. It looks ischemic to me. Did you have a heart attack?”

“Precisely. Three weeks before my 64th birthday.”

“I’m so sorry.”

“Thanks, kid. I have to say, I’m awfully proud of you and your classmates. I know school isn’t easy, especially during COVID, but your class has been doing one heck of a job.”

“Thanks, but honestly some days it feels like there is just too much to learn. Every lecture we hear about ten new diseases, ten new ways our loved ones could suffer or even pass away. Our treatments and therapies, in comparison, seem so weak. I can’t believe how even in 2021, if our patient gets cancer in their pancreas the best we can do is palliative care.

“You’re not wrong, but you’re ignoring all the progress medicine has made. Sure you guys can’t cure every illness. I’m a living example. Or uh, dead example. But you can help a whole lot. I’m sure I would have kicked the can years earlier if not for what your colleagues had done for me.”

“But what about something like Crohn’s disease? One of my closest friends got it a few years ago and the best we can do is shut down his immune system and pray he doesn’t catch an infection. So much of the time things seem so hopeless, like are we even making a difference?”

“If your friend’s life is better because of the medication, then yes, you, meaning healthcare, are making a difference.”

“And I don’t mean to sound selfish but let’s put aside patients for now. What about us? We’re going to be a quarter of a million dollars in debt by the time we graduate, already four years behind our friends in other industries. Then we’ll grind away a handful of more years working for less than minimum wage, only to become attendings at 29 and find ourselves drowned in paperwork, fighting through red tape, and homicidally enraged at our EHR systems, all while getting reimbursed less for what we do. Sometimes I seriously wonder if it’s worth it.”

I waited for his response. He sat still for a few seconds, saying nothing. Then he took a deep breath in and spoke.

“You ever wonder what a single day is worth in dollars? Just some random, ordinary day if you were to put a price on it. Some people say you can’t put a price on something like that, but that’s bullshit. People make that assessment themselves when they offer to work for someone for $5 an hour, $15 an hour, or $50 an hour. Most people’s days are worth a couple hundred dollars at most. If you’re a surgeon and pull off a surgery that saves 10 years of a person’s life then bam, think about the value you brought back to them.”

He stopped for a second and studied my face. He knew he hadn’t convinced me of anything.

“Look kid, let me say one last thing. The day I had my heart attack, I had taken my granddaughter to the river near our house. In fact, I took her there nearly every day that summer. It’s a small river, no more than 10 feet at its widest. But it’s beautiful, really. Sometimes we’d just sit on the banks and watch the water go by. My granddaughter would ask me questions, questions only a child has the innocence and curiosity to ask. Other times we’d go up close and try to find fish. No matter how many times she spotted one in the water, she would smile and beam with excitement.”

I noticed that he began tearing up. His eyes were far from the glass, life-less objects the other cadavers had. They were real eyes, filled with real tears.

“Do you know what one more day on the river with my granddaughter would be worth to me right now? All the money in the world wouldn’t be enough.”

“I won’t ever get another day with her, and I’ve got to make my peace with that. But as a doctor, you can help your patients get another day with their granddaughters, their families, their friends. You can give them life, opportunity, and time, all through your efforts. Not an infinite amount, and not for everyone, but for a lot of people. Tell me then, is there anything more worthwhile than what your training to become?”

I stood quietly, lost for words.

“I have to get going, kid. I’m sorry we couldn’t go over the other structures. Remember, the ascending colon is on the right, descending is on the left, and the transverse is in the middle.”

He shot me a quick wink and began to lay back down.

“Wait!” I shouted. “Is this real? Or am I just dreaming?”

He paused. Then smiled.

Darshan Kalola MD Class of 2024 Rutgers New Jersey Medical School