He stood at the window, gazing out into the bleak, foggy morning. His fingers slowly traced words and symbols on the frost and then quickly wiped them away. His hands looked different he noted—the skin like tissue paper, thin and crisscrossed with fine lines. His veins raised and pulsing. He clenched his fist, wincing at the stiffness. He couldn’t remember when his hands changed. When they were last full and firm, strong enough to pick and throw and grab and twist.
With a sigh he picked up his steaming mug of tea, hands trembling slightly as he brought it to his lips. He felt restless, as if there were much work to be done, and he didn’t know where to start. If he had been at home, he would have slipped his calloused feet into worn rubber slippers and walked down towards the stream on the well-known path, stopping to peek at the cuttings he had planted last week and to stretch as the muggy sunlight washed over his face. His heart would have beat strongly and steadily, without the flutter that now concerned him.
It was his heart that brought him here, to this place where the sun was white and weak, unable to chase away the morning chills. His daughters wanted him close, to watch over him, to care for him. Next time he would not be so lucky, they said. What if the boy who delivered the morning milk had not taken the back path to the house that day? What if the boy had not seen him collapsed and cried out so loud that the field hands had come running?
But he wondered if it would have been better if he stood firm and didn’t get on that plane to come this country. This country was strange. Its people ran around during the day, and then cooped up in their houses as soon as the light faded. They were always “so busy.” He missed walking to town, stopping to chat with his neighbors, having a glass of tea from the corner store, letting time pass slowly. Here, he was invisible. Back there, not one would go by without stopping to say hello, to ask after his health, to update him on their lives. Here, he was just an old man, slightly stooped, frail, foreign. There, he was the old schoolmaster, commanding respect from the generations he had guided from adolescence to adulthood.
Here, his doctors told him to rest his heart. Not to strain himself. Or rather, they told this to his daughters. They glanced at his weathered scowl and then back to their screens and spoke only to his children. They learned of his recent arrival status and decided that he couldn’t understand them. If they took a minute to look into his face and a moment to ask his thoughts, he would have surprised them with his nuanced command of the English language. They dressed him in thin paper gowns that left him vulnerable and ashamed. They poked and prodded but did not appreciate the story of diligence and hard labor written on his sinewed body. They gave him pills that made his stomach churn, but he never told them because they never asked and his daughters looked relieved to have found a cure. They said his heart was healing well, but they never asked if his heart was happy.
He noticed his daughters’ whispers. They talked about his heart, but it wasn’t his heart that made him restless and chased away his sleep. He missed knowing his place, missing knowing what he had to do each morning. He drew away from the unfamiliar faces, the unrecognizing stares, the treeless, dirtless metal and concrete streets. He longed for his roots. He was sad and lonely, even with his daughters around him. He missed his wife’s presence in the home they had built. He hated that his home was shuttered closed and watched over only by strangers.
And so when his heart began to flutter again, when he felt that squeeze that caught his breath, he didn’t say much. Because he knew that a few more pills wouldn’t fix him. That his thoughts were no longer here but back there. That he was satisfied with this life. That his final goal was a simple one, to make sure that his daughters didn’t worry.
Founder and Editor-in-Chief Emeritus
Albany Medical College
My name is Aleena Paul, and I am one of the founders of in-Training. I am currently a General Internal Medicine and Academic General Pediatrics Fellow at Hofstra/Northwell Health, where I am pursuing a Masters in Health Professions Education. My research interests include the use of the humanities for medical education, women's leadership in medicine, addressing health disparities through advocacy, and providing quality primary care medicine. I graduated from Albany Medical College in 2016 and subsequently completed a combined internal medicine and pediatrics residency at the University of Massachusetts Medical School.
I currently serve as the editor-in-chief for in-House, the online publication for residents and fellows, and as a founding member of Pager Publications, a 501c3 non-profit literary corporation that curates and supports peer-edited publications for the medical education community.
In my free time, I enjoy skimming through The New Yorker, catching up on science fiction shows, wandering through museums and forests, and long conversations with friends.
