In high school, I learned about humanity’s darkest corners far too early. I came across videos online of people telling stories of unthinkable violence, suffering and cruelty that left me profoundly shaken. I learned about snuff films that glorified murder, stories written by women who experienced sexual violence, and serial killers with sadistic rituals. “How could anyone even fathom committing those acts?” I wondered. “Where is the light I’m supposed to look for in ten people, knowing that if just one of them were capable of such darkness, I would never be able to trust again?” Although these thoughts often weighed me down, I realize now that they were also the catalyst for my professional goals. How could I, someone who wants to help the most at-risk, just spend my days fixing hip joints and sitting in an office?

Then, in college, I worked in an Emergency Department, where I saw the worst of the worst in a hospital. I witnessed a pregnant woman coming in after being assaulted by her partner, children under fifteen years old for gunshot wounds and several patients being rolled in after a mass shooting. I told myself that the “light at the end of the tunnel” was not observing these events, but learning from them. Just then, just maybe, the memories of those victims would not go in vain, as I would become a physician who tries to make sure no one else has to suffer the same fate. However, I knew this dream was overly idealistic and a facade to make sense of the tragedies I witnessed. Like a child who covers their eyes when counting for hide and seek, just to be able to peek through the cracks of their fingers and see everybody as they run away. Deep down, I knew I was only one person, and the job to fix these complex social issues required a culture shift. I did not think the beliefs and efforts of an individual could make a difference. My old acquaintance of overwhelming dread poked its head through yet again.

During medical school, I wanted to properly explore the idea of mortality and what motivated the loved ones of the deceased to keep living. On this journey, I came across John Green’s book Everything is Tuberculosis. The crux of the public health argument presented in the book is that TB is an easily curable disease, yet it remains the leading cause of death outside of the wealthiest countries. Green highlights the irony: the wealthiest countries have access to all of the cures for TB, yet possess a minority of the cases. In contrast, poorer countries have all of the cases, yet are forced to suffer without the cures due to corporate greed and lack of international cooperation. In other words, people do not die from Mycobacterium tuberculosis—they die from poverty and the genetic lottery that determined where they lived.

Although I could go on about how Green makes TB such a fascinating bacterium to study, what stands out most to me is the passion behind it all. It is muted, yet apparent, how furious Green is about the inequity in treatment. He befriends a TB patient named Henry, the same name as his son, whose condition worsens over time and carries a poor prognosis, yet he still finds hope and faith in his cure. How does he do it? When asked why he goes to such great lengths for just one patient,  Henry’s primary doctor responds: “Yes, I know, it’s just one patient. There are so many patients, and Henry is just one. Why should we move mountains to save one patient? Because he is one person. A person, you understand?” 

Although I did not formally recognize it then, Dr. Girum Tefera’s words were ultimately what motivated me toward my vocation during those dark years. In healthcare, it is easy to extrapolate your horrifying experiences to the outside world. The more gruesome cases you see, the less you feel like a shepherd who keeps their sheep in a herd so that they do not become privy to the horrors of the real world. Instead, you become more like one of the sheep themselves, playing your role in a never-ending cycle that has gone on for decades. However,  this sense of powerlessness in an endless cycle is not the whole truth. Improving the life of even just one patient makes the job worth it – even if the system follows suit.

In a later interview with NPR to promote his book, Green shared a perspective that fundamentally changed how I see progress:

“I keep in my wallet a little note that says, ‘The year you graduated from high school, 12 million children died under the age of 5. Last year, fewer than 5 million did.’That progress was not natural. It did not happen because it was always going to happen. It happened because millions and millions of people, hundreds of millions of people, maybe billions of people, came together to make it happen, to make the world safer for children.” (Green, NPR, 2024).

Although the patients I saw in the Emergency Department came in for truly gruesome injuries and in overwhelming quantities, they were not representative of life outside of the hospital. Just because I witnessed senseless deaths due to gang violence, that did not mean there have not been activists fighting to make their neighborhood more peaceful and succeeding. Although there are people in this world who prey on children, there are also those who teach them and make their eyes light up once they discover what they are passionate about. There are partners whose loved ones suffer cardiac arrest on Thanksgiving day, yet who put whatever they had half-cooked in the oven into the freezer, since they could not imagine a life in which their loved one did not get to hear how thankful they are for them over delicious food.

 The answer I have come to realize in facing the horrors of this world—although my younger self would be furious that I came to what seems like an overly simplistic conclusion—is hope. Hope, in my view, is not about seeking lofty goals and setting unreachable expectations, but about assuming that if others support me, laugh with me, and care like me, then there is hope that the world can change for the better. What motivates me now, after seeing an overwhelming number of gunshot wounds, is no longer the reverie of becoming a hero, but the few isolated interactions I had with other patients. Although I may witness atrocious traumas at work, they do not always follow me home, and I can still be a compassionate doctor: one who sees the worst in humanity and the beauty that can arise from its darkness.

I have recently begun applying this philosophy of assuming the best in people in my everyday life. I pay for my friends when they need it because I hope they will do the same for me. I give leftovers from school events to the unhoused people on my way home because I hope they would do the same for me. I offer food or water to a wife who has been sitting with her injured husband in the ER for eight hours without any, because I hope that someone would offer me the same kindness if I were in her position.  Although acting as an optimist while seeing myself as an innate cynic has not always yielded the results I had hoped—friends not paying back, others doing deeds for resume building, and hospital staff treating patients rudely—I still find relief in this practice. In a world where I see the evils as overwhelming, carrying out these actions feels like the only weapon I have in fighting back. 

To hope is not a sign of weakness—it is the most human thing we can do. To hope is risky. It is to know that circumstances are not in your favor, and yet still push on. It is, in fact, one of the most powerful things we can do: to acknowledge the evils in this world and still choose to fight them. Hope is an act of defiance. It is to take arms against whatever powers that be and say that, despite the unjust circumstances they force us to live in, we still fight to shape them into the image of our likeness. To hope is to not to be overwhelmed by the wickedness that precedes and awaits us; it is to see the beauty of life and be reassured that things have gotten better, and will continue to get better, now that we too are part of the fight for progress.