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There is much pain, sorrow and sadness in what we do, as much as there is joy, humor and life. We try to prepare for it, categorize it, study it: the wailing grief, the anger-clad hopelessness, the oft-repeated five stages of whatever. We approach it valiantly at times, as a comforter or a quiet listener, an encourager or guide of sorts.

We empathize, we inform, we defend against heated insults, guard our souls and psyche from getting pulled in and laugh and infuse joy wherever we can — but we have a goal: to carry ourselves and others through to the other side, to move through the mire as soon as possible. After all, is that not where the healing is?

Mr. Adams had heart; I will give him that. Presenting for ankle pain, altered mental status and shortness of breath, it quickly became apparent that a far more worrisome picture was being painted with each passing day. Pleural effusion unmasked a mass, which shortly unveiled primary lung cancer with metastases to the liver, brain, spine, kidneys, colon and pelvis: Stage IV, as textbook as it comes.

He wanted to fight though, despite our encouragement to consider palliative care — to be comfortable and experience these final moments as painlessly as he could. This angered him — the idea of just giving up or not at least trying — and there were many mornings where I would sit in the visitor’s chair across from him in his bed while he vented these frustrations. His voice would rise, and a gruffness would take its place. 

“You’re a bunch of vultures — you just want to give up on me! I don’t care what you say. I’m tired of hearing it!” 

I tensed.

How to redirect, how to diffuse … how to offer wisdom and guidance for the end of a journey when I am still in the first few chapters of my own? 

Then he would pause, as the silence slowly, gently settled in around us.

And in those brief moments, as the thunder rolled on elsewhere, there was but the cool drizzle of rain on a lonely gray pond — two souls sitting quietly at its banks. No agenda, no plans, no waiting, hoping or moving. Just there, feet in the soft, damp grass with water lapping at the edges as the rain carried on.


These moments came few and far between, but there was something profound about them: they were places where we could peer into the depths of those dark waters and know that an answer wasn’t coming.

I know the urge to fix. We enter this career, this vocation, as fixers. Even for the Mr. Adams with metastases to every organ on the list, we still want to offer encouragement or counsel, motivation or guidance.  Those things can be good and life-giving on so many occasions. But in this busy world, in this busy career, this day-to-day, moment-to-moment move and go, admit and discharge, diagnose and treat and refer and consult, there is still a place for Still. A place for no answers. A place where that pain and sorrow, that sadness without understanding or words, can simply be. 

Does it fix anything to sit on those banks together and do nothing but feel the rain? I do not know. This is not my pond, this clearing in the forest. I will stand up and leave it behind, moving on far sooner than he will, if he ever does. The truth of the matter remains, however: someday, I will find myself at waters just like this again, gazing into its depths in the stillness between the storms. This time however, it will be my questions left unanswered, apart from one:

Will there be another to sit beside me?

Author’s note: Names have been changed to protect patient privacy.

Image credit: Rain Study 3 (CC BY-SA 2.0) by amandabhslater

Joe Vielbig (1 Posts)

Contributing Writer

University of Oklahoma College of Medicine

Joe Vielbig is a fourth year medical student at the University of Oklahoma College of Medicine in Oklahoma City, OK class of 2023. In 2017, he graduated from Pepperdine University with a Bachelor of Arts in psychology. He enjoys photography, playing keyboard, stargazing, and camping his free time. After graduating medical school, Joe is planning on pursuing a career in Family Medicine.