Mark Bernstein
Cell 2 Soul. 2005 Winter; 1(4):a1
How much is $250 worth? To me, to you, or to another? Maybe it's just the memory it buys. Maybe it's a relatively cheap investment in feeling we've done a good thing.
It was 1985. I had finished my arduous residency training in neurosurgery and had recently started on staff at a large teaching hospital. I was bright-eyed and bushy-tailed, brimming with idealism and naiveté.
One of the surgical patients in my first six months was a lovely man, an immigrant from another country where he was an academic. He sounded like it, too. Although he spoke with a thick accent, his grammar was impeccable and his vocabulary elegant. Here in his new chosen home, the land of opportunity, he was forced to do menial work. His medical condition required a complex operation for a benign condition. As his surgeon, I was happy with a good outcome.
There were one or two routine post-operative visits. Then, many months later, he requested an appointment with me. I feared he was returning due to complications from the surgery. However, he walked into my office looking just fine. He stood straight and tall and was as well-dressed as usual. His beard was perfectly trimmed, as always.
I don't recall the exact words we exchanged, but I do recall the situation. I can clearly see him sitting across the desk from me. He was in some kind of jam and needed some urgent financial help, short-term, one-time. As he made his request, he seemed to be much less uncomfortable than I imagined I would have been had our situations been reversed. He did not divulge any details and I did not think it my place to ask. I don't recall the words "loan" or "borrow" being used by either of us. He did not specify an amount. I asked him to return to my office in a week.
I did not want to ask a senior colleague for advice as I certainly knew what the answer would be. So I presented the dilemma to my wife. Not only was she my best friend and most trusted advisor, she was also the one person who could possibly have a stake in my decision. I was just starting a job, my earnings were modest, we had debts, and our third child was on the way. She told me I should do whatever was in my heart. While that was great advice, I had conflicting feelings in my heart. My instincts as a person told me to reach out to this man and help him. My instincts as a health care professional screamed, "Are you mad? What if he has a major complication and you become an accomplice? Get your boundaries straight, dude!" I slept on it for a few days.
I was aware of boundary issues with patients. Yet, something about this man and his situation touched me and compelled me. I felt that he was honest and decent beyond question. He was in need and I was apparently the only person to whom he felt he could turn. The day he returned to the clinic I locked the office door and handed him $250 in cash. I have no idea how I arrived at that amount. He thanked me and walked out. I made no documentation on his chart or anywhere else, and there was no cheque. The transaction was untraceable and did not exist except in his mind and mine.
I don't know if I did it to be truly philanthropic or if I was just afraid of how I would feel about myself if I denied his request. Over the months and years, I never expected or received either reimbursement or any news from him.
Why am I writing about this now? Over the last two decades, my wife and I raised three wonderful daughters and several canines. We have enjoyed our cottage and have traveled the world. I continue to enjoy an amazingly stimulating and satisfying career in academic neurosurgery. During this time, I have occasionally thought of this patient.
And then, twenty years later, I saw him. I was driving alone on a beautiful evening week night in an ethnic community rife with atmosphere. He was walking along the street and then running for a streetcar, which slowed to allow him to board. There was no mistaking him — the same noble stature, the same handsome face, the same immaculate clothes. His beard was trimmed exactly as twenty years ago, now with an odd streak of gray in it.
I was behind the streetcar and stayed close, following it. At each stop I looked to see who disembarked. After about ten stops, he got off. He paused briefly on the sidewalk to talk with an acquaintance. I pulled over to the curb about 10 metres ahead of him. I turned my head and watched. I wanted to talk to him, to ask about his life, to make sure he was alright. I felt I had made some kind of investment in him many years before and was somehow responsible.
I watched him walk away and I drove on. I could not bring myself to get out of my truck and approach him. I felt that, when he recalled who I was, he might feel embarrassed. Again, just as twenty years earlier, I don't know if my decision was out of kindness for him or to protect myself from potential discomfort. I drove home.