“He could have been one of the guys we were fighting!” exclaimed my teammate. He was right—I had a decision to make. It was hot in the desert of Iraq, and after a long day of fighting and caring for our own wounded, I was tired, sweaty, dejected, and covered in blood. But I learned early on as a special operations combat medic, you don’t get to pick when, where, or how your patients come to you. This one had arrived at the entry point of our forward operating base not long after we had returned looking like he’d been through hell.
My Arabic language skills were limited, but I knew he had been shot and was clearly in pain as his blood stained the sand dark red. How he was shot and by whom was left to speculation. Although we had been working with many of the local tribes, he clearly was not from one of them. The truth was, however, in this conflict, good and evil, friend and foe were not always black and white. I was pretty sure this man was living in the gray.
I’d been in Iraq for about 8 months and knew many in the local population sided with whoever appeased them in the moment. I’d also treated many locals who had been seriously injured by ISIS (Islamic State of Iraq and Syria) or those helping ISIS, especially by improvised explosive devices. Could this man have built or even planted one of those devices? I’d seen a lot of people shot, both innocent and combatant. Was he just shooting at us not more than 2 hours ago? There had been lots of attacks made on our base already. If I let him in, would he try to harm us? The questions swirling in my head were interrupted by my teammate: “We have limited supplies already. Are you really going to use what we do have on someone who is probably just going to end up fighting us again, or hurting innocent people?” I didn’t know.
Once again, he was right—our supplies were limited and our distance from any logistical support made it difficult and dangerous to get resupplied. I also couldn’t be certain of this man’s actions prior to his arrival, and I had no clue what they might be once he left. But then again, did that matter? The decision still loomed as the heat remained oppressive in defiance of the setting sun. My back ached under the weight of my body armor. A long night still awaited me. I needed to clean my gear, debrief the recent mission, and prepare for the next mission. I needed some food and some water. But more than anything, I needed to make a choice.
I clearly knew where my teammate stood in all of this, but ultimately it was my decision. To treat or not to treat. What did I even stand to gain? What would my team think of me if I treated this man and he turned out to be an enemy? What would our partner force think if they saw me treating him? I started to feel a mix of anger and sorrow as I thought of the child from earlier today who had just lost his father to ISIS. There was no doubt that the candy I’d given him did nothing to temper his grief. As silly as it may seem, I feared for what that child may think of my actions. If healed, would this man take away more fathers? As I pondered his potential endeavors in the aforementioned gray, I suddenly remembered one of my favorite books, Between Shades of Gray. In it Ruta Sepetys reveals, “love is the most powerful army. Whether love of a friend, love of country, love of God, or even love of enemy, love reveals to us the truly miraculous nature of the human spirit.”
What was the nature of my spirit? Did I possess the moral courage to love this man and treat him with kindness? I realized it didn’t matter if he was friend or foe. It didn’t matter what he’d done or what he may do. All that mattered was that he was my patient. Before me was another human, vulnerable and pleading for help. It wasn’t up to me to decide if he deserved it. It only mattered if I had the ability to give it.
I brought him into my makeshift clinic and started treating his wounds. Despite the language barrier I knew he was trusting in me, and I could tell he knew I would take care of him. Against my avid refusal he left me with his tribal ring. I don’t know its monetary worth, but as I look at it now, I know that it has immense value. It represents a connection between 2 humans from vastly different walks of life. He needed me in his physically low state to provide him with care. I needed him in my moral ambiguity to remind me what is right and important in life. The ring is not encrusted in diamonds nor appealing at its surface, but like true humanism there is no break in its connection.
What he did after that, I’ll never know. What I do know is in the desert of the Middle East I learned that the right decision isn’t always the easiest or most appealing. Our patients don’t need our judgment; they need our help. Even in a world full of pain and suffering, the smallest light still can’t be overtaken by any amount of darkness. There are many who are struggling in the darkness searching for help. Be the light.
2022 Hope Babette Tang Humanism in Healthcare Essay Contest
The Arnold P. Gold Foundation holds an annual essay contest to encourage medical and nursing students to reflect on their experiences and engage in narrative writing. The contest began in 1999 open to medical students and expanded in 2018 to include nursing students. Students are asked to respond to a specific prompt in a 1,000-word essay.
For the 2022 contest, students were asked to use the following quote as inspiration to reflect on humanism in healthcare, drawing from their experiences as an individual or as a member of a healthcare team (doctors, nurses, therapists, patients and families, etc.).
“Creating a connected life begins with the decisions we make in our day-to-day lives. Do we choose to make time for people? Do we show up as our true selves? Do we seek out others with kindness, recognizing the power of service to bring us together?”
—Excerpt from Together: Healing Power of Human Connection in a Sometimes Lonely World by Dr. Vivek Murthy, U.S. Surgeon General and Vilcek-Gold Humanism for Healthcare Award recipient
More than 400 essays were submitted. A distinguished panel of judges, including esteemed healthcare professionals and notable authors, reviewed the submissions. Three winning essays from medical students and three winning essays from nursing students were selected, along with 11 honorable mentions. The winning essays will be published in consecutive issues of Academic Medicine and the Journal of Professional Nursing in the fall/winter of 2022.
The contest is named for Hope Babette Tang-Goodwin, MD, who was an assistant professor of pediatrics and an exemplar of humanism in healthcare. Her approach to medicine combined a boundless enthusiasm for her work, intellectual rigor, and deep compassion for her patients.
The Arnold P. Gold Foundation is a nonprofit organization that champions humanism in healthcare, defined as compassionate, collaborative, and scientifically excellent care. This Gold standard of care embraces all and targets barriers to such care. The Gold Foundation empowers experts, learners, and leaders to together create systems and cultures that support humanistic care for all. Learn more at www.gold-foundation.org.