"The Visitor"
By Dr. Paul Berman
It was quiet and dark in the library with one lamp lit at the end of the table to read by. This was my place to escape the pressure and stress of the hospital and I had made it a nightly habit to come and sit quietly reviewing the day’s work and catching up on the news both medially and socially. My phone was the only thing that attached me to the outside world, but I put it on vibrate so it would not break the silence of the room. Here I could be alone with my thoughts and love of books.
The Library was usually empty at this time of night, most of my colleagues taking the break time to nap before the next rush of patients. But this evening was different, I became aware of another person in the room, a bearded old man sitting at the end of the table. He didn’t seem to move. I thought he was reading without a light, sleeping or, god help me, dead!
But he looked familiar. Was he an old staff member? I am sure that I had seen him somewhere. How did he get in the library? I just could not place him. Was he a former professor of mine or a patient? He stared straight ahead at the stacks of books seemingly unaware of my presence. I watched him and finally decided to introduce myself. I walked over and said hello. He turned and looked at me smiling and called me by my name. How did he know who I was? Are you reading history he asked? I answered: “history of medicine.” I told him this library contains not only up to date resources but voices of the past, like Hippocrates and Galen whose precepts about “mal air” guided the profession well into the late 19th century. I mentioned Pasteur who showed that those little “bugs” under the microscope could cause human disease. I was on a roll and noted that there was also Harvey’s work on blood flow; Sydenham’s description of diseases like gout, scarlet fever, measles and cholera. He emphasized “observation and experience” something we sometimes forget in this technical age. There was Auenbrugger who developed percussion, Laennec the stethoscope, Louis analysis, Austin Flint who grew up in a town near me and founded Buffalo Medical School and wrote a wonderful book on medicine and Osler who can forget Osler. It is so important to understand where we as physicians came from, how we got to this level of sophistication. Knowing our history is important, like knowing the history of our patient.”
The man listened to my discourse and at the end simply said: “Osler, hmmmm wasn’t that the man who stated: "the practice of medicine is an art based on science.” I was surprised, that was one of Osler’s famous aphorisms from a lecture he gave to students. Yes, I said, a great lesson as important today as when Osler stated it years ago. Especially now with our scans and robots we seem to be losing the sense of caring for the person. We are cracking the gene which promises great things, but the cost will be prohibitive, what I like to call “commercial eugenics”. Only the rich will be able to afford that care. We seem to forget that our science contains lots of uncertainties which still require judgement and yes, experience. The art is as important as the science, maybe more so as we learn more and more about less and less. He laughed and said: “remember….” But was cut off when my phone suddenly lit up, “ICU-Stat”. I am a critical care specialist. I wanted to stay and continue our conversation, but the hospital was calling. I turned to tell him I had to go and regretted not being able to continue our conversation, but he was no longer at the end of the table, he had disappeared. I heard no footsteps, no door closing, nothing. Had it been a dream? Had he really been there? Who was---the visitor.
