So Much More Than Meets The Eye

black and white image of Holocaust train tracks

An Exchange to Remember

I had a powerful exchange with a patient at the clinic, who came in to be cleared for surgery.

He was going in for a procedure, getting his graft replaced for hemodialysis, and needed an internist to give the ‘ok’. The visit may have begun as routine, but ended as anything but.

To assess his level of functioning, I asked if he was able to climb a few flights of stairs without feeling winded. It was one of the standard set of questions I normally asked in my evaluation prior to surgery.

He looked up at me with a surprised look and I fully expected him to respond in the negative. He was in his 70’s, after all, and on dialysis three times a week.

But instead, I got my answer, exclaimed with his obvious pride:

“Doctor, I ride my bicycle every day, for 10 to 15 miles. I biked from Montreal down to Teaneck, New Jersey just the other day.”

black and white image of hands pausing from writing in a greeting card. In the background, the hands belong to a male wearing a shirt with the image of bicycles on it.

I must have taken a step back in surprise as I did not expect this from the man sitting in front of my eyes. black and white image of an older man with a beard. This image is not of the man who the story was written about. He was elderly and very thin, his skin hung on him like an oversized coat covering a small child, back hunched. Kyphosis, we called it in medicine. He appeared tired, all the weight of the world carried on his pale, drooped shoulders.

But beyond the light that reflected from his eyes, I saw something deep, beyond the surface, though I wasn’t sure yet what it was.

He continued to impress. His vitals signs were superb: blood pressure optimal, pulse better than many of the younger men I had cleared. The exam, other than his nonfunctioning dialysis access, was unremarkable. When I interpreted his EKG later in the visit, I reported that it looked better An eye, close up, is looking straight at the camera.than most 40-year olds who had it done. I told him this.

He smiled, his excitement palpable.

What came next was the surprise, the touching part of the encounter. It had been hidden all along in the depths of his eyes’ twinkle.

His Story

He had been extricated from the country of his birth, Romania, and shipped off to Ukraine, where he was saved by a lone farmer once the Germans came to take them away. He was only 5. His mother had dropped him off there, in the barn where he hid, surviving on potato skins. Miraculously, she made it through the war separately and on her own.The world map is seen in the background, on it lays a notebook open to a page, completely blank, with a pencil laying on top. In front of that are a pair of reading glasses, near magnifying glass, a camera and some photos

His father and step siblings did not fare as well and disappeared, not to be heard from again. He recounted these stories as matters of fact, without displaying much emotion. I asked what he thought of modern day Holocaust denial, and of countries that chose to remove its studies from their curriculum. He turned to me and said:

“I think children need to go there and see for themselves. When you see for yourself, you cannot deny.”

He continued, describing the different concentration camps he visited later in life and started to weep as he recalled the ‘children’s shoes’. This was what really hit him. The piles of children’s shoes.


piles of children's shoes, with al little girl's pair at theforefront


He described the area just outside the crematorium, where the bodies were burned. There, lay a small, pearl bathtub. It had been used by the crematorium director himself to bathe in each day after work, washing off the remains of the day’s burnt flesh, the ash and the dirt.

Again, he cried.

I took a step back, this time in theory, and took my own brief mental survey. My patient was here, waiting for surgery, having gone through so much in his lifetime, and yet not quite ready to give up. The bad experiences of his past did not impact the hope that he seemed to hold for the future. After all, he was there to have his body fixed. He was looking to restore his health, to live through many more years, with the optimism that those years would bring with them a better future than the past he had experienced.

He smiled when he told me about his family. A wife and two children.

An elderly man appears happy, his forehead pressed agaist that of an elderly woman, presumably his wife. They appear in black and white, from the side. She is laughing.

‘Oh, and four grandkids!’ He added, glowing.

I wished him “to 150”, on a twist of a popular Jewish greeting in which we wish life until the age of 120. No, he said, looking tired, that’s too long. “Then to 120,” I quipped. He chuckled and exited the room, leaving behind him the remnants of unforgettable impact.

I never imagined this would come from a standard 20 minute pre-operation clearance visit. It was simply moving and not to be forgotten.

Elie Wiesel quote, "There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest."

Note: permission given by this patient to share his story on this site.

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