Every medical case, to paraphrase the writer Viet Thanh Nguyen, is lived twice: once in the wards and once in memory. Some of what follows is still intensely vivid, as if it were shot in high-def video. Other parts are blurry — in part because I must have subconsciously deleted or altered the memories. I was 33 then and a senior resident at a hospital in Boston. I had been assigned to the Cardiac Care Unit, a quasi I.C.U. where some of the most acutely ill patients were hospitalized.
In mid-September — it had been a moody, rain-drenched month, as I recall — I admitted a 52-year-old man to the unit. I'll call him by the first letter of his given name, M. As medical interns, we were forewarned by the senior residents not to identify too closely with patients. "A weeping doctor is a useless doctor," a senior once told me. Or: "You cannot do an eye exam if your own eyes are clouded." But M.'s case made it particularly hard. He was a doctor and a scientist — an M.D., a Ph.D., like me. He must have been about 15 years ahead of me in his schooling; I could imagine him returning to my class in med school to teach us "Patient-Doctor," in which students are taught how to deal with real-life patients. He'd trained as a medical resident and then as a fellow in cardiology at another hospital across town. He was now an assistant professor — it seemed like such a victory to have that title — and ran a small laboratory. I knew a student who once worked with him. Six degrees of separation? There was barely one.