On Loving Strangers (Patients and Otherwise)

By Bahar Orang

When I was a little girl, I’d often go on long walks with my parents. They would talk to each other, and I’d quietly stroll along beside them, utterly distracted by all the passing strangers on the streets. I’d reach out, silently, solemnly, to every single one – keen to move and be moved by them. I always returned home with a strange, searing sadness in my heart: why had they entered my life so briefly? What was the purpose of so ephemeral a shared moment – so incomplete a connection? And I was deeply concerned about how I could possibly cope with a lifetime of unfinished, transient relationships. How does one carry on knowing that the earth is so vast and so messy that finding and feeling each other will always be a struggle, that our lives are too short to love as much and as many times as we’d like, and that we develop deep and sustainable intimacy rarely, and against all odds?

As a medical student, I ask these questions with more urgency and anguish than ever. Recently, in one short afternoon, I met five newborn babies. Have you ever listened, closely and completely, to the sound of a baby’s heartbeat? Their hearts beat quick and relentless – light and buoyant as short, sweet rhyme. Have you ever held a baby’s stare? They are fierce and bold; they don’t look away. And to cradle a baby, to stretch out her little legs, and to feel her soft head, is an exercise in profound gentleness, a practice of tending to another’s incredible vulnerability. But those babies came and went, not unlike strangers passing me on the street. I likely won’t see them again, and after they had left with their mothers, I waited wistfully in the clinic for the next person, each time grateful for the shared moment with the previous patient, but also heartbroken that it was already relegated to some fading, winding, inaccessible past.

I once believed that a loophole to this inescapable brevity was books – literature. I can embrace a book over and over, it remains intact and whole no matter how long I have spent away from it, and each time it opens itself up to me like foliage reaching for sunlight – honestly and shamelessly. Every time I reread a book, I find the universe generous, for I am afforded yet another chance to relive, to remember, to return, to redo. I take comfort in my library – I can envelop and be enveloped by my books again and again, as frequently and as absolutely as I need.

Rereading a book, returning to a painting, replaying a record are all indeed palliative magic for the painful melancholy of unactualized love, for the aching angst of existential crisis. The possibility of rediscovering a familiar art is like a breath of air amid the stifling grief of loss, the painful anticipation of loss. I am thankful everyday that at night, before sleeping, I can reread the same poem I read in the morning, just after waking. Maybe it’s simply a matter of slowness; our rapid-paced, consumer-based culture leaves little room for poetry, which should be reread slowly, carefully, thoughtfully.

But in medical school, reading has not always been enough. Everything feels so unstable these days – even the strength of story, the permanence of poetry, is subject to my feelings of bitterness and impatience. The days move so briskly, the work is so insoluble, and there is such little room to stray from accepted modes of thinking and feeling – that I find myself longing for a solace that is more vital, something that can be more immediately held and touched.

Medical school homogenizes, standardizes, and objectifies people – and my only irrational, anxious rejoinder has been to feel, too often and too much. In one case, I became unwisely attached to the nearest person, another student. They are entirely wrong for me, but we both know the throes of medicine, we both know the isolation and the fear, and they too want to hold and be held and feel something other than insecurity. We’ve spent many a quiet, tired night trying to understand that delicate thing, the heart – its steady strength, its elegant intuition, but also how swiftly and suddenly it can fall apart into a weak, withholding organ. We’ve talked, at length and in detail, about the fierce but fallible body, about a body that beats on, against every current, despite its fundamental ephemerality. We’ve sat across from each other, in coffee shops and in class, wondering silently and out loud – what of the moment when we, who sometimes think the same strange thoughts, go in different ways? What of that forthcoming pain, and how foolish is it to keep on like this, finding more things about each other to cherish and to savor? And the deeper we go into love and medicine, questions about our passing encounter become more and more entwined with questions about mortality. Because we don’t just enter each other’s lives briefly, but we’re also, here, like this, alive – beating heart and shifting lungs – briefly, too. How do we understand this most final, enduring loss of all?

I insist that medicine, in its purest, most powerful form is a radical, repeating act of love. You must consciously and devotedly decide that each person who enters your clinic is infinitely valuable and worthy of your fervent, flawed care. This posture calls for love: you must love all the strangers that you meet. And love takes tenderness, openness – you give all of yourself, most of yourself. But loving is severely at odds with nearly everything about the systems in which we live and work. We numb and repress because emotionality is deemed weak; we forgo deep connections with others because the individual is ultimate; we retreat and recoil at the possibility of drastic change within ourselves because the paths of least resistance are so clear and consistent; we suffer in loneliness since we’ve been told that intimacy should only be felt through (certain kinds of) sex; and we die in agony and amid existential terror because we’ve been far too busy all our lives to pause for love or to think genuinely about loss.

In medical school, we are taught that professionalism calls for stable emotional boundaries. We are told that maintaining a particular emotional distance is the ethical way – that striving for intersubjectivity (for love!) between patient and doctor is neither necessary nor advisable (it is too volatile, too indefinable, too inappropriate).

How then, in this social, political context, do we have the courage to love, to lose, and to reconcile the necessity of love with the inevitability of loss? How do we love over and over, knowing that those whom we love – patients and otherwise – are simply brushing shoulders with us, meeting our eyes for just a moment, before continuing on their ways? Our meetings are so transitory, our bodies so fragile, that as I listen to a patient’s story, or count a patient’s breaths, or internalize a lover’s traumas, or fall asleep against the rise and fall of a lover’s chest – I ask, I need to know: why do I care so much, why do I care at all, if they’ll be gone today, tomorrow, or soon enough?

I feel, but then I can’t move on; I can’t let go. I feel, but then I struggle to recover; I struggle to accept the brevity of everything, everyone. In medicine, where death is daily, and failed or fleeting intimacy is frequent, it’s that much harder to have the courage to feel again, to fall again.

And yet, it’s one of our most powerful, most burning forms of resistance: to love, to love, to love.  To love warmly and softly, even when everything is harsh and cold. To love generously and indiscriminately, despite knowing that some people will walk away. To love firmly and fiercely in the face of death, in the face of complete ambiguity. I still have many unanswered questions and I foresee many more heartbreaks, but I refuse to be shamed into unfeeling, to be devastated into unthinking. Because perhaps such restraint is not the natural order of things after all – perhaps overthinking and overfeeling inspire us to reimagine a world where community matters most, where intimacy is everywhere, and where all life is inherently valuable. I choose instead to politicize my capacity for love – in the clinic and elsewhere. I choose instead to listen and attend to my longing to love and be loved by all the strangers who pass me in the hospital corridors, the lecture halls, and on the ceaseless streets.

Bahar Orang is a first year medical student at McMaster University. She holds an MA in Comparative Literature and a BASc in Arts & Science, and is passionate about women’s health and narrative medicine. She is currently reading “Bluets” by Maggie Nelson.