I mean it is kind of lonely being your doctor. I picture it as sort of a covenant. Between you and I.

On one side you. And your family. And friends. Your house and your dogs. Your communities and lives.

On the other side me. Alone. Of course there is always the hospital, but were really not friends. My partners and specialists. They all make an appearance. But when the going gets tough.

I am like an island. That you inhabit from time to time. Occasionally good times. Often bad. And I pray that there is enough of me to sustain. For there are rarely other visitors. Rarely extra provisions.

My island floats independently in the sea. I face each brutality and hardship with you. But since I am land and you are my inhabitants we often see from very different perspectives.

When you hurt, and suffer, and die. You call. And sometimes from the depths of hibernation I answer. My eyes twitching in the darkness as I try to decide whether to give more lasix or should I try fluids? There is no nephrologist in the bed next to me. No cardiologist. And if there were would they remember the time your shortness of breath was anxiety? Remember the time your anxiety was a heart attack?

You pray that I make the right decision. Did you know that I pray to? Pray that tonight I will be less fallible. Pray that I will remember each piece of imminent minutia. Unlock the bodies tenuous riddles and splay them out in front of you as if they were a healing potion. A soothing balm.

Each covenant ends the same. Either you or I will die. Your suffering over and your family mourning.

And I will remain. Alone. Fighting to provide for the other two thousand inhabitants of my island.

Each one a covenant. Each one signed with a golden quill … signed in my own blood.

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.

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