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What this physician learned from the starfish story

Kathy Stepien, MD
Physician
April 27, 2016
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I thought about the rather corny starfish story when I was driving home after clinic today. You know the one. It goes something like this:

A man was walking along a deserted beach at sunset. As he walked, he could see a young boy in the distance. As he drew nearer, he noticed that the boy kept bending down, picking something up and throwing it into the water. Time and again the boy kept hurling things into the ocean.

As the man approached even closer, he was able to see that the boy was picking up starfish that had been washed up on the beach. One at a time, the boy was throwing the starfish back into the water.

The man asked the boy what he was doing. The boy replied, “I am throwing these washed up starfish back into the ocean, so they don’t die.”  The man replied, “But, you can’t possibly save them all. There are thousands on this beach. This must be happening on hundreds of beaches along the coast. You can’t possibly make a difference.” The boy looked down, frowning for a moment. He then bent down to pick up another starfish. Smiling, he threw it back into the ocean and replied, “I made a huge difference to that one!”

There is a piece of me that has a hard time getting beyond concerns about why thousands of starfish are on the beach in the first place. I also wonder what harm a forceful toss can do to a starfish and how good intentions when attempting to help others can cause even greater problems.  But, today, I thought about the boy.

You see, today I saw a depressed teenager in the clinic. Tears were rolling down her face as she haltingly told me her life story. She is in a difficult situation and she is still a child — poorly equipped to cope with such big problems. She has many challenges ahead and few resources to support her. I did my best, created a plan with her input, and will see her again for follow-up. I’m not sure what I did today helped, but I like to think so. I like to think “I made a huge difference to that one.” Time will tell.

Here’s my point: The starfish story isn’t only about the starfish; it is also about a boy who lives with hope in something unknowable. Through his actions, he may save the lives of a few starfish. Perhaps he inspires other people to also save starfish or to organize a starfish–saving nonprofit. The boy cannot know the ripple effect of his actions. But, I like to think, his life is more meaningful because he lives with hope. His life is richer for trying.

As a physician, I too need to live with hope. Trying to help others matters. In and of itself, as an intrinsic good. Regardless of whether I make a huge difference to the patient, being able to try to help makes a huge difference to me. My life is richer for trying.

I understand starfish ecosystems are more complex than this story allows, just as many things can cloud otherwise simple human interactions. But in the end, the practice of medicine itself is meaningful. Being a physician is about being a person who lives in a world where people care about each other and use their talents to help one another.  That hope is the gift of medicine to me. Despite the day-to-day challenges of EMRs, pre-authorizations and the scourge of Dr. Google, my life is better because I am a physician. For this gift, I am thankful.

Kathy Stepien is a pediatrician who blogs at the Institute for Physician Wellness.

Image credit: Shutterstock.com

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