“Dr. Baban? Dr. Baban?”

His slurred voice rasps across the room, weak but insistent, cutting through chiming monitors, buzzing fluorescent lights, and the screeching pager slung next to the empty gnaw in my stomach. I freeze where I stand, one hand scratching out post-operative orders on the last emergency surgery of the day, the other midway to the nursing station phone, grasping the silenced pager. My eyes sweep over the recovery room clock, too numb to cringe at the display. Another 15-hour day, looping from ER to pre-op, to OR, to post-op. It has been a good one and capped by a small personal victory, but anyone not on nightshift, including my attending, is long gone. I was almost home free for dinner, a shower, and bed.

When I look up, he is just starting to come out of the anesthesia, his non-operative eye still closed. Several beds away, I am sure he has not seen me. Most likely, I tell myself, he would not be able to hold or recall a coherent conversation now. It would better serve him, surely, to save our discussion for when I check on him in his room tomorrow morning.

“Dr. Baban?”

The voice and duty call. If I am honest, there was never really a question. This is what I kept getting dinged on in medical school; spending too much time chatting with patients was well-meaning but “inefficient.” I love medicine, I love surgery, but none of it means anything if not for a human partnership that undergirds it. And so, as I remind myself of my own principles, I will my feet, one leaden clog in front of the other, to the bedside, and regard his still face from across the metal gurney rail.

“Yes, Mr. Krueger, I am right here,” I rest my arm on the rail and touch his shoulder lightly, pausing to assess if there any recognition. Drowsily, the eye that is not bandaged opens, and he turns to face me. His color has not yet returned, his ashen skin blending into a braided beard and long gray ponytail. Without his leather jacket, the motorcycle tattoos covered by a thin blanket, he looks much smaller than the strapping man, full of bravado and adrenaline, who was helicoptered in after being hit in the face with a barstool. He had smilingly volunteered that he instigated the fight, as though admitting to sneaking treats from the cookie jar. Not bragging or with malice, but rather self-deprecatingly, owning a personal foible that came home to roost, with a result that was surprisingly charming.

“The surgery went well,” I smile with warmth I surely feel but need to display intentionally, both to reassure him and because I am conscious that my exhausted face may not if left to its own devices. “How are you feeling, sir? Is there something I can do for you?”

It is plain that he is still mostly not himself; whatever is on his mind now will be the most pressing thought that has pushed to the surface as his conscious brain comes back to moor. I expect him to ask for pain medications, which I have just ordered. In addition to substantial bruising from the barstool we have also, after all, just removed his badly damaged eye. After a careful determination that it was not salvageable, we had to act quickly; through a quirk of our immune systems, delaying would have unnecessarily risked his healthy, remaining one.

The goal is always to save the eye whenever possible, so we do few of these enucleations. With no repair involved it is one of the least technically nuanced surgeries we do but, as he was aware when he signed the consent form, we do so few that even as a senior resident this is my first time as primary surgeon on this procedure.

Most patients understand, even appreciate, that this is a teaching hospital and are unconcerned about who in particular will be their primary surgeon. But Mr. Krueger is among the few I have met who seemed actually excited to be my first. Again, rather charming. He told me as we prepared for surgery that he has “made a lot of mistakes” in his life and was glad something good, my learning, could come from this. I want to be particularly certain he is as comfortable, physically and emotionally, as possible. Though I am confident he will not recall it later, I expect that after we address the question of pain he may return to some of the topics we have already touched on, and that we will reiterate at his follow-up tomorrow: post-operative care, the expected timeline to fully heal, when he can be fit for a prosthetic, what life will look like now and how he can best adjust his daily activities to his new reality. Yes to biking, but with a helmet; no to any more brawling that would risk his remaining eye, for a start.

But I wait patiently for him to awaken enough to tell me what he needs. Looking up at me from his pillow, I see his remaining eye focus on mine as he wills himself to greater consciousness. As he does, his drowsy face becomes animated with heavy-lidded urgency, a look almost of fear that had been notably absent when we met, even when we discussed that the eye unfortunately could not be saved. And I feel a twinge.

He is alone in the recovery room, as I expected. Briefly, with smiling regret but without blame or self-pity, he had told me that he did not have family or friends who wanted to be with him, referencing those past “mistakes” that distanced those who should be here. Even his adult son, who lives just a few minutes away, has declined. The only available candidate, I prepare myself to play part of that role, too, as surely anyone deserves. I wait but, though his face is more animated, he is still groggy and his words do not yet come.

“The surgery went well, sir,” I assure him again, giving him a bit more time to awaken, and now with less brightness in my voice, more of something soothing. “There’s nothing to be worried about now, all you need to do for tonight is rest.” I am ready to provide company and solace, enough that we can both get some sleep before tackling his recovery plan in more detail tomorrow.

This seems to register, and he nods a bit, but as impatient as a man still heavily sedated can appear to be, he brushes off my words. He clears his throat, very likely sore from the general anesthesia tube, and seems to adjust his dry mouth and tongue to speak.

“Dr. Baban,” now struggling to sit upright he intercepts my hand as I reach out to help him, and he holds it tight. His face is serious, anxious; he seems now to have his teeth firmly into the urgent matter that was on his mind, that caused him to call into the darkness as he awoke.

“Dr. Baban,” he rasps again. “Please, I just need to know.” Another ginger throat clearing. “Did you learn something?”

The churn of the recovery room falls away; stunned at the reversal of roles, I pause a beat. Among the many bedsides just like this one that I have attended to throughout my training, this is a first. The unspoken promises we make to each other in academic medicine, doctor and patient, teacher and learner; at our best, we are imperfect members of a shared community each striving in our own ways to become more perfect and to better serve others. This gentleman, alone in his gurney, not yet fully back to consciousness, has laid the subtext bare with his simple and extraordinary question. Fully present in a new way now, I feel my eyes become damp. My second hand joins the first to hold his.

“Yes, sir, I did. Everything went beautifully. Dr. Moretti was overseeing the whole time. And,” with a gentle squeeze of his hand, “I am confident that I can provide the same care now for anyone else who needs it, because of you. Thank you for trusting me.”

Immediately, I see his face and shoulders relax, and his color begins to rise. Mr. Krueger gives my hand a pat and, smiling, lays his head back down. He closes his eye, and sleeps.

Kaylan Baban is an internal medicine physician.