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The First Time We Met

You remember, don’t you?

That night,

the stench of blood and sweat,

the fear behind someone’s prayer caught between sob and silence.

I was still young then, still foolish.

I thought medicine was a ladder out of chaos.

That if I moved fast enough,

I could climb past grief.

But you were already there.

In the corner.

Watching.

Waiting.

We were working on a patient in his forties.

Blue, silent, surrounded by panic.

I counted compressions like incantations,

believing my hands could command life to return.

And you, you said nothing.

You never do.

You stood behind me, patient and certain,

like a god who has seen this ritual too many times to be moved.

When it ended,

when the line went flat and the room fell still,

you came forward,

just enough to remind me who’s in charge here.

I remember

the sound of silence,

how the world didn’t pause for him,

how the next call came within minutes.

That was our introduction.

You didn’t shake my hands.

You just

stayed.

The Long Conversation

We’ve been talking ever since,

haven’t we?

You

and I.

Every shift, you wait in the doorway,

leaning against the wall, arms folded,

watching me bargain

with inevitability.

You inch closer to me every second,

in the stutter of a dying pulse,

in the pale lips that refuse

the breath I give them.

And yet, I fight.

With tubes.

With trembling hands.

With words I no longer believe in.

You take, I resist.

You whisper, I shout.

You wait, I rush.

And between us, life flickers like a candle trying to remember how to burn.

There are moments you came too close,

your breath brushing the back of my neck as the monitor slows,

as someone cries out a name

I can’t pronounce.

And in those moments,

I don’t hate you. I envy you.

You are steady. Certain.

While I’m all trembling hands and borrowed hope.

The Theology of Futility

You’ve taught me things, though.

Hard lessons.

Cruel wisdom.

That love is measured in minutes, not years.

You’ve taught me that medicine is not a conquest,

that it is choreography.

That we don’t defeat you,

we just distract you long enough to matter.

I used to think futility was failure.

Now I see it’s the only truth we ever touch.

Futility means we try, knowing we’ll fail.

It means we show up anyway.

You've watched me whisper apologies

to patients who didn’t make it.

You’ve seen me touch the hands of the newly gone

as if warmth could be reversed by blind faith.

You’ve stood at the edge of the room

while I told families what you’d done.

You listened to their silence,

their disbelief, their surrender.

I think, sometimes,

you pity me.

Because I measure meaning

in minutes and heartbeats.

The Quiet After

When the night ends,

you always leave first.

You slip through the corridor,

quiet as an apology.

The monitors hum again,

the floor smells of antiseptic and sorrow.

Someone laughs by the nurses’ station,

someone eats a biscuit over a death certificate.

Life resumes,

unashamed of its persistence.

I sit there, staring at the empty bed,

my hands heavy with guilt.

You linger just enough to say goodbye.

I nod back.

Because no matter how many times we meet,

you remain the only constant.

The only honest thing in the room.

I go home before sunrise.

The city still asleep.

I wash my hands till they burn.

Yet, your scent stays. Your silence stays.

Tomorrow, I’ll see you again.

At another bedside.

Between another breath.

You’ll smirk. I’ll fight.

The world will keep turning on the axis of our argument.

You’ve taken hundreds from me, but I’ll keep coming back.

Because someone must stand in your path,

even for a second.

So when they ask me again,

Why Emergency Medicine?

I think of you,

the way you linger in the doorway,

the way you wait, patient and precise,

the way you let me believe I’m winning.

I answer:

because it’s the only place

where you and I speak the same language.

Where life is raw, and grief is honest.

Because here,

in the space between your breath and mine,

I learn what it means

to love the futile.

And one day,

you’ll stand behind me and whisper in my ear,

almost tenderly,

“I’ll take you too.”

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More soon.

Another moment.

Another reminder that we are still, somehow, human in all of this.

Yours,

Dr. Adarsh Nath,

Letters from the ER

Disclaimer:

Patient details have been changed to protect confidentiality. This is a personal reflection, not medical advice or substitute for professional care.