Knock Knock. I gently knock on the door, carefully walking in. From behind, he is a frail figure, his green hospital gown swallowing his being. He can’t quite swing his head fully around to look at me, so I move closer to the bed to be in his vision. He’s in the middle of eating his breakfast, some eggs and a fresh pastry his wife brought him yesterday. He doesn’t have many teeth left, so he can’t eat much. I bring him his walker, and together we walk down the hallway. I swipe my ID badge, and with a “click” the doors to the inpatient psychiatry unit unlock. He follows me to the conference room around the corner. The conversation dissipates once the doors swing open, all attention on the star of the show, our patient. We go over how he’s doing and how he’s been sleeping.

“Any thoughts of hurting yourself?” This frail old man looks down for a moment, and says “No, everything is good.” This frail old man who, because of his cataracts, can barely see us, his loved ones, or his beloved weather channel. This frail old man who can barely go down the stairs in the morning. This frail old man who rarely speaks with his children anymore for fear of overstepping into their independent lives. This frail old man who feels like a burden. This frail old man who tried to end his life.

The more I learn about him, the more I understand how much he has lost. As his eyes lose sight, his legs grow weaker, and his energy dwindles, his every day is a ghost of his past life. What does he have to live for?

Over the next few days, his wife comes in every day with food he likes and the pastries he craves. His children have family meetings with him and us, his care team, to understand how he can be inspired to live. When it’s time for him to go, he shuffles down the hallway, no longer in the green hospital gown, but overwhelming swallowed just the same by the clothes that hang on his tiny frame. He is inspired for now, by the support of his family.

A couple weeks later, I am on the consult psychiatry service. We’ve been consulted to see a patient on the general surgery service because of the patient’s recent admission to the inpatient psychiatry unit.

It’s him. When I walk into the room, I am struck by how he swings his head to look at me the same way he always did when he was in the inpatient unit—not quite able to turn all the way around, but understanding it is me just the same. He looks tired, defeated, in pain. Back in that green hospital gown. He has been taking his SSRI and his children visit him more. His son helps him walk to his favorite café down the street to get coffee in the morning, just like he used to. But he’s here with yet another setback, another hospital stay.

He is getting surgery on the day that I go see him, and the anesthesiologist walks in while I am speaking with him. I stay, at the patient’s request. I remember worrying about how this new provider was going to describe to the patient his OR and anesthetic plan. I was worried there was no way this provider knew how delicate and vulnerable the patient was. That he had tried to end his life a mere two weeks ago. That how the patient is treated during his surgery and how he handles the process could play a huge role in the progress he has made.

But it turned out I didn’t need to worry. The anesthesiologist came in and spoke to the patient with patience, gentleness, and knowledge. He spoke with him in the reassuring manner that comes from advocating for and taking care of countless patients with many different fears about surgery and anesthesia. He anticipated questions and knew how to word things to make the patient feel like he knew what was going to happen, that he would have someone by his side the whole time, and that it was normal to be scared.

That was the last time I saw that patient. It was the last day of my psychiatry rotation as a third-year medical student. But what has always stayed with me is the impact that anesthesiologist had. He had no idea what kind of story he was walking into, yet he was able to provide the support and reassurance that patient so badly needed.

As an anesthesiologist-in-training, I will always carry that with me. I will never know the full context in which I am meeting someone in their medical journey, as that is just the nature of the specialty. And more likely than not, I will only be with that patient for at most a day, and never see them again. But I can never underestimate the impact my interactions will have on them. I will always try my best to understand where patients come from, make patients feel safe, and be their strongest advocate as they go through their surgery day, no matter what. Because that is what anesthesiologists do.