Human hands are complex, intricate and intimately part of who we are and who we become. One of my mentors once told me “hands are the gateway to the soul.” I’ve often been enamored by beautiful eyes, always considering them the gateway to one’s soul. The stunning colors of the iris, the contrast of solid black and then brilliant white; staring into the human eyes can make your heart skip a beat. This is not the same feeling attached typically when you look at your wife’s, husband’s, childrens’, parents’, or even your own hands. But have you ever held someone’s hand and thought what those hands have held, touched — felt. How many hearts had they comforted? How many hands had they held? How many lives had they changed? Your hands give you a sense of identity, a means to give, to receive. A way to create, to change. Each hand being different than another, each hand the gateway to a soul. 

My life will change soon. As I close a long chapter of surgical training, my reflection on my own hands has changed significantly. I see them aging, but strengthening. The callouses forming, the work increasing — the responsibility they hold growing. Transitioning from my residency to the next step — a hand surgery fellowship — I will not only continue training my hands to perform and function in a precise manner, the delicate hands of others will be held in my own. They will look upon me to help their hands moments of need, to regain what injury, illness, time has taken from them. The ultimate responsibility, the ultimate trust. A father’s hand — unkempt, calloused, broken — needing to provide a life for his family. A mother’s hand — slender, fragile, powerful — still holding her baby despite the overwhelming agony of pain. A child’s hand — chubby, curious, limitless — deformed by circumstance, genetics — but beautiful and capable nonetheless. I will hold these hands in my own, and I will care for these hands as my own.

As hands are the gateway to the soul, time is the gatekeeper to change. Time changes us all, for better or worse. We are all at the mercy of time, something that our minds — or hands– can never fully grasp. Youth turns to senescence, innocence turns to maturity — life turns to death. The natural progression of every human, every life. Although our own mortality is a terrifying thought, the impact your life can have may carry on through the generations of life. Human hands across time have shown love, and hate. Peace, and war. Both beautifully created, and heartbreakingly destroyed. Every hand I touch, every hand I restore — repair, I am taken back by how they have changed the past, and how they may continue to change future. Every incision, every stitch, I wonder — what will these hands create, change, impact? Hands of a fathers, mothers, sons and daughters — hands of time.

“As long as you are standing, give a hand to those who have fallen” — Unknown

Hercules — half man, half god. The strength of his father, Zeus, and the heart of his mortal mother Alcmene. A mythical hero, a Guardian for all that’s good. Ancient humans created these figures as a beacon of hope in moments of weakness and tribulation. Strength over weakness, an ancient evolutionary concept — survival of the fittest. Strength and weakness have infinite definitions, all relative to our individuals lives, careers, even cultures. Time proves, these words may be defined differently as your life evolves. We all have moments of weakness, often which can define who we are, or destroy us. How, as mere mortals, do we prevail in strength — or at least avoid perishing in weakness?

I began reading the “House of God” recently; a book that is notorious amongst the medical community as being a “must read” as a resident in training. The author writes of a medical resident’s struggles with life and death, in a cynical, and sadly hilarious, often negative way. I found myself relating much too often to the main character in the book, as I too have felt the burnout and exhaustion of medicine in my path to becoming a surgeon. The hardships we all face in our personal lives, are often overshadowed by having to remain professional, pretending we are unable to feel pain — as if we gave our souls to medicine and have become superhuman (I can assure you, we are not!). Doctors learn to care for other humans, and often place their own mental and physical health aside, but we are still human nonetheless! The culture of medicine has long required this, as any sign of weakness may mean you are not “fit” to handle experiencing and empathizing with pain, suffering and the mortality of patients. Last night, as I read through the first couple chapters, I thought to myself — is any human truly capable of such empathy and selflessness?

I believe we all are. I took this picture walking through a wat in Chiang Mai, Thailand. Awestruck by the sheer size of this majestic tree, I almost missed the statue that was directly in front of it. As I walked up to the statue, with the sun peering through the clouds onto the tree casting a massive shadow over the temple, thoughts of my own strength seemed to pale in comparison. But when I reached the position of this picture, I realized even a object of such massive proportions, growing for hundreds of years casting the same shadow over generations of humans, still needs a Guardian. The statue made me pause — it guarded this tree and silently, but effectively nonetheless, communicated a sense of strength and protection. Subtle and nonthreatening, the statue signaled a sense of peace. Still, hundreds of years after it’s creation, it remains protecting this splendor of Mother Nature. As I looked up once again to bask in it’s beauty, the vines leading up the thick trunk reminded me of our own bodies like green blood flowing through it’s arteries. I paused, as thoughts of how fragile life is began bouncing around in my mind. The incredible life of this tree, could end in a blink of an eye — in one moment of weakness. Just like the exposed neck of a warrior in full armor, this giant “beast” stands tall in strength, but also in weakness. Does that make you think of this tree any differently? Because it’s guardian stands in front as protector, does that make it any less beautiful or powerful?

Strength requires an ability to understand weakness. To understand weakness, one must experience being vulnerable, and welcome it. True strength comes when one learns to overcome their weaknesses. Periods of weakness will always exist in your life, but how you respond to these will define you. Often as physicians, we are faced with being the protector –the Guardian — that patients and their families need in moments of vulnerability, of weakness. I recently have been dealing with a significant family medical issue, and I can tell you, it is hard to not be the doctor, but instead be vulnerable. Surgical training has instilled the fear of weakness, and that fear IS weakness. But I am still human, am I not? We all need to remind ourselves of that daily. Allow Guardians into your life — let them protect you, lift you from the inevitable days this world will try to push you into darkness. Never underestimate the power of a “hand on a shoulder”, a simple intimate gesture of comfort — of strength. Be a Guardian, and be someone worthy of being guarded. Embrace periods of your life in which you rely on others for strength, and return the favor when the ones you love need the strength.

In joined hands there is still some token of hope; in the clenched fist none. — Victor Hugo

Starting this blog was a decision made to relieve stress during an intense surgical residency training. For me, writing has always allowed my mind an outlet — something that during difficult times in life is more than a necessity. The past five years I have spent focused on caring for individuals with a multitude of physical deformities — illness and injuries one can only attempt to explain — and have often placed my own mental and physical health aside. As I have stumbled my way through, I’ve come to realize that without an outlet, the mind becomes jaded in a way only those who care for others truly understand. As my life as a resident begins to set and change inevitably enters, this is my mind’s outlet — one I hope may provide others a similar benefit.

Our life is the creation of our mind — Buddha