My patient died 45 minutes after he left the ER. His death was beautiful and awful, and I remember snapshot moments that will last to eternity.

I am learning to roll with the punches. I am becoming more resilient, developing a degree of toughness. I hope in the process I do not forget my manners, or the tears on the face of the mother.

We do not work alone: your work affects my work, and my work affects yours. A kind word, a harsh word, a procedure done well, cancer pain untreated; our practice has a ripple effect that spreads far beyond my workplace and yours.

Haircuts, ice chips, popsicles, and pillows; sometimes I wonder—did I go to school for this? Yes, I think I did.

Is it acceptable to sacrifice the best interests of one patient to the confidentiality rights of another? Is it ethical for a clinician not to tell the truth?

The laying on of hands is essential to learning the art of medicine. If clinicians do not practice this art, how can they hope to become skilled diagnosticians?

A patient's dramatic amputation injury causes the author to reflect on the dangers of taking shortcuts, for clinicians as well as patients.