Mountains

I ran along the northern edge of the city this morning through Fort Mason and the Marina Green, past the domed rotunda of the Palace of Fine Arts, threading through soggy patches of sand still drying off from weeks of rain. I landed at the northwest tip of the Presidio and paused to look back at San Francisco stationed beyond the expanse of foamy waves, drowsy in the early morning, skyline dulled against the unflagging fog.
 
I thought of you, wondered if you had embarked on your morning workout too. Groggy from an overnight shift, I trailed behind you early yesterday as you did laps around the ward, undaunted by the day ahead. Your fingers gripped the IV pole infusing preparatory alkaline into your veins and a knit cap gripped your scalp, a role your hair shirked cycles ago. I didn't know you, but as you proceeded on, calm and dignified, you moved me.
 
There is a portrait on this ward: two photos stacked in a frame. THIS is NOT the mountain I intended to climbTHIS, capitalized and underlined, leads into a murky photo of a man surrendered to his hospital bed, his face nondescript, a surgical mask shielding his nose and mouth from nosocomial germs. April 2005. Below him, a dark figure pressed against sheets of avalanche white, hunched under the weight of his backpack, braced for alpine ascent. May 2004.
 
History of NSCLC s/p radiation, prostate cancer s/p radical prostatectomy, and DLBCL s/p R-CHOP, found to have treatment associated AML, my sign-out read. I texted a friend: how many cancers can one person have?

I know you don’t exist for me to romanticize. Still, I wonder what mountains you were climbing when the doctor called and rerouted your entire life. What you most hope to return to once the malignant proliferation and subsequent toxic assault remits, allowing your your vitality to seep back. What is worth enduring these dark hallways for.
 
I know you don’t exist to remind me of my own mortality. Still, I wonder when life will swap sand and pavement for the tiles of a hospital ward. When my time would come to unlace my shoes and grip the IV pole. It seems inevitable, and I wonder if I’d ever be able to stand as valiantly as you.
 
I’ll run until then, because I think you would want me to.

This post was written by Mariam Nawas, MD.

Note: key details of this story have been changed to protect patient confidentiality.