I read in a dusty novel that a famous pirate said there are no legacies in this life. Our lives, he said, float atop a fickle sea, and when we die, nothing remains. Many hands work the decks and, in the process, are worn, discarded, and forgotten. The sea gives, and eventually, she flushes the flotsam, leaving no monuments to souls and their adventures.
Well, this is not entirely true. And, I did not actually read this in an ancient book but rather heard it recently in a tawdry Netflix movie. The captain who uttered these poetic lines was giving advice to the quartermaster, but somehow, he spoke to me. He was far too handsome to be a pirate—let’s be honest—and yet, from a chair in the living room, the captain’s wisdom resonated with me. What could this possibly mean?
I am at present charting a course as far away as one can sail from the pirate life. I don’t rob and rape but rather give generously from my provisions. I don’t burn ships and drink rum in a Nassau shanty, though I must say that part has some obvious appeal. And, given my annual bout of compassion fatigue and primary care burnout—who knew—pirate advice is apparently what I need this summer.
I now understand that I have my own experiences of staring wistfully, not across the sea but down the hallway. If my ship is The BMC (Berkeley Medical Center), then my ocean is health care and—my god—does she take it all away. The dark water around me is full of unheralded triumphs, small battles, and characters worthy of songs and poems. Deaths, various mutinies, and a tattered map from my ports of call used to swirl inside me, mostly forgotten, flotsam somewhere on the vast expanse.
I share a strange kinship with Captain Flint as I have spent years reflecting on the unmarked moments in my doctor voyage. What is the enduring meaning of it all? For decades, people died under my care, and there were really no monuments to their lives. Sure, there were Facebook posts or similar, but this was ephemeral. A lack of memorial never sat right with me, and I never knew what to do about it. I had so much inside of me, and because I had no tools to build an edifice, in the end, these intentions simply sank.
A few years ago, in the professional storm of my life, I crashed onto the rocks of writing and, in doing so, discovered a way to chronicle the touchpoints. Funny enough, I called my electronic journal The Captain’s Log, a name which was previously cheeky but suddenly is auspicious. Does inspiration from handsome Netflix pirates make me a moron, a genius, or something else?
I’m not interested in answering that question because my heart tells me that inspiration and wisdom, wherever they come from, are real and true. I have sailed and seen, and that’s why I know if we don’t write the songs and verses, then, yes, Captain, these lives will be forgotten. I used to do just this, but that was because I had no skills to dress the wound in my chest, the one that caused me to shed tears even as I sailed forward, often on an unknown course. Like a pirate, I found reverie and rum did not help and maybe made things worse.
In my writing, I can’t get it right as there is no way to describe—truly—a hospital room where the spirits descend as someone is taking their last breaths. The family gathers, and when hard realities settle in, sometimes the storm clouds gather. And other times, they miraculously part. The powers I have witnessed are ancient and real, transcendent and tangible, though maybe impossible to describe. It is electricity and love, dead reckoning and resplendent. I have seen angels in the room and demons and the powers of hell. I have witnessed things that will bring you to Jesus and moments when families blessed “assalamu alaikum” upon me, wishing me every good thing in this world, whether I deserved it or not.
If this sounds like pirate voodoo, maybe it is, but this is the reality on the health care sea. I can never paint a proper picture of distant shores; my stomach is often in knots from my patients’ suffering and my inability to make it stop. But, the recognition that every captain needs a log, those who sail need to put experiences and coordinates into words, this is how monuments are erected to the souls and spirits we have seen. In this regard, I disagree with Captain Flint. He decided long ago that he would not place memorial plaques on a quayside. I, on the other hand, have come to believe that these words are a testament to the fact that no one’s life is flotsam.
Ryan McCarthy is an internal medicine physician.
