“The Legend of the Sacred Red Fern,” from Where the Red Fern Grows

by Wilson Rawls

“I had heard the old Indian legend about the red fern. How a little Indian boy and girl were lost in a blizzard and had frozen to death. In the spring, when they were found, a beautiful red fern had grown up between their two bodies. The story went on to say that only an angel could plant the seeds of a red fern, and they never died; where one grew, that spot was sacred.”

I am an anesthesiologist.

For six years, I practiced aggressive resuscitation, striving toward a capable left biceps brachii and a worthy grip. Full Code was a given, and life prolongation was the ultimate aim. The hours could be long, the physiology complex, the pace frenetic. Always, the threat of death loomed. Avoidance of this threat was the first way in which I measured my success.

I have just completed a year-long fellowship in hospice and palliative medicine.

For the past twelve months, I have had to undergo a profound paradigm shift. The year began with the ringing of a Tibetan singing bowl, and a discussion of our feelings. I nearly left. I concentrated… hard… on not rolling my eyes. I questioned what I had just done by leaving my practice, and how I would ever survive such contrived melodrama.

Except that it wasn’t contrived. And it wasn’t melodramatic. It was life. And it was death. And it was the denial of my feelings surrounding these two entities that had filled me with the burnout and frustration that sent me in search of a different way of practicing medicine.

This year I have learned that death does not always equate to failure, and that letting go is not the same as giving up. In fact, when done well, in peace and in comfort, with dignity intact, dying can be the most freeing act of one’s life.

I saw what a life well-lived looks like, just as I saw ones filled with regret and sorrow. I cared for patients who left behind generations of legacy, just as I cared for ones whose legacy lives in the hearts of their parents and young siblings.

I realized that practicing good medicine isn’t just about physiology and pharmacology and avoiding perioperative complications, it is also about getting to know my patients’ thoughts, fears, faiths, and desires, and walking alongside them when they most need to be heard. It is about life. And it is about death. And everything that comes between.

So today, alongside my skills for providing aggressive resuscitation, I can provide aggressive symptom management. Accompanying my desire for a bionic left upper extremity, I strive for bionic ears to hear what is really being said, and a God-like soul to know how best to respond.

I tell my husband that I adore him. I listen to my child, even though he’s only two years old. I call my grandmothers. I plan more vacations. I apologize.

And I remember my patients. For they are the ones who have taught me these lessons. They are the ones who showed me how best to live. They are the ones whose stories I recall when I need patience and wisdom and humility.

Beside each one, a red fern grows.