Everything that fits in the palm of your hand - Ovidiu Calapod

Every day at my practice begins the same way - an empty chair and a space waiting to be filled. In front of me was a 45-year-old man. I stretched my hand across the table between us and quietly told him to sit down. He didn't say anything. He just rubbed his hands together repeatedly. Every time he looked up at me, he quickly lowered his eyes to the floor, as if it were difficult for him to maintain eye contact.

In my hands I held the results of his biopsy - a simple piece of paper, but one that felt like it was burning my palms.

"Unfortunately, the results are not good," I said quietly. It confirms that it is esophageal cancer.

The silence between us settled suddenly, like a thick, almost tangible fog. I could feel my heart beating in my temples, my chest tightening, and part of me wanted to run away.

He was silent for a few seconds, then looked at me intently, without blinking:

"Am I going to die?"              

A simple question, devoid of drama. But it hit me right between the eyes. In a split second, I felt my own fears and anxieties wash over me, moments when I had asked myself the same question. "Am I going to die?" was no longer just his question - it was mine, ours, everyone's.

I took a deep breath so as not to give the answer too quickly, too mechanically.

"One day, we will all die. But now we have treatments we can start. We will fight together to make the time that comes as long and as good as possible. And, above all, you will not be alone."

He nodded slowly and said nothing more. Neither did I. We just sat there for a few moments in that strange silence, which was neither comfortable nor oppressive. Just necessary.

Not all patients ask me about death. Some ask me about trust. Sometimes, the hardest part is not giving them bad news, but building a bridge in a noisy world where social media, populist rhetoric, and general distrust of any form of authority erode the connection between us.

A few days later, a man with a chronic illness entered my office with a look of distrust on his face. The file was open, the treatment plan was clear. But when I started talking to him about the next steps, he shook his head and said:

"I've read that these treatments do more harm than good. Everyone on the internet says that anything that comes from outside is full of chemicals. I'm not going to take anything like that."

The words hit hard. That word - “chemicals” - I had heard it dozens of times. It wasn’t just a word, it was a sign of a chasm between us.

I could see his clenched fists and tense jaw. His anger wasn't directed at me - it was old and deep, the anger of a man who had felt invisible for too long. Ignored. Judged. I knew that beneath that hard exterior lay fear. Fear of no longer being able to control anything. Of being alone again in a system that had left him behind. And as I looked at him, something of his loneliness began to stir in me too – the same heavy silence that I often feel when I choose, again and again, to be the one who doesn't waver, the one who stays there.

I closed the file and began to talk to him not only from books, but also from experience. Many would have called him a "difficult patient." But I saw something else - a man left alone, trying to defend himself as best he could from a tremendous fear. I told him about people who wasted precious time chasing illusions. About others who followed treatment and gained years of life.

I didn't convince him.

I left the office that day with my jaw clenched. The days when I face mistrust are difficult. If in his case the challenge was to build a small bridge of trust, other times the challenge is different: not to convince, but to remain present in the face of news that changes everything.

One day, a 33-year-old woman was already waiting for me in my office. She had just found out she had a serious intestinal disease. When she saw me, she asked me directly, in a faint voice:

"Will I depend on this treatment for the rest of my life?"

 Her question came almost as a statement. Without fear. It was more like the exhaustion before a long journey, which she could already see ahead of her: days upon days, years upon years, all fragmented into pills, tests, and checkups.

I was silent for a few seconds. Not because I didn't know what to say, but because I needed to breathe before I could speak. In that silence, my mind raced to all the little things I do without thinking. Her question wasn't about treatment. It was about meaning.

    I smiled and showed her the drawing I have on my desk, clumsily sketched by me during therapy sessions. It is a person with an open palm, holding a circle in the middle with ‘my illness’ written on it. I told her that in her palm, the illness occupies only a small spot. It does not fill the entire space. There is room for joy, for love, and for everything that makes us human. And even if that dot will not disappear, it does not have the power to erase what is around it.

I know that medicine can sometimes be cold. I also know that many of those who wear white coats cannot always offer their presence and empathy. I know you have experienced this.

Sometimes I couldn't offer it either. Because in the struggle with the system's shortcomings and deficiencies, with endless shifts and bureaucracy, I learned to put up walls. To survive. There were episodes of burnout that made me stop and wonder if I could go on like this. There were hundreds of hours of therapy in which I learned to be present without losing myself.

Sometimes, at the end of the day, when I turn off the light and close the office door, I lean against it for a moment. I run my hand over my face, as if I want to wipe away something that cannot be seen, but remains there. The hallway is quiet, only the faint smell of disinfectant hangs in the air and the cold neon light hurts my eyes. Then I understand more clearly than ever - empathy is not given, it is chosen. Day after day. With an open hand, not just to offer solutions, but above all to say: I am here.