My grandfather was a country doctor, and somewhat of a local legend. Grown men would introduce themselves to him at July 4th parades, shaking the knobbed hands that once delivered them safely into the world. Women would drop off baskets from their gardens, full of bright green peppers and juicy red tomatoes, living products of the earth which in a way symbolized the regeneration he aimed to effect. But at the end of his life I would watch him sitting alone, retired to an old chair, in the shade of the crumbling barn behind his house. His clothes were chosen for comfort, his beer for ease of swallowing, and his facial expression for the complicated memories haunting his thoughts. He would watch the clouds for hours.

Now a family doctor myself, I wonder what he saw in those clouds. Each one is a vague message, some inscrutably beautiful, most others frighteningly unstoppable as they drift across skies of blue, grey, and violet at the end of day. I can see daydreams of cured patients taking shape in puffy white whorls, before morphing into stillborn infants cradled by weeping mothers. There is an absurd distance between the earth and the sky above. Another cloud passes, unloads its burden, accepts a sprinkling of advice, and then floats on to be shredded or lifted by future winds.

A doctor’s career is surely marked by triumphs, but the very nature of life ensures many defeats. I hold hands robbed of strength by strokes, look into eyes hollowed by Parkinson’s, read MRI reports of nightmarish creatures nestled in brains, and I cannot rewrite the stories. Tears are shed over jobs lost, parents suffering and dying, sons killed in car accidents, daughters possessed by addictions, even family pets mercifully put to sleep. I consider the very act of getting out of bed each day an act of heroism for the self aware.

Attending to human misery is a daily task of doctors, social workers, nurses, counselors, pastors, and all the listeners. At times it is overwhelming. Compassion fatigue is a natural result, and a doctor’s sudden lack of empathy might be that day’s defense mechanism instead of an enduring character flaw. To be a doctor, to be blamed when things go badly, to endure the barbarism of a lawsuit that seeks to personify you as the source of outrageous fortune… it’s certainly enough to make you cast your eyes up to a weightless sky.

I know my grandfather achieved much, helped many, but it was a melancholy greatness known by any physician who takes an honest measure of his calling. There are just too many broken bones, broken hearts, and broken lives.

So what do we accomplish, and what do we gain from our life’s work? At the end of each day we should only be enriched by the human bravery we’ve witnessed in defiance of adversity and disease. We can only be humbled by those who fight chaos with story, inspired by those who challenge nihilism with purpose, moved by those who negate despair with hope. We can only listen, counsel, and when invited into another’s private hell, walk gently and resolutely. We can only accept that one day it must be our turn, and that every day we must seek to create happiness. We must exalt the woman who walks in front of us, proudly, with her body full of cancer, as we search the clouds, hoping for a kind summer rain.