You are like a rich man entering heaven through the ear of a raindrop. Listen now again.—Seamus Heaney, The Rain Stick

Earlier this week, I stood in a hospital room while an adept PA student discussed the pathophysiology of heart failure, cardiac output, myocardial oxygen demand, and the effect cocaine use had on these things. She was speaking to a kind young man in his 40s. Her register struck a balance of clarity, nuance, and respect. She spoke on his level, as a peer; she asked openly about his readiness for change, listened to his responses, paused before responding herself, and demonstrated grace and curiosity. They both held consistent eye contact. She placed her hands on his body in natural, caring ways as she examined his heart, lungs, abdomen, and legs. She had gained his trust. Toward the end of their conversation, he respectfully declined to speak to the addiction medicine team.

“But you already explained all that,” he said. “How the drugs interact with the beta-blocker, and how my heart can't get what it needs ... that really helped.”

We left the room with a mutual affection for the man; we spoke about his naiveté, leaving unspoken our own naive hope. As we walked and reflected on the patient, I shared my admiration for the PA's attentiveness to him: a kind of relieved pride, in that we teachers are cultivating habits of attention in our students. And I believe something like friendship occurred between us.

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The next day, I was consulted to see a woman who had been admitted with profound fatigue and a 35-lb weight loss over 2 months. A lymph node biopsy performed the day before showed aggressive lymphoma. The woman was in her 80s; as I entered the room, it was very clear to me that she was not a candidate for chemotherapy. She was bedbound and unable to speak above a whisper. We spoke for several minutes about her biopsy results; I was a bit unsure if I was explaining things well. She said she just wanted to go home and asked me to call her husband, who had gone home to get a nap.

I reached him on the fourth ring. I tried to get him to drive back to the hospital without breaking the news over the phone, but I failed to do so. Between his weepy breaths he cried out, “You're telling me she's going to die?” After several seconds of silence he said, “I guess I'll come get her then....”

We discussed the process of a hospice consult. Several minutes later, when I hung up the phone, I realized how quiet the broom closet of our office had become. My colleague and a visiting PA student were unable to avoid hearing it all, even the husband's voice through the receiver. One of them generously broke the silence: “That's really hard.”

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The husband arrived, and on the way to the patient's room, I ran into the hospitalist, who was serving as head of the patient's primary team. I asked him if he'd like to see them together. This hospitalist is tall, direct, confident, and ever available. As we entered the room, I heard the patient whispering into the air, “I just want to go home.” Her husband was seated at her bedside, ball cap tilted up, hands wringing themselves in his lap. A denim jacket covered his frail frame; he was smaller than I had imagined. He squinted his eyes hard and cried out with a desperation that surprised us both: “I just need to bring her home ... she just needs to be home.”

There was little to be said. The patient was to be discharged the next day. Palliative and hospice care would come, a case manager would be involved, decisions would be made about transport and durable medical equipment. In the midst of all of this, though, I was observing the demeanor of the hospitalist. The timbre of his conviction and resolve turned to comfort the husband, his aptitude and verve fashioned into eye contact, his attention, his hand on the shoulder, taking his time. I found myself admiring him, happy to watch him aptly occupy a space that is typically mine.

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What was it that caused these moments to cling to me this week? Something tender, satisfying, and challenging. I was the passive agent, a witness to colleagues doing their job, being themselves; chances to see others at their craft, the craft of attention.

I wonder if these colleagues were aware of the small lights they carried into those rooms, like lanterns in a dark space.