Mondays With Marlone

It was the simple way our eyes met. Kindness and warmth emanated from between the wrinkles and tattoos on his face. His gaze wandered across a room spotted with mats and people drifting to sleep. I sat spinning the blood pressure cuff valve in my hand wondering if I should walk over. Before I could decide, he slid into the chair next to me with his arm extended.

“Would you mind checking it? It’s been a long time, and I know it runs high.”

I took his arm and rested it in my lap. “Of course. Do you mind if I ask why it’s been a while?”

“Well… moved away from some trouble and I’m just happy to be here. Want to turn things around.”

“Well, I’m glad you’re here, and hope things do turn around,” I replied. “What have you been working on?”

As his arm lay in my lap with the blood pressure cuff waiting to be inflated, he unfolded his story. As midnight approached and my shift ended, I told him I would be back next week to hear more. This is how Marlone and I met. Unbeknownst to me at the time, he would become a patient, friend, and teacher who would bring me closer to the physician I want to be.

During my first year of medical school, I spent each Wednesday in the hospital learning the practice of medicine. We moved through different wards, performing the basic exam and building a differential diagnosis with random patients. I felt myself becoming more confident in each maneuver of the physical exam, more comfortable with weaving together each element of the interview, more adept at asking the right questions. But something was missing. Since school had started, I had spent a few Mondays a month volunteering as a clinical coordinator in a night shelter for those experiencing homelessness. While I had initially looked forward to Wednesdays in the hospital, I instead found myself anticipating Monday nights. I was unsettled by how different these two worlds felt.

The following Monday I found myself sitting next to Marlone again, our backs sharing a wall that was still radiating the heat of the day. His hair hung down around the sharp edges of his face and his eyes were blank as they looked out across the room, absorbing his surroundings. I checked his pressure and asked, “I know this week has been a scorcher, how have you been?”

“Just try’n to avoid it ya know. Spent the day at the library working on this.”

He pulled a carefully folded piece of paper out of his shirt pocket, opened it with purpose and extended it to me.

“It’s my résumé. I got a librarian to help me format it and everything. Still not happy with it, though.”

I spent a minute reading through each underlined heading and the bolded bullet points below. “This looks incredible,” I told him, “but why is your education section at the bottom?”

“Well I only graduated high school, not that much to be proud of.”

“Graduating high school is an accomplishment, you should be proud of those years and all of the hard work you put in. It shows your dedication and ability.”

His eyes brightened. We spent the rest of the evening talking over his résumé, rearranging sections, moving ideas, adding more skills, and finishing another draft. As my shift came to an end, he said, “I am glad you are going into medicine, the world needs more docs to sit and listen to their patients.”

I froze for a moment, surprised by this comment. I had forgotten that I was in the shelter to provide health care and outreach. Over the year I had spent there, my time had become less about counseling people about their health, and more about listening to their stories. Walking home, I realized that my conversations with Marlone were filled with more compassion and connection than many of the brief interactions I had with patients in the hospital. Why? He had already given me the answer.

Even though I had been asking the right open-ended, thoughtful questions in the hospital, I was never truly listening. As my patients spoke, my mind would simultaneously look for buzz words, consider pertinent positives and negatives, mind the clock, and generate the next question. I could feel myself becoming the physician-machine I had been warned about. Medical school was training me to follow patterns, reinforce notions and biases, and control my interviews. At the same time, Marlone was teaching me about what had initially drawn me to medicine. He was showing me his humanity.

***

As the sweltering summer days began to cool, I knew that my life was about to change. My first year as a medical student was coming to an end and I would soon enter the hospital for my clinical year, where pressure and time commitments escalated. This would mean that I could no longer spend my Monday nights with Marlone and others I had become close with. It would mean that I could no longer be a reliable caregiver for Marlone, and, more importantly, I could no longer be there weekly as a friend.

I had met Marlone during a tough period in his life, but over time he began to flourish. Each week, I watched a flower bloom between the concrete cracks of Boston’s redlined streets. Each Monday, I watched colors of other emotions appear in his face: excitement, pride, and determination. Marlone finalized his résumé, let go of relationships that were holding him back, and began applying for his dream job working as a chef. Each Monday I was so excited to see my friend, to just listen.

A few hours before my final evening shift, I received an email from the attending physician that the clinic was canceled. Deciding I would go anyway, I waited under the scaffolding over the entrance to the shelter and looked for Marlone. As I sat on the curb watching the line of people waiting to enter, I felt a hand on my shoulder.

Marlone sat down next to me and slapped my knee.

“I heard this was going to be your last night! I’m glad to see you.”

“I’m sorry I didn’t bring it up before, wasn’t sure how,” I told him. “During this next year I’ll try to pick up any spare shift on a Monday, though I may not have time right away.”

“Don’t worry about it, you have to do what you need to do. I know the hospital can be an intense place. Do me a favor though,” he said. “Don’t change how you see people.”

***

Soon after I started my clinical year, COVID struck. The phone number I had for Marlone stopped working. About 40% of the Boston homeless population was testing positive for COVID, I could only hope Marlone was doing well. I tried not to imagine the worst, and instead remember his lesson. I remind myself to be fully present, to truly look at someone, and to listen with my ears, mind, and heart open. In doing so, I carry him with me throughout the hospital, and look forward to sharing with him how he impacted me if our paths cross again.

It is clear to me that the lesson Marlone taught me of humanizing interactions extends beyond medicine. The social, ethnic, religious, and political divides that we are currently experiencing in the United States and around the world are perpetuated by the alienation of groups of people. By being disconnected, we dehumanize those who are different from us. There is no simple solution to heal the divides between us. Listening is not the full answer, but being open to those who have different experiences than us has the potential to start healing.