4AM

At 4AM, two alarms ring simultaneously in two different states. One alarm is for a middle-aged man and the other is for a woman nearing thirty. They each lie in their beds already awake. At the ringing of the alarm, the man puts on jeans, a flannel shirt, and $10 compression socks. The woman puts on slate blue scrubs and $20 compression socks. The man’s commute takes 2 hours and involves multiple forms of transit. The woman’s commute is a 20-minute walk.

The man owns a convenience store so small that it has no room for customers, who line up at the window and order various mixtures of caffeine and sugar. The man fulfills each order within seconds. The man sees a regular approach from down the block and has their drink ready by the time they reach the window. The man has been doing this work for almost thirty years.

The woman is a medical student at a hospital that occupies several city blocks. Outside the hospital, the woman pulls on her white coat and adjusts her face mask. Inside, she studies patient charts and summarizes them for the doctors. She follows the team as they visit patients on morning rounds. The woman watches a doctor ask a patient about his throat pain. She has a tongue depressor ready by the time the doctor turns to her. The doctors leave the room, but the woman lingers. She moves the patient’s breakfast table from the corner of the room to the patient’s bedside. She turns off the harsh hospital lights. After all, it is 5:30AM.

At 7AM, another alarm goes off and the man’s wife and son both wake. The son needs to be driven to college today. The wife pulls a T-shirt over the son’s head, secures the velcro tabs of his orthotic shoes, and hands him his crutch. This has been their morning ritual for over twenty years.

The man spends hours on his feet taking orders and counting change. A customer in a tailored suit asks, “Where are you from? India?”

The man has heard this question before. He doesn’t mind it. He answers, “Yes, sir. I’ve lived here for more than half my life, perhaps too many years.” He lets out a quiet laugh.

The customer asks, “What’s keeping you here? You have family?”

The man replies, “Yes, sir. I’ve got a wife and two kids.”

The man looks at the clock on the lottery machine. 7AM. The man thinks of his wife and son getting ready for the day. He thinks of his daughter, the medical student. He tries to picture her in the hospital. He’s not sure what her days look like exactly. He will have to ask his wife.

The woman carries heavy duty plastic bags of sterile blue gowns and green gloves into the operating room. She introduces herself to the surgeon and operating room staff and puts the spelling of her name on the whiteboard. The anesthesiologist brings the patient from morning rounds into the room on a hospital bed. He is a middle-aged man. Today, they will remove his thyroid.

The woman asks the patient, “Would you like music?”

“I’d like a Bach concerto, it’s okay if you can’t.”

While the surgeon reviews his plan, the woman watches the patient and the anesthesiologist trade jokes. She thinks of her father. He trades jokes with his customers sometimes. He is probably handing someone their morning coffee right now. Her mom and brother are probably sitting in traffic on their way to college.
The woman goes to the computer, pulls up a Bach concerto on YouTube, and presses a button on the sound system. The concerto plays from the overhead speakers. When she returns to the operating table, the patient smiles at her. The woman smiles under her face mask and with her eyes.

“I’m scared,” the patient tells the woman.

“I know this is a scary experience,” the woman says. “Would you like a hand to squeeze?”

The patient nods and lifts a hand from the operating table. The woman holds it.

“Squeeze as hard as you’d like,” she says. “Women giving birth haven’t broken my fingers yet.”

The patient grips the woman’s hand and the woman thinks of her brother back home: his hand squeezing hers as he rises from the living room couch, as he crosses the street, as he lowers himself into their parents’ car. Last year at his high school graduation, her father took the photo  while her mother watched: the woman and her brother stood in front of the school. He squeezed her hand to keep himself from falling.  The woman hopes the strength in her hands might someday be the strength of a surgeon. Her father’s hands are covered with buttery residue as he prepares New York bagels for his customers.

As the surgeons work, the woman holds the retractor, a blunt piece of metal bent at a right angle, that keeps the patient’s muscles and tissues out of the way in the open neck. She remains still as the surgeons meticulously dissect layers to reveal the thyroid.

“Where are you from?” the head surgeon asks the woman.

The woman is the only person of color at the operating table. She is also the only woman.

“I’m from Queens,” she answers. “My family is from India.”

The surgeon makes an incision and the woman adjusts the retractor. The woman’s hands, in their green gloves, look identical to all of the other hands in the room. But the woman knows that underneath her gloves, her hands are not identical. They hold the hands of her brother, her parents, and her patients—people who have shaped her hands. She hopes her hands can shape other’s lives.

Hemali Shah is a student at Yale School of Medicine. She enjoys knitting and spending time with her family.