Nothin' Left To Lose

Nothin’ Left To Lose*

Imagine feeling so trapped and scared as a young man in 1968 that you enlist to go to Vietnam because you feel your chance of living is better there than on the street in front of your home? One wintry morning in 1978, I met such a man in an encounter that shattered the arrogance of my youth.

The two of us sat there in that cold and unfriendly room, part of a veterans’ psychiatric hospital 30 miles outside of Philadelphia. We sat there, face to face: one white, one black. There were similarities between the two of us. He was 28, I was 22. He was from West Philadelphia. I was from Northwest Philadelphia. He remembered Ritchie Allen, a Phillie who routinely rocketed homeruns out of Connie Mack Stadium. And so did I.

But it is the contrast that gnaws at me. I was the doctor. He was the patient. My father was a prominent surgeon who, to this very day, I idolize as my greatest role model in life. He only remembered seeing his father twice. He dropped out of high school at the end of 10th grade. I graduated from an exclusive prep school.

In the fall of 1968 , as a boy of 12, I loved to watch the Dallas Cowboys. In the fall of 1968, as a boy of 18, he enlisted to go to Vietnam to avoid being shot and killed by a rival gang on the streets of West Philadelphia.

The session was meant to be one in which a young doctor polished his interviewing skills by speaking with a patient dealing with mental illness. The hospital was filled with Vietnam veterans, so all 20 of my other medical school classmates were also conducting their own interviews on that day. The young man opened up “I enlisted to go to Vietnam because I thought my chances of living would be better there than on the streets of West Philadelphia with the gangs. I knew that I had made a mistake when the plane was flying me into Vietnam and I saw all the bombs going off in the distance.”

He was quiet and very sensitive. His voice quivered and his words were somewhat guarded, all so consistent with his story of violated youth. On this day, the doctor had no words of wisdom. On this day the doctor did the learning.

Today, I am a physician in an urban health center. I have carried his words with me across 28 years in time. They have never gone far from me. Periodically I have thought of him, although his name I have long forgotten. He taught me great humility on that day and I hope that I have carried that humility to the bedside of every patient for whom it has ever been my privilege to care. I now remember him as one of my greatest teachers in medical school.

I sit here in my office in Camden, New Jersey. It is on one of the top floors of the medical center and from it I can see far across the Delaware River where I have a clear panoramic view of the City of Philadelphia. Through the eyes of a now 50-year-old man, I see off in the distance that city’s tallest building, Liberty Place. It stretches proudly into the night sky, a well-lit beacon symbolizing the spirit of man reaching to new height. And its name reminds us all of a declaration in support of independence from fear and need so bravely articulated 230 years ago. With the advent of this New Year, so many of us celebrate the wonderful blessings that freedom in America has made possible. I am one of them.

But as I look out my window I do see an expanse of low-income, and even abandoned, housing that unfolds before me. I see Camden, a city known for its poverty and crime. And, in the distance, the City of Brotherly Love which was plagued with nearly 400 homicides in this year. I think of 47 million uninsured Americans struggling in a land of plenty. And I think of the similarities between the Iraq War and Vietnam.

As I look off towards Liberty Place, I think of my teacher and what he taught me that day. We hear so much about freedom these days. In this Holiday Season 2006 there are hundreds of thousands of Americans who will be in far off lands away from family for the cause of freedom.

For a moment I look out my window and think back to the fall of 1968. I see a young black man in the streets of West Philadelphia and he is tired and scared, trapped in a jungle of youth violence and poverty. He makes a decision to go to Vietnam in search of a better life? Perhaps Janis Joplin sung it best: “Freedom’s just another word for nothin’ left to lose.”*

Beautiful Sunsets,

Strawberry Fields


*From “Me and Bobby McGee”- sung by Janis Joplin, 1971; written by Kris Kristofferson