While in clinic one afternoon, amidst all the paperwork and coordination of care, I discovered nothing short of a living miracle. She had been living for 57 years with spinal muscular atrophy and was now only able to speak and move her thumbs. Upon further discussion, I learned how much she had accomplished. With such minimal motor function, she had completed high school, earned a college degree, served as a minister, recently learned Spanish, and was in the process of writing a faith-based book for others who had spinal muscular atrophy. Having found that she had achieved all of this with a mouth-operated computer mouse, I was in awe. As I examined her, assessing for muscle strength, I suddenly became aware of my own movements. Never had I realized what a blessing it is to perform tasks as simple as lifting a pen, turning a page, or scratching my head. With this heightened consciousness, it felt almost as if I was doing them for the first time.

As I walked home that evening, a wave of immense gratitude washed over me. Each step was now precious. I couldn't help but to ponder over how much she had achieved with only her thumbs. What would she have accomplished had she been given what I had? Upon further introspection, I began to feel almost ineffective. As are many of our patients, she is a true champion of the human resolve, and I, just a meager participant. Perhaps the universe isn't that cruel after all, as studies have shown that patients with spinal muscular atrophy are more intelligent than their peers.

As physicians, we often view our patients as those in need of our helpan opportunity to cure an ailment or ease suffering. We serve as guides throughout their battle. Every so often, we encounter extraordinary individuals who serve as a mirror. Upon peering therein, our own flaws are revealed by those who would otherwise be considered ailing. In the process of examining and assessing my patient, she had revealed to me my own pathology. It was a reversal of the doctor-patient role. Her determination had inspired me to expect more of myself, to tap into my latent potential. Seeing her as an exemplar, I would certainly always have room for improvement.

Many physicians primarily choose to go into medicine, and furthermore neurology, for the personal human interaction with our patients and to serve as healers. In an era where many of the discussions and decisions surrounding the practice of medicine revolve around its financial aspects, it has become increasingly easy to lose focus of that initial purpose. As I continued my walk home that evening after MDA clinic, with my sense of newfound gratitude still lingering in the air, my phone alerted me of a new email in my inbox. Finding that it was an invitation to an upcoming talk for young physicians about how to set up a profitable clinical practice, I couldn't help but to give out a sarcastic chuckle.