Dr. Nagel for NH
  • Home
  • About Dave
  • Beliefs
  • Accomplishments
  • Priorities
  • The Missing Chapter
  • Contact

The Missing Chapter
Ellen, a Man in Despair, and too Many in Pain

The Missing Chapter is my second book, and I am sharing it with you because the thoughts expressed in it are what motivate me to do what I do.

There is nothing worse than poverty—it is the most terrible of all sufferings. A person who is crushed by poverty is like the one to whom all the troubles of the world cling and upon whom all the curses mentioned in the Bible come. [i]
     Transforming moments happen often when we least expect them, when we are unaware. Sometimes the transformation is immediate. More often, the moment is a seed planted, one nurtured over time as a journey, one which yields its harvest slowly, over time. This is the story of such a journey.

     The journey began when I met Ellen. I was a nervous freshman in college, she an established and popular junior. Despite her 4’11”, 85-pound stature, she frightened me by her confidence and her New York City toughness. Little did I know that her tough façade hid a warm and caring interior.

     Our paths crossed many times during my first year and early into my second. At some point she did acknowledge my presence. As I was anything, but popular, such acknowledgements did much to elevate my sagging self-esteem.

     One evening that all changed. After a long night of studying, I headed to the school pub, grabbed a beer, and sat down at a table with a few friends. Not long after, Ellen sat down opposite me. My heart raced as she began to talk to me. As we talked, I slowly calmed down as both our guards were lowered. I was quickly overwhelmed by the depth of both her thought and her vulnerability. As much as her tough façade gave me pause, I quickly came to see that beneath that exterior lay a depth of thought and a kindness for others that drew me to her. Immediately we became friends, lifelong ones at that. What a gift. For a short time, we dated. Quickly, we realized that perhaps that was more than was intended for us.

​     Ellen graduated too soon. She returned to her native New York City, a place that scared me. The noise, the crowds, the smell…  One thing scared me more than any other, the homeless. I had never seen such people where I grew up.

     I have no idea why they frightened me, but they did. I think it was their un-predictability. Perhaps I feared that there was really little but fortune than separated us. I was afraid of what they would do to me if I ventured too close. I think that what frightened me most were the ethical challenges they posed to me.

     As I thought of them, I could not help but be drawn to Jesus’ story of the Good Samaritan in the Book of Luke. The story is complex and has great meaning to many, the morality shared guiding virtually every code of ethics in every culture, one we all profess, but rarely live up to.

     There are two parts to the story which are connected by a challenge to Jesus posed by a scholar of the law. He begins by asking Jesus what he must do to achieve eternal life. Jesus asks him what the Law says.

     The scholar replies: “You shall love the Lord, your God, with your heart, with all your being, with all your strength, and with all your heart, and your neighbor as yourself.”

     The so called “greatest commandment,” which gives rise to the “golden rule,” rules proclaimed long before Jesus form the basis for every faith and every code of ethics in our world.

     So easy to say, so hard to do.

     After Jesus praises him for his answer, the scholar further tests Jesus by asking him: “And who is my neighbor?” Jesus, as he was prone to do, answers this inquiry with a story, a parable, one we know as the story of the Good Samaritan.

​     He begins by speaking of a man who was traveling from Jerusalem to Jericho, a mountain road notorious for its danger. Upon this road, he was attacked by robbers. They stripped him of his clothes, beat him and went away, leaving him half dead.

     A priest happened to be going down the same road, and when he saw the man, he passed by on the other side. So too, a Levite, when he came to the place and saw him, he also passed by on the other side. Both the Levite and the priest would be expected to proclaim and follow the Golden Rule.

     But a Samaritan, a person considered impure to the scholar whom Jesus was addressing the story, came to where the injured man was; when he saw him, he took pity on him. He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, brought him to an inn and took care of him. The next day he took out two denarii[c] and gave them to the innkeeper. ‘Look after him,’ he said, ‘and when I return, I will reimburse you for any extra expense you may have.’

​     Jesus then asks the scholar, “Which of these three do you think was a neighbor to the man who fell into the hands of robbers?”

     The expert in the law replied, “The one who had mercy on him.”

​     Jesus told him, “Go and do likewise.” [ii]

     As a child, I found it easy to criticize the scholar, the Levite, and the priest. As an adult, I realized that I am the same as them, a lazy coward afraid of those in need, too easily crossing the street to avoid any responsibility for those in need, too often justifying my actions by blaming the one suffering as responsible for their sorry state.

     So easy to say, so hard to do.

     ∞

     In 1982, Ellen invited me to stay with her in New York. One day, we walked down one of the major thoroughfares. As we did, the object of my fear knelt on the sidewalk just to the right side of our path. I, big, tough, compassionate me, sought any means at my disposal to cross to the opposite side of the road. As I sought my escape, there was no hesitation in Ellen. All 4’11” and 85 pounds of my diminutive Jewish friend walked over to the man, bent down to him, put her hand on his back, and with a smile, she put a few coins in his cup. As she did, I was struck by the transforming effect this had on the man. For a moment, his shoulders relaxed, and a smile came to his face. A Good Samaritan actually cared.
Picture
     I was embarrassed by my reaction, or, more aptly, my lack of action. If Ellen noticed, she never told me. She merely continued on down the road oblivious to the effect her action had on me. My journey of transformation had begun. Like most journeys, I had no idea where this one was taking me.

     ∞

     On a beautiful sunny day a few years later, I strolled down a sidewalk in Seattle. It was a weekend, so the streets were relatively quiet. I had just left church, and was deep in thought, reflecting on the sermon I had just heard. I was oblivious to the world around me.

     
While I strolled aimlessly along, others were scurrying to wherever they were going. I was in no hurry. The sermon had been about our responsibility to help those in need.

     “Clothe the naked, heal the sick, feed the hungry, give hope to the hopeless…” Mathew 25 31 – 46, referred to as Judgment of the Nations.

     I don’t know if I thought about Ellen that day, but I did think about the poor. What could I do to help? Great plans came to mind. I could work in a soup kitchen, or raise money to buy blankets, or say some prayers.

     
In the midst of my reflections, I was suddenly confronted with the object of my thought. A man sat on the sidewalk with a sign, which read:
Picture
     He was a young man, perhaps mid-thirties. He was average height and average build. His hair was brown and scraggly, about shoulder length. He hadn’t shaved in days. You can tell a lot about a person by their hands. His hands were big and callused. The nails were overgrown, and there was a good supply of dirt underneath.

     
His clothes were in tatters. He wore an old army jacket, with the sleeves ripped and fraying. His blue jeans were covered with the grime of the gutter. On his feet was an old pair of basketball shoes. The laces were missing, replaced by some well-placed twine.

     
I tried not to stare at him, but I couldn’t help it. The desperation of his sign combined with his appearance created an overwhelming conflict in me. Part of me was drawn to him. I saw him as a man in need, someone I could help. But at the same time, I wanted to flee. I was afraid of this man. Was he honest? Did he want money only to buy drugs? Did he really have a family? Would he hurt me?

     
And then, too, I felt disdain. He obviously had done something to deserve his lowly state. He must be lazy, an alcoholic or a drug abuser. Maybe he was a school dropout. He deserved what he had and his lot in life was no worry of mine.

     
My soul was tortured. All these thoughts ran through my head simultaneously. I was being challenged. The words of the sermon kept ringing in my head:

     “Clothe the naked, feed the hungry….”

     
Didn’t Jesus also say there will always be poor? However, he also admonished us to do unto others as we would have done to us. He told us love was the greatest commandment.

     
I was afraid of this man. I was afraid because there was very little that separated us. With just a roll of the dice, I could be in his shoes.

     
I thought of my mother, a woman with severe rheumatoid arthritis, living in constant and severe pain. Where would she be if she didn’t have such a loving husband? She couldn’t work. She couldn’t take care of all her daily needs. For a moment, I saw my mother in this man.

     
I thought of my brothers and myself. Where would we be if we didn’t have such wonderful parents who were there to praise us when we were good and punish us when we weren’t, parents who gave us opportunities and encouraged us to take advantage of them?

     
This man made me afraid because he made me ashamed of having and not helping. He paralyzed me. He aroused visions. I thought of all the great people in history. Jesus. Mother Teresa. What would they do if they were standing in my shoes? Would they help him? How would they do it? Would they experience the ambivalence I was feeling? It shamed me to feel that way.

     
I looked again at the words on his sign:
Picture
     He didn’t want money. He wanted an opportunity.
Picture
     I wondered where they were and what they were doing. I thought of my own children. What would I do if they were starving? I pictured them playing. I wondered if this man’s children played like mine.

     
Like a black hole, this man dragged me into his world. There was no escape. I needed to understand him. I longed to help him, if only because by doing so, I was helping myself.

     
As I approached him, I noticed his smell. There is something unique about the smell of poverty. I have been in the woods on a campout without a bath or clean clothes for several days, and I haven’t noticed this odor. It is indescribable. It is somewhat metallic, somewhat oily. It irritates the senses.

     
Still, I came closer. As I did, I saw his face. It drooped with the weight of fatigue. It longed for something or someone to prop it up. In the middle of the face were two blue eyes. From a distance they seemed empty and lifeless. You can often read a person by their eyes. His seemed hopeless. They seemed to say, what’s the purpose? Why bother? As I came closer, though, I looked deeper into those eyes. As I did, more was revealed.

     
Beyond the pale exterior, deep in the hole of his iris was a glimmer. It reminded me of the sparks of a fire, either when it is just starting, or just going out. I wondered which they meant for him. As I looked into his eyes, I was inspired to learn this man’s story, the book of his life. I longed to read on, to find out what this book was about.

     
I stopped to spend some time with him, and he told me about himself. His story started in a small town, not unlike the town where I grew up. He lived with his parents and a younger brother. They were very happy. He and his brother were close, and they loved to play in the woods. He went to school and had several friends. He was not a great student, but not a poor one either. He loved sports and was a good basketball player. His friends appreciated his laugh. He could warm up a room with it.

     
It was during his junior year when it happened. He was walking home from school after basketball practice when he heard the sirens of the police cars and the fire engines. He wondered what was happening. His curiosity rose up within him. In a perverse way, he wanted to see the flames. He didn’t want to see anyone harmed, but at some level he just thought it would be cool. If it had to happen, he wanted to see it… just like on TV.

     
While TV shares the sensational merely to excite us, it rarely shares the mundane story that follows, one this boy was soon to live.

     
He followed the sounds of the fire engines, first walking fast, and then running. The sounds led him to his own street. He turned on to the street and then stared in horror as he saw his own house engulfed. The firemen were struggling to get the fire under control, but it seemed hopeless. He ran to the house, calling for his mother, father, and brother.

     
When he arrived, he hoped to find them outside, but they were nowhere. He screamed for them, but they didn’t answer. A neighbor came and held him back. He could tell by the quiver of the hug that something was very wrong.

     
“Where are my parents?” he shouted, afraid of the answer.

     
The neighbor said nothing, just hugged harder.

     
Finally, the fireman dragged something out of the house. It was a body… then another… then a third. The ambulance drivers looked at the bodies. Then they placed white sheets carefully over the faces. No CPR. No bandages. No IV’s… only white sheets.

     
As I stared into his eyes, I could see that white sheet. I saw the frightened little boy, suddenly all alone in the world. I saw the next few years, placement in foster homes, no longer a basketball player, no longer an average student. He “acted out.” At first, his friends tried to comfort him, but one by one they left, as they went on to their own lives. Soon, he was alone.

     
He dropped out of school. It didn’t hold anything for him, and all it did was remind him of old memories, memories too painful to face. He went from job to job, but he didn’t have any skills, and he didn’t last at any very long. He started drinking to numb his pain. At first it helped, but then it didn’t. He had no money and no place to go.

     
He ate at the homeless shelter. It was there that he met her. The only thing special about her was that she made him feel like somebody. She wasn’t pretty. It didn’t matter. Soon they spent more and more time together. When he was with her, all the pain of the past went away. For the first time in years, he could smile. He had hopes. He had dreams.

     
He didn’t intend for it to happen, it just did. With the joys of togetherness comes the fire of passion. One night they lit the fire. Nine months later they had a child. Neither had a job. They had no money. They had no place to go. They only had each other, now a third.

     
As he looked into the child’s eyes, he saw his own life. He remembered his parents and his brother. The memory was no longer painful. For the first time since that day, he smiled when he thought about them. He walked back to his old neighborhood and looked at the place where his house had been. He walked to the cemetery and sat by their graves. He got down on his knees and prayed to God for strength.

     
“God, please help me to help my wife and son,” he begged.

     
The next day, he started looking for work. He looked everywhere he could. The employers looked at his hair and his clothes.

     
“A bum,” they thought. “Never get a decent day’s work from him.”

     
Days went by, then weeks. All he wanted was a chance.

     
Reality came to him. He had a child to feed. He decided to beg. Not for money, but rather for a chance.

     
That’s what he was doing that day when I saw him. As I looked into those eyes, I saw a fire that was growing, not going out. All it needed was some kindling to feed it. Despite all he had gone through, he had a hope deep inside, that if he tried hard enough, everything would work out.

     I don’t know how long we talked. It was probably only seconds. I forgot his clothes and his smell. I forgot all I had thought about him before. I looked at him and apologized that I didn’t have any work for him. I handed him $40, which was the money I planned on spending at an expensive restaurant that night. He told me he couldn’t take it.

     
I told him, “God loves you.”

     
“I know,” he replied.

     
I often wonder what happened to him. I would like to fantasize that all the trials that God delivered to this Job would be undone. I imagine him living in a nice house, sending his kid to a nice school.

     
Then I realize that is not real or likely. Life is not scripted. The Hollywood endings are for the screen only. This is real life.

     
And so, I changed my fantasy to that of a man tortured by the most brutal lessons of life who gladly gives what he has to others, helping those in need, helping them climb the mountain that he had struggled so mightily against. By feeling the crushing weight of the world upon him, he somehow learned to love others. It could happen. Would I have the courage to respond that way?

     Was I a Good Samaritan that day? At least I did not flee to the other side of the street. Too often I have.

     ∞

     
Our lives are a book and the world a library, full of wonderful stories. Some books have pristine covers. Gold and leather adorn them. Others have covers that are worn and tattered. Our senses superficially seek the pristine and ignore the tattered. We judge by the cover, ignoring the comedy or tragedy that lies inside. We seek the path of least resistance, the easy route. It is easy to judge by the cover. It takes time and energy and courage to appreciate what lies within. We don’t have time. We don’t expend the energy. We are too afraid to be courageous.

     
The person who loves has the courage to look inside and experience others for who they are, not what they appear to be. When one skims and judges others on their appearance alone, this does a great disservice to them. Words can hurt. False judgments destroy. The greatest harm we can do to others is to rob them of their dignity, their self-esteem, their ability to believe in their own self. Yet, when we judge superficially, that is exactly what we do. Initially the accused may be able to ignore the world’s judgment. However, over time, when they hear it again and again, they start to believe.

     “Maybe I am no good,” they tell themselves.

     
They start to act as if they are not deserving of respect. The prophecy becomes self-fulfilling. Another life lost just waiting for someone to believe in them. The hero is the person with the courage to believe. The Good Samaritan is the person who takes a moment to leave his path, to go help someone in need.

     
I long to be a hero. I wonder if my actions that day were heroic. Perhaps they were. On that day, I dared to look into his eyes. If I hadn’t, I would have had a wrong impression of him. By looking into his eyes, I was rewarded to see his soul, and therein was something very special.

     That was not what I was taught to do. We like to believe what we are taught because it is easy to do so. It requires no energy. What do we do when we are confronted with something that doesn’t fit our view of the world, the view instilled in us by our teachers? The sages who have taught us are omnipotent. We cannot even imagine them as being wrong. If they are wrong, then how will we deal with our world?


     Is the emperor wearing clothes? No. The right thing to do is question our view and question all that we are taught and try to change the view to fit with reality. However, questioning requires energy, which is uncomfortable. The wrong thing is to rationalize. However, that is what we usually do. Like fitting a square peg into a round hole, we try to stuff the image into our preconceived notion. As we see the square peg dangling precariously out of the hole, amazingly we somehow find a way to take a step back and admire our mental work. Somehow, we have found a way to keep our ego safe from the assault of the aberration.

     
Bums are lazy. Bums have no hopes. Bums have no dreams. Bums live only to annoy those around them. Right? Wrong? Do you have the courage to question your view of reality? Do I?

     ∞

     Years later, in medical school, I came to see the same of those in pain to the medical world as the homeless to the world as a whole. As a student, I was taught to ostracize, stigmatize and blame those in pain for their infirmities. The medical establishment taught me to walk the other side of the street and avoid caring for those in pain, those in need. In my travels, I met Ben and Mr. Smith and Dolores and so many others who, like Ellen and those homeless people, challenged the view of the world I was taught. They in turn forced me in my book, Needless Suffering, How Society Fails Those with Chronic Pain, to challenge that view, not just in medicine, but in the world as a whole.

     
Heroes among us, too often invisible.

     
Yet, they have the potential to guide us when we least expect it.

     
Thank you, Ellen. Thank you to the homeless man in Seattle whose name I will never know.

​     
My journey is well on its way. I look forward to where it will take me, hopefully to the right side of the road.

[i] The Midrash, Exodus Rabbah31.14, New York, Soncino, 1877
[ii] Luke 10, 25 – 37.
 
©David Nagel February 18, 2018.
General Election: November 8, 2022
​Please Vote!!!
  • Home
  • About Dave
  • Beliefs
  • Accomplishments
  • Priorities
  • The Missing Chapter
  • Contact