“I pray you’ll find some peace,” said the president, her tone so gentle she might have been whispering to a sleeping baby. A tear slid down her cheek and bumped across the edge of her mask. “All of us in this room are praying for your survival.”

He nodded at her, acknowledging her statement even as he shook his head. “No peace,” he said. “I’ll worry about my girls . . . ’til . . . my dying breath.” He pulled up his mask, took in a deep breath, and pulled it down again.

“Ma’am?”

“Yes?”

“Thank.” He sucked in another breath and held on to it. “You. For everything. You’ve done.”

—

CHASTENED BY THE president’s demonstration, I lost the next few minutes of the meeting. It’s one of the dangers of academic medicine: you focus on metrics and lose sight of the beautiful, messy, heart-stabbing reality of the human beings those numbers represent. Afterward, the president hadn’t spelled out her message to us, but she hadn’t needed to; the image of the breathless, gasping, dying Mr. Amir, whose only concern when offered the full assistance of the president of the United States had been the welfare of his family, would be burned into our brains forever. And her: I will never forget the absolute stillness of her face, the burning focus of her gaze as she’d trained it on Mr. Amir, narrowing the world to the two of them. In that moment, none of us had dared to breathe, transfixed by the shared pain of the most powerful person in the world and an ordinary man who would not live through the night. More than anything else, that tear sliding down the president’s face defined the crisis for me.

Every facet of medicine dealt with this paradox: to be a good clinician or a good researcher or a good public health advocate, you had to care about the essential force of humanity behind your work. And yet, if you focused too hard on those you were trying to help, grief and dismay would defeat you and thereby hobble the very aims you sought to achieve. To cope with all the dying, you had to act like all the dying wasn’t happening, or was happening only in some shadow-world form, the events separated from their impact. If you weren’t a psychopath to begin with, you had to protect yourself by adopting something of the psychopath’s talent for dissociation. If that applied to clinicians and researchers, it must apply even more to the woman running our nation, who bore on her small shoulders the weight of all her people.