Anthony Papagiannis
Thessaloniki, Greece

It is New Year’s Eve, the last day of the year, and as I ride the hospital elevator down to the underground car park, oddly but not inexplicably I think about life and death. Ever since I started medical practice, at the end of each year, I go through my records and list the patients who have left this world, either from the hospital wards or elsewhere. This review serves as a private mortality audit (How did they die? Were the deaths anticipated or sudden? Were they preventable?) and as a reminder of our common destiny and the hereafter.

I think of the hospital as a model of the world at large. Within its walls,  lots of people live out personal dramas, fight battles against disease, or combat other misfortune, either as patients, health professionals, or other carers. While we are in the hospital, we are part of the system, involved in its workings in our various capacities, and affected by its overall atmosphere. As soon as we leave its premises we are free from this atmosphere; we know that the hospital is there and that its work is going on, but the climate of the place does not affect us any longer. We are now external observers of this closed system.

In an analogous way, we can view all earthly life as a closed system where humans live for a variable, but finite duration. Time is a feature of this world, the scale on which all events take place. Every kind of drama, from plain comedy to gross tragedy, is enacted on its large stage. All sorts of human passions, foibles, and idiosyncrasies are manifested here, and have consequences, sometimes disastrous, on large segments of the population. While we live on Earth we are actors, protagonists or extras in the ongoing worldwide play. Whatever happens anywhere may have repercussions on every one of us. However, once we abandon this life, our original role is over; we are out of the confines of this world; the tragedies and passions of the people on Earth do not touch us anymore, although we are aware of them. We have become external observers of the system, impervious to its conditions and workings.

Such are my thoughts at the end of the year, and in this frame I view all my departed patients. Some of them had been under my care for decades; some were friends rather than clients. Now they have “shuffled off this mortal coil,” as Shakespeare would put it, and have joined the myriads of external spectators in the antechamber of eternity, where all of us will eventually go, each one in their good time.