The Parable of the Cynical Doctor
There once was a doctor who lost his way.
Like so many, the doctor entered the field of medicine young, optimistic, and talented. He loved to diagnose, prescribe, treat, and heal. He chose to be a primary care physician at a family clinic, and in his first few years he got to see and treat everything: from children’s first coughs to the elderly’s final palliative management, and everything in between.
But over time, something nagged at him. As much as he treated their needs, patients kept coming back. The child he treated for an ear infection would come back months later with pink eye or a strange rash. The clumsy teenager who sprained his ankle broke his arm a year later. The middle-aged man with high-blood pressure would have periods of successful treatment only for the hypertension to return. The senior woman’s cancer would go into remission for years, and then come storming back, claiming her life.
After a while, this nagging became an obsession that affected his bedside manner. When some parents brought their child back in for a new ailment, he snidely remarked, “You again? I just fixed you months ago.” He began scolding patients for their illnesses and injuries:
“Why can’t you be more careful?”
“Maybe you should just stay locked up inside so you don’t catch anything.”
“You’re a burden on the system if you can’t stay healthy.”
“There’s no point in treating your mom’s cancer, it’ll probably just come right back.”
While he often took it out on his patients, the doctor’s real frustration was with himself. If I were a better doctor, he thought, my patients would get better, and stay better. His physician friends tried to offer platitudes and encourage him that it wasn’t his fault: “Some patients just can’t be helped,” they said. But this didn’t satisfy his existential crisis.
Needless to say, his practice dwindled. Patients spread the word to avoid the cynical doctor. He went a whole week without any appointments or walk-ins, and was preparing to close up early on Friday when he an old man walked in, limping on a cane, but with life and bounce in each hobbled step.
“Am I too late?” the old man asked. “I’d like to get a checkup.”
The doctor rolled his eyes a bit, but ushered the man in. “How old are you?” he inquired.
“91 years young,” smiled the old man.
“Not much time left,” sneered the doctor. “A checkup? What do you want me to tell you? That you can run a marathon next weekend? That you’re gonna live a good, long life?”
The man chuckled. “You’re a bit sour, aren’t you? Going through something?”
The doctor almost went on a tirade, but caught himself. Not worth it, he thought. So he redirected. “Do you have any thing specific you want me to look at or to consult about?”
The man then listed every ailment, prescription, treatment plan, and condition he’d had for the last two decades. The doctor’s eyes widened, impressed at the old man’s recall and seemingly thorough medical knowledge. “Sir, were you a medical professional?” he asked.
“For 45 years!” the old man beamed. “And lots of years volunteering at the free clinic after that.”
With this, the doctor’s face fell and he could not hold his facade any longer.
“How?!” he implored. “How could you do it for so long? Treating the same people over and over and over; watching diseases come and go; people get better from one thing only to get sick with another? Are you insane, or are you just a fool?!”
The old man laughed again, “Ah. Now I see what the trouble is.” He glanced around, “And why your waiting room is so empty.”
The doctor was stunned and sullen, “I just… what’s the point?”
“Can I tell you a secret?” the old man asked. The doctor shrugged.
He looked the doctor square in the eyes. “All of your patients—even the ones who get all the way better and never come back to see you—they all eventually die.” He lingered on that last word.
The doctor frowned. “That’s no secret—and it certainly doesn’t help! That just proves my point. Why should I work so hard to heal people if they just get sick again? And in the end, no matter what I do… death always wins.” Tears began streaming down his face, the last of his composure gone.
The old man smiled knowingly through a long pause and a deep breath. “That wasn’t the secret,” his voice was lower now, and the doctor leaned in.
“This is the secret: the fight for life isn’t won at the end; it’s won in every wild and precious moment you still have. Every second of every day of living—each one is its own victory dance over death if you use it to love, to rest, to work for good, to feel all this life has to offer.
“Of course, you can’t live other people’s lives for them, and some may choose to take those days for granted, or waste them on resentment or fear. But how many extra moments have you given to people over the years? And how many of those moments did you make better? Moments that would have been spent in pain or discomfort that you relieved or made more bearable because of your treatment? You made millions of moments possible, and millions more of them easier to enjoy.
“Everything ends. But giving people more chances to live, and to live well? Son, that’s a miracle—every time.”
Over the years in my field, I’ve encountered many folks who are going down the path of the cynical doctor. None of them were doctors, of course; the parable is a bit fantastical in that way. Medical professionals usually know that their goal is to ease pain and suffering, not to eliminate it.
But for some reason, when it comes to homelessness, mental health, and substance use… I think we tend to forget that.
I’ve heard it any number of ways. When a person gets housing after a long period of homelessness, but then loses it. When a person’s mental illness seems to lessen under a new treatment plan before returning with a vengeance. When a period of sobriety ends in relapse.
I’ve heard it from their friends and family, and I’ve heard it from seasoned case managers and social workers. The voice of the cynical doctor: “What was the point? All that time and energy was wasted! Should I even bother to try again?”
If you’ve ever found yourself in that spot—I know I have!—then remind yourself what the old man knew:
Any moment spent living safely inside
Any moment spent with a clearer, healthier mind
Any moment spent in a safer and freer relationship with drugs and alcohol
Each is a precious, liberating gift—a victory dance over the forces of displacement, terror, trauma, and powerlessness.
Each of these moments also stores up resilience for the future. None of us start from scratch each time we fail, yet when it comes to “failure” in homelessness or substance use, we imagine that all the work put in is gone.
Nothing could be further from the truth.
Each of those moments is your new foundation, the floor you raised. It’s the check-point from which you now get to start; not from the beginning, but from the new innermost place of strength you built for yourself piece by piece.
Let’s not be like the cynical doctor and allow the end to dictate our joy—or to stop us from fighting for another ending, another million moments of life.
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Kevin, I think I need to read this regularly! This week I’ve been the cynical patient - struggling to see the point in continuing to try to heal and improve my quality of life. This reframing really helped me!
This parable is really powerful, and what I needed to read today. Whatever goals we have for trying to do good can seem hopeless at times, and you've let me know that no act of kindness is too small. Thank you so much for lowering my cycnicism.