Looking back, I probably shouldn’t have put my hand on her knee. But I really didn’t know what else to do. There she sat, on the 32 Route, leaving the school, dissolving into tears. There I sat, across the aisle on the bus, heading home, frozen with fear.

I had never seen someone cry like that. Nothing up to that moment had warned me. Her back was flat against the seat. Her feet were planted on the black-rubber floor. Her face was blotted out by her hands, as if I was a toddler she would “Peek-A-Boo” into laughter.

Yet her hands hid anything but joy. They blotted out a flashflood of tears. They muffled her weeping. They smothered eyes so red and thick, that they would look like mascara. Have you ever peered into a Van Gogh spring day and been surprised to hear thunder?

And then. It was over. Just like that. She uncovered her face. A quiet sniffle. A gentle cough. Ah, yeah. Summon a smile. Change the subject.

Turn away the mirror. But I know you. I’ve danced those steps. I’ve been there before. Everything I could not see still hit home.

*****

That chit-chat with my medical school classmate on the bus began like every other chit-chat that had ever been had. General. Interchangeable with anyone else. Numbing to the point of frustration. Sometimes that’s the point. It’s hard at the end of the day to be genuine. It’s harder when strangers are close enough to overhear.

I gave her an innocuous “How are you?” What often follows is a hollow permutation of “finegoodgreathowareYOUdoing?” We reciprocate, but only because we feel compelled to. We might not always care. Here are 140 people whom you will see every day for 18 months. Many of those days turn out as varied as the next glass of milk. But maybe it’s pathological in medical school. Here are 140 who are “too accomplished” to truly discuss failure, too outgoing to shine the light on themselves, and too tough to uncover their hands.

Many people are genuine. And on many days, many are genuinely happy. But sometimes, what you see are cardboard cutout of smiles and speech bubbles. And sometimes, they front for a world of pain, uncertainty, and confusion crammed into a singular, lonely head. Pushing on those cutouts can be tenuous.

“Fine,” she started off. From there, it could have continued like a regular conversation: your weekend, my sports team, everyone’s weather. But she continued with, “Well…” Those ellipses audible. Paused at a “But…” I don’t know why, but I pushed. And she relented, showing me fragments of where the last six months had left her. Uncertain if, “I can do this, if I’m cut out for it.” Confidence in tatters. Mind in turbulence.

Looking back, how could anyone stay dry?

*****

Once I realized that she was, indeed, crying, I had no inkling of what to say. What could I say? So in my helplessness, I reached out and put my hand on her knee to comfort her.

And so, while her hands covered her tears, I did nothing. I fought my base urge to look away, to pull back, to pull out my phone, to sayonara and swan dive out of the window. I waited.

When she lowered her hands, I told her about one of my own episodes back in December. How, in the blender of anatomy and immunology and failure, I had left—I had to leave—class to dissolve into my tears in a bathroom stall. How I found some stability with my own back against the wall, below the window. How I hid my feet to hide my presence. How I never bothered learning that class, because fuck it. Fuck that class.

I don’t know if telling her helped. I don’t know if I made it about myself by accidentally co-opting her pain. But I hope she understood what I couldn’t have articulated then.

This hole of misery you’re in, I know it. I’ve been down here before. I still visit often. And while I don’t have all the answers, I am offering you my hand. You don’t have to hide behind yours.

Initially published in The Hospital Drive