"I was going to give this to my sister, but I want you to have it."

He handed an onion to the neurologist. It was freshly picked from his garden with the leaves still intact and bits of dirt clinging to the roots. The neurologist hesitated a moment before gently taking it.



The man's appointment wasn't about his liver disease. I can't recall details of the neurological concerns he presented with. That aspect of the appointment was sidelined in light of the gross ascites the gentleman came in with and the other stigmata of liver disease. He was visibly uncomfortable and unwell.

The neurologist queried the gentleman about it and asked when he was going to see someone about it. He stated the Urgent Internal Medicine clinic (a misnomer in this case) planned to see him in about a week's time.

This was not satisfactory to the neurologist as the patient was in clear distress. He dedicated himself to the task of getting this man seen and worked up sooner. I was quiet as I watched him coordinate a more timely consult and an urgent ultrasound to assess for any abdominal pathology. The patient was taken aback by the efforts to address something that was wholly not neurological in nature.

The man was sick, and that was obvious. Carefully wrapped in paper towels in preparation for gifting to his sister, it was clear he was proud of that onion. Whereas a healthy individual would be able to tend to a garden with ease, it was a struggle for this man to harvest even a few root vegetables.

Despite it being a humble onion, the neurologist and I understood the gravity of the gesture. The man conveyed his gratitude through presenting it to him. It wasn't just an onion - it was a symbol of how hard this chronically ill gentleman worked to produce it. There is a wry humour in the fact that the onion made me tear up though it remained physically intact.

I learned a lot from that neurologist in that simple exchange. The importance of seeing a patient as a whole person rather than just a sum of organ systems; the significance of looking beyond just your scope and doing what is ultimately right for the patient. Even though he had a busy morning clinic and it technically was outside his direct consultation, he saw the suffering in that man and did whatever he could to alleviate it. I pray that I will refine and retain that level of humanity and never lose that appreciation of a patient as a human and our role to help them. I hope that, one day, I am the type of clinician that will receive an onion.