As physicians, scientists, and nurses, you will experience numerous encounters with patients, colleagues, and students, many of whom will be strangers to you. Such encounters, as commonplace and routine they may seem, can offer significant opportunities to make profound differences in the lives of others.

I will share with you three personal (non-medical) stories in which I either engaged a stranger or I was the stranger. These were my most enlightening, exciting, fulfilling, and transforming encounters of the past year. They speak to diversity, apprehension, surprise, pleasure and the exchange of psychological gifts. They may be relevant to your professional and personal lives.

Dr. and Mrs. Lazare with their eight adopted children of three races at their daughter's wedding.

Story #1
Six weeks ago (1999), my wife and I were waiting at Los Angeles International Airport for the flight to Boston. It was one and one half-hours to flight time. I was wearing sneakers, jeans, and a baseball cap. An Asian woman was escorted to the seat next to my wife. Frightened and lost, she tapped my wife on the arm and showed her a note that read: “Please help this woman. She is Vietnamese and does not speak English.” The Asian woman then pointed to her watch, presumably to have us tell her when her flight departs. I looked at her ticket and noticed she was at the wrong gate. Her destination was Miami.

I quickly rose and began searching the airport for her correct gate. After locating the Miami gate, I returned to the Vietnamese woman and waved her to follow me. I led her to the Miami gate and placed her between two women whom I instructed to ensure that she boarded the correct flight. I returned to my seat next to my wife. As I walked with her, I was overcome with emotion, near tears, aching for this woman who seemed alone and frightened, searching for God knows what and whom. I thought of the biologic mother of my daughter, Hien, a wonderful Vietnamese-African/American child we adopted at age four in 1973. (She was the fifth of eight children we eventually adopted.) Her mother wrote the following letter in the process of legally giving up this child for adoption:

“For one and one-half years I have not had a job or any income to support my child. Because it is impossible for me to continue to care for us both, I want to return to my own family. But I cannot take a black child to my family…I want my daughter to go to her father’s people to be raised, loved and educated as the daughter of Dr. and Mrs. Aaron Lazare. Therefore, I irrevocably and without any conditions, freely and with peace and joy in my heart, give my dear daughter Hien to Dr. and Mrs. Aaron Lazare to be their own adopted child forever.”

I had the fleeting and irrational thought that this was my daughter’s biological mother searching for her daughter. I also thought of the last line of Moby Dick, narrated by Ishmael, the only survivor of the doomed ship Pequod that had been wrecked in the engagement with the great white whale.

“On the second day, a sail drew near, nearer, and picked me up at last. It was the devious-cruising Rachel, that in her retracing search after her missing children, only found another orphan.”

I also thought of a discussion at the dinner table in 1975, a few months after the arrival of our Amerasian/Vietnamese sons (ages eight and nine) from an orphanage in Vietnam. They had just read about the boat people who escaped from Vietnam. Some were now coming to the U.S. The boys asked with some apprehension what would happen if their mother came to get them. (I could imagine their conflict over such a possibility. Their mother abandoned them to the orphanage two years before their arrival. I thought they feared losing their new home and parents while, at the same time, hoping to reunite with their mother.) I could not think of what to say. My wife came to the rescue with: “Well, she will come and live with us too.”

After returning to my seat at the Boston gate, I noticed that an Asian couple now occupied the two seats next to mine. My wife pointed out to me that their package resting on the floor had an address with the first name Hien, my daughter’s name. This, of course, is a Vietnamese name. I immediately began to converse with the husband who related his family’s heroic escape from Vietnam to Thailand in a 20- foot boat. Their five children are now in the U.S. in the Boston area – all educated and doing well. It was a heartwarming story.

I then asked him to follow me, that we had something important to do. I took him to see the Vietnamese woman. I wanted him to speak to her and comfort her. He did that. Her plane was now boarding and the two women to whom I had instructed to watch over her were gone. We ensured that she boarded the plane to Miami. I wish I knew more about her.

Finally, the Vietnamese couple and my wife and I boarded the plane to Boston and arrived at Logan a few minutes before midnight.

As we headed for the luggage claim, I noticed this couple’s entire family coming to meet them – daughters, sons, and in-laws. I told Louise I could not leave until I met the family, especially Hien. The father introduced me to his entire family. The son told me he would have been a physician had he remained in Vietnam. I told him it was never too late, gave him my business card, and invited him to visit our campus where I would offer him career counseling.

Story #2
In this story, which occurred about six months ago (1999), my wife and I were the strangers. We adopted an African-American son, Thomas (at age 10 months), who is studying and working in Los Angeles with his fiancée. Her parents, whom Louise and I met on two previous occasions, invited us to their 25th wedding anniversary, which was to be held in the basement of a Pentecostal Church in Roxbury. (My son and his fiancée would not be there).

On the day of the celebration, as the sun set on this cold and rainy Saturday, I became apprehensive of getting lost in Roxbury. I phoned the church to ask for directions. The female voice on the other end of the phone asked where I was coming from. I said Newton. She responded that “You can’t get here from there.” (She did not know how profound a statement that was.) I persisted and she advised me to phone the parents of my son’s fiancée. The father, immediately understanding my apprehension, graciously invited me to meet him at a Howard Johnson’s on the highway and he would take us to the church. We accepted.

When we arrived at the church, the parents went in the opposite direction from us, perhaps to take photographs. We were the first to arrive and were escorted to a rectangular head table. Eight other round tables were filled with African-Americans who, I felt, were staring at us. I imagined they were thinking: “Who are these white strangers sitting at the table of honor?” I was very uncomfortable. I felt we did not belong, that we were unwelcome – worse than being alone. (I can only imagine what it must be like for one or a few African-Americans being surrounded by whites, often on a daily basis.) After a few minutes, I told Louise: “I learned something from being chancellor and dean of a medical school; let’s work the tables.”

We went to each table where I introduced us. As soon as I said, “We are Thomas’ parents,” the people at the table would say with considerable animation and pleasure: “Oh Thomas, we love Thomas.” After 15 minutes at the tables, we were all family. The meal was wonderful and the gathering in the room reminded me of family events from my childhood rather than hostile events with people whom I believed resented our presence. I find it remarkable that my perception of the world could change in such a short period of time.

After dinner, it was time for testimonials. Each speaker began with “praised be the Lord for this day” …or something similar. My future daughter-in-law’s mother, to my surprise, asked me to speak. “Praised be the Lord” was not a natural thing for me to say, so I translated this sentiment in my own words. I then began my five-minute speech by informing the audience that Thomas gets his good looks from me. (He is a very handsome dark-skinned African-American.) Their positive response to my humor put me at ease.

I then told the audience how proud I was that Tom wanted to join this family and how grateful I was to this family for taking him in. (In some strange way that is difficult for me to articulate, I feel very proud that we raised this sensitive, moral, outgoing child who, while very much our loving son, is returning to his heritage.) Finally, I said, welling up with emotion, that “we adopted Thomas 27 years ago when he was 10 months old. Now I am asking all of you to adopt us.” Translation: “Please accept these two white strangers into your family.” Based on their response, we felt enveloped with love. We anticipated with great pleasure a wedding and new relatives. This event came to pass several months later.

Looking back, it is so clear that my family and Louise’s family share the same values with our future new family-in-law through marriage. The differences are only in style—such as the speeches after dinner, a wonderful custom for which I will always be ready. (I always quote New Testament scriptures to the delight of their family, especially my daughter-in-law’s grandfather, the bishop.)

Story #3
Last May (1999), I was awarded an honorary degree from the College of the Holy Cross. When friends asked me how I felt about the event, I said it was a great honor. For the few days following the graduation, I was preoccupied, obsessed with thoughts of the event. The idea of “honor” was inadequate to express the emotion, which I decided had more to do with the idea of my being a stranger.

My childhood and early adulthood occurred before Vatican II. During these years, Christianity for my Jewish friends and me was synonymous with anti-Semitism. It was perilous for Jewish kids to be on the streets, particularly on Sundays after church. This now seems so absurd logically, two spiritual groups, brothers and sisters, monotheist descending from Abraham, being so estranged.

For decades, I have experienced no anti-Semitic events and most of my friends are Christians, predominantly Irish and Italian Roman Catholics. Several of my friends are Muslims. With the awarding of the honorary degree, I realized that my childhood trauma remained with me to that day. But now I was being taken in to share, as a Jew, the spiritual gifts of the College of the Holy Cross and a unified spiritual community.

Receiving the honorary degree, together with the accompanying citation, moved me to the core. My scholarly writings were described as “priestly, almost” and the final statement of the citation read: “That all may know of our esteem for you and that our students may have in you an example to imitate, the College of the Holy Cross confers upon you today the degree, Doctor of Science, honoris causa.”

This was the healing of a stranger. I am a stranger no more.

Religious Implications

Aaron Lazare

The Bible is full of stories about encounters with strangers (the terms stranger appears in the Hebrew Bible and the New Testament 205 times) : Joseph was a stranger in the land of Egypt after being sold by his brothers. He became the second most powerful man in the country and was in the position to save and forgive his brothers. The Passover story from Exodus has the recurrent theme, “We were strangers in the land of Egypt.” There’s the parable of the Good Samaritan who reached out to a stranger; the parable of the Prodigal Son who, after becoming estranged from his family, was unconditionally embraced by his father; Hebrews: 13:2: “Do not forget to entertain strangers, for by so doing some people have entertained angels without knowing it.”

Matthew 25:35: “For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in…;”

What does this have to do with all of you on this important occasion of your graduation?

Our patients, strangers to us, worry about loss of function, physical and mental pain, and the ability to pay for needed medical services. They commonly perceive their diseases as defects, shortcomings, deficiencies, or weaknesses. This is the experience of shame. They are expected to tell physicians and nurses, people in positions of greater power, and usually strangers, about such limitations and then remove their clothes and disclose their secrets so that the doctors and nurses can examine and probe all the private parts of their bodies and minds.

Although we are supposedly “in charge” our task in caring for these strangers is not simple. As physicians and nurses, we believe we should have mastery over knowledge, which is impossible to master. We want to control events that are impossible to control. We aspire and swear to “do no harm” and yet we make mistakes. We are subject to the scrutiny of the public who regard us alternatively as saints and sinners. We are supposed to be compassionate and non-judgmental but sometimes we lack compassion and we judge harshly.

With such dynamics between these two strangers (doctor/nurse and patient) in every clinical encounter, the stakes are high. But we have the ultimate power to reach out to the patient/strangers and take them in; to help them bear their suffering; and, equally important, to preserve their dignity.

In such encounters, we become transformed, just as I was in the three stories I related earlier. The gifts are there for us.

We must cherish these interactions with our patients, colleagues, and students. We should regard these medical encounters as hallowed, sacred events.We should regard every human encounter as a hallowed, sacred event.