Running Into Dr. Qazi

The Palliative Lens

Andrew Esch

Airports are funny places.

Thousands of people moving in every direction, rushing to gates, staring at phones, dragging luggage behind them. Most faces blur together.

And then occasionally, out of nowhere, you see someone who instantly transports you back twenty-five years.

That happened to me recently when I ran into Dr. Khalid Qazi, my Internal Medicine residency program director at Sisters of Charity Hospital in Buffalo, New York.

For a moment, I wasn't standing in an airport terminal.

I was back in residency.

Back in a hospital that probably wouldn't make anyone's list of prestigious training programs.

Back in a place that shaped nearly everything I would become as a physician.

Ironically, I never even applied there.

I went to medical school in Buffalo and planned on leaving, I interviewsed for medicine residencies at University of Arizona, University of Utah, Brown, UCSF....but then my wife at the time was offered a faculty position at the University at Buffalo School of Pharmacy....and plans changed. Then through a series of conversations and opportunities, I signed outside the match at Sisters Hospital.

No rankings.

No more interviews across the country.

No dramatic Match Day envelope.

Just a young physician trying to build a life.

At the time, I probably wondered if I was settling.

Looking back, I couldn't have been more fortunate.

Sisters wasn't famous.

It wasn't flashy.

What it was, however, was full of remarkable people.

The kind of physicians who taught medicine because they loved it.

The kind of attendings who knew your name.

The kind of mentors who quietly shaped your character while teaching you how to care for patients.

It was a happy place.

Every Christmas the hospital transformed itself. Decorations appeared throughout the halls. There was a warmth to the place that is difficult to describe but impossible to forget.

For reasons I still don't fully understand, I seemed to take call every New Year's Eve.

While friends were celebrating, I was admitting patients, covering floors, and answering pagers.

Those nights are some of my favorite memories.

Residency has a way of turning exhaustion into nostalgia.

The training was demanding.

I spent thirteen months in the ICU.

Thirteen.

That wasn't a typo.

By the end of residency, there wasn't much that could walk through a hospital door without my having seen some version of it before.

The experience made me clinically strong.

More importantly, it taught me how to recognize when someone was truly sick.

Not when the numbers were abnormal.

Not when the chart said they were sick.

When they were actually sick.

The subtle changes.

The look in their eyes.

The family member's expression.

The feeling that something wasn't right before the labs came back.

That skill has served me every day since.

But Sisters taught me something even more important.

It taught me to recognize suffering.

Not just disease.

Suffering.

The difference between the two would ultimately define my career.

After residency, I stayed.

For nearly a decade I worked as an attending on the Internal Medicine teaching service.

Some of my best professional memories come from those years.

The residents.

The students.

The friendships.

The privilege of teaching while continuing to learn.

And then there was the Emergency Department.

Countless nights spent downstairs doing admissions.

Anyone who has ever worked hospital medicine knows exactly what I mean.

The ED becomes a second home.

Somewhere during those late-night admissions I met a physician moonlighting in the department.

His name was Chris Kerr.

At the time neither of us could have known how much he would influence my future.

Chris became one of my hospice mentors and helped shape my understanding of serious illness, suffering, and the work that ultimately became my professional calling.

Funny how life works.

You think you're just admitting another patient.

Years later you realize you're meeting someone who will change the trajectory of your career.

As Dr. Qazi and I stood in the airport catching up, I found myself reflecting on where medicine has taken me since those days.

The path has been anything but straight.

Academic leadership.

National work for 12 years at CAPC

Administrative titles.

Committee meetings.

Strategic plans.

Conference chairing.

All important in their own ways.

Yet the older I get, the more I appreciate what Sisters gave me.

Not a title.

Not prestige.

A foundation.

The ability to care for sick people.

The ability to recognize suffering.

The ability to sit with uncertainty.

The ability to find meaning in the privilege of being present when people need us most.

Those lessons are why returning to clinical medicine later in my career has felt so right.

Today I practice at Moffitt Cancer Center.

My academic title is smaller.

I have fewer leadership responsibilities.

No large team reporting to me.

No major administrative portfolio.

Far less influence on paper.

And yet, in many ways, I have never felt more connected to medicine.

Moffitt has given me something I didn't realize I was missing.

A chance to simply be a doctor again.

To sit with patients.

To hear their stories.

To help them navigate serious illness.

To focus on the work itself rather than everything surrounding it.

In some ways, it feels familiar.

Not because Moffitt is anything like Sisters of Charity.

The institutions are very different.

But because both places remind me why I entered medicine in the first place.

The best professional homes aren't always the most prestigious.

They're the places where your values align with the mission.

The places where you can do meaningful work alongside people you respect.

The places that make you excited to come to work.

The places that help you become who you're supposed to be.

Seeing Dr. Qazi in that airport reminded me how fortunate I've been.

Fortunate to train at Sisters.

Fortunate to spend ten years teaching there.

Fortunate to meet mentors like Chris Kerr.

Fortunate to find another home at Moffitt.

And fortunate to still love medicine enough that after all these years, I keep finding my way back to the bedside.

Sometimes all it takes is an unexpected encounter in an airport to remind you where the journey began.