I'm a great believer in geography being destiny.

In America, we have always taken it as an article of faith that we 'battle' cancer; we attack it with knives, we poison it with chemotherapy or we blast it with radiation. If we are fortunate, we 'beat' the cancer. If not, we are posthumously praised for having 'succumbed after a long battle.'

I think we learn from medicine everywhere that it is, at its heart, a human endeavor, requiring good science but also a limitless curiosity and interest in your fellow human being, and that the physician-patient relationship is key; all else follows from it.

According to Shiva, life is in the end about fixing holes. Shiva didn't speak in metaphors. fixing holes is precisely what he did. Still, it's an apt metaphor for our profession. But there's another kind of hole, and that is the wound that divides family. Sometimes this wound occurs at the moment of birth, sometimes it happens later. We are all fixing what is broken. It is the task of a lifetime. We'll leave much unfinished for the next generation.

We come unbidden into this life, and if we are lucky we find a purpose beyond starvation, misery, and early death which, lest we forget, is the common lot.

What we need in medical schools is not to teach empathy, as much as to preserve it. The process of learning huge volumes of information about disease, of learning a specialised language, can ironically make one lose sight of the patient one came to serve; empathy can be replaced by cynicism.

The key to your happiness is to own your slippers, own who you are, own how you look, own your family, own the talents you have, and own the ones you don't. If you keep saying your slippers aren't yours, then you'll die searching, you'll die bitter, always feeling you were promised more. Not only our actions, but also our omissions, become our destiny.