The Surgical Loneliness

Loneliness is the quiet epidemic — cured, sometimes, by nothing more than company.

The body survives on science; the soul survives on whoever shows up.

I’m a self-professed astute observer of human medical conditions, and this is one of them.

Hospitals are not lonely places, but they contain a lot of lonely people. Over the years, I’ve realised that recovery after surgery doesn’t depend only on the precision of a scalpel or the dosage of a drug. It often depends on who waits for you outside the ICU.

A wound heals faster when there’s someone to change the dressing with care, even if they use the wrong tape. The heart beats steadier when it recognises another voice nearby. And patients who have someone to hold their hand recover sooner than those who have only hospital linen for company.

In most private hospitals, there’s an unspoken hierarchy of caregiving. The wealthy outsource affection. Patients are looked after by nurses, ward boys, dietitians, physiotherapists, and occasionally by family members who make brief appearances between business calls. They arrive with hampers of dry fruits and the latest gadgets to “cheer up Dad” before disappearing again into traffic.

The poor, on the other hand, bring devotion. I’ve seen old men sleeping under their wives’ bed because there isn’t another option. Sons spoon-feeding their mothers soup with the same reverence with which one might pay obeisance to a deity. Daughters massaging their fathers’ feet as if trying to press life back into them. Their love is raw, inconvenient, unpaid, and utterly medicinal.

A few years ago, an elderly couple came to see me. He was ninety-two, she was eighty-nine – both slightly stooped but perfectly synchronised, the kind of couple that walks together without needing to speak. She had a compression fracture in her spine after a minor fall. “Doctor, fix her,” he said, as if I were a tailor and her vertebrae a loose button. We treated her conservatively, but age is a fragile thing. She developed a chest infection and passed away one morning. He was inconsolable. “We were married for sixty-seven years,” he said, his hands trembling. Three hours later, he collapsed and died too. His heart was fine. His will wasn’t. The body, it seems, can only live so long when its reason for living leaves the room.

Loneliness doesn’t just visit the elderly, it haunts youngsters too. During my fellowship in America, I was astonished at how often patients came in alone for major procedures. They’d drive themselves, park, sign the consent, get operated on, and then Uber home post-op, their discharge summary folded neatly next to a salad. No family, no fuss, no waiting arms. Independence taken to its tragic extreme.

In India, we do the opposite. We arrive with entire neighbourhoods. Aunties bring food, cousins bring opinions, and all ask if there is free parking. It’s chaos, but it’s a living, breathing kind of chaos – proof that we still care enough to crowd.

Even so, I often see old patients come to my clinic alone. They walk in with scans tucked under their arms, sit quietly on a chair, and wait their turn. When I ask who’s come with them, they say, “No one, Doctor. My children live abroad.” They smile as if it’s a badge of pride. But when I tell them they’ll need surgery or prolonged care, the smile falters. “Who will stay with you?” I ask. They look down. That pause, heavier than any diagnosis, is what I’ve come to recognise as surgical loneliness.

A few months ago, a widower in his seventies came in for a spine procedure. He lived alone in a flat filled with books and dust. After surgery, he insisted on going home the same day. “Who’ll help you up the stairs?” I asked. “My Alexa,” he said. We laughed. The next morning, he called to thank me – “Not for the operation,” he said, “but for asking that question.”

Loneliness, like cholesterol, creeps up quietly. It doesn’t show up on blood tests but corrodes everything that keeps us alive. You can see it in the eyes of patients who have no one to call, no one to text, no one with whom to share the fear that their next operation might be their last. Science doesn’t yet have a metric for love, but I sometimes think it’s the most potent post-op antibiotic.

Yet, amid the sterility of wards, I’ve witnessed small acts of human repair: a nurse who sings to an old woman while changing her bandage; a ward boy who feeds a paralysed man lunch, joking about cricket scores; a junior resident who sits with a patient long after rounds are done. These moments don’t show up on discharge summaries, but they are where healing truly begins.

We are creatures wired for connection. When that connection breaks, so do we. Machines may monitor pulse, pressure, and oxygen, but they can’t measure hope. Hope isn’t quantifiable. It’s given quietly, in the way a hand rests on another, or in a voice that whispers, “I’m here.”

My all-time favourite Jagjit Singh once sang,
“Mujhe tasalli na do, sirf baithe raho,
Waqt mere marne ka tal jaayega.”
(Don’t console me, just sit with me; time itself will delay my death.)

I’ve seen it happen – in ICUs, in waiting rooms, in homes. Sometimes, love keeps people alive longer than medicine does.

In the same ghazal, Anwar Mirzapuri writes,
“Yeh kam hai ke maseeha ke rehne se hi,
Maut ka bhi iraada badal jaaye?”
(Isn’t it something, that the mere presence of a healer can make even death change its mind?)

However, even among doctors, there’s a peculiar kind of loneliness. We spend our days surrounded by strangers. We talk endlessly but rarely speak. Our WhatsApp groups are busy, but our hearts stay in airplane mode. Loneliness isn’t the absence of people – it’s the absence of being seen. The business of a 16-hour day masks it all.

I recently read somewhere that medicine is considered to be the loneliest profession, because doctors rarely speak well of other doctors and colleagues are rarely friends. We attend the same conferences, exchange polite smiles, even click photos together. We’re co-surgeons, co-authors, and co-panellists – but seldom companions. ​A possible reason for this is that medicine, unlike most professions, is built on rank and hierarchy. Only the ‘toppers’ get surgery. Only the ‘best’ get post-graduation. Only a handful ‘make it big’. ​So, we start running – not to be better doctors, but to be better than other doctors. It’s not malice, it’s conditioning. But the repercussions are lethal.

Studies from reputed show that doctors report the highest rates of professional isolation compared to engineers, lawyers, or corporate professionals. ​One study found that over 60% of physicians have no close professional friends outside their immediate workplace. Besides the obvious mental health repercussions, this is damaging even on a professional front: When doctors stop trusting each other, they stop learning from each other. When envy replaces empathy, the whole ecosystem suffers – and everyone loses, especially the patients.

Technology may let us replace joints, valves, and vertebrae, but it cannot replace the presence of another human being. Machines heal the body; only people heal the soul.

We are all caretakers, whether we admit it or not. The question is: When the time comes, will we be the ones holding a hand, or the ones waiting for someone to hold ours?