Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Hobbits of Healthcare

Hobbit holes, Hobbiton, Matamata, New Zealand. Photo by Jackie Ick, flickr.com, public domain, wikimedia.org.


The excellent clinician demonstrates hobbit-like bravery by leaning into hard conversations.

It’s like the great stories, Mr. Frodo, the ones that really mattered. Full of darkness and danger they were, and sometimes you didn’t want to know the end because how could the end be happy?
-Samwise (Sam) Gamgee in “The Lord of the Rings: The Two Towers”


Over the holidays, I watched “The Lord of the Rings” trilogy back to back to back. I had seen the movies in the theater when they first came out, but now I was experiencing them anew with my kids. As it had before, the epic tale of Light vs. Dark in Middle Earth resonated deeply with me. I identified with the small band of brave warriors—the Fellowship of the Ring—who venture out against unfathomable odds to try to do the impossible, go deep into the land of evil to destroy the One Ring, which captivates and corrupts those who come near.


And I identified most with the hobbits, especially Frodo and Sam. All of three feet tall, they are not skilled, not strong, and not heroic in the traditional sense. They are simple, humble, and as the story unfolds, incomparably brave. Frodo carries the immense burden of the Ring, with all the weight of darkness and temptation that task entails. And Sam, through selfless friendship and sacrifice in the face of danger and even rejection, carries Frodo. They alone have what is needed to reach the journey’s end: a different kind of courage, one rooted in humility and the single-minded pursuit of a higher vision.


Who are the hobbits of healthcare? Allow me to submit palliative care providers for your consideration. Humble and often overlooked, they demonstrate unconventional bravery by leaning into hard conversations, complex dynamics, and intense suffering. And they focus with singular passion on some simple and timeless truths: patients’ stories matter, death is part of life, presence is powerful.


I am a palliative care doctor. Almost every day I’m in the hospital, I enter into stories “full of darkness and danger,” per Sam’s quote above, when happy endings are often in question. (Side note: in this context, could it be that a happy ending might mean not only disease cure, but better quality of life?)  As I try, in my humble way, to follow in Frodo’s footsteps, I may need to navigate treacherous terrain and bloodthirsty orcs (I’ll let you imagine what these might be). But as I do so, I hope I’ll keep my eye on the simple and true: I’m here to bring a little light—clarity, comfort, peace—to a dark place.


As Sam says a bit later in the speech quoted above:

But in the end, it’s only a passing thing this shadow, even darkness must pass. A new day will come, and when the sun shines, it’ll shine out the clearer.

Amen to that.