Catastrophe Transforms Lives in Profound Ways — The author’s experience as a young medical intern during the 1985 Mexico City earthquake fundamentally changed him, turning a routine day into a defining moment that shaped his entire medical career and understanding of what it means to be a physician.

Medicine at Its Core Is About Human Connection — In disasters, titles, protocols, and technology become secondary. What remains is the simple human decision to move toward suffering and help others with whatever knowledge, skill, and compassion one has.

Fear Is Inevitable, But Courage Is a Choice — The essay emphasizes that true courage in medicine (and life) is not the absence of fear but the willingness to respond to others’ suffering despite personal discomfort, a lesson that remained consistent through later events like the Loma Prieta earthquake and the COVID-19 pandemic.

The recent earthquake in Venezuela brought back memories I have spent nearly 40 years trying not to relive. Watching images of collapsed buildings, frightened families searching desperately for loved ones, rescuers digging through mountains of broken concrete with little more than their hands, and physicians struggling to care for the injured under impossible conditions transported me to another place and another time. 

Trauma has an extraordinary memory. It does not matter how many decades have passed or how many lives you have saved since then. Sometimes all it takes is another earthquake, another cloud of dust rising over a broken city, another exhausted physician covered in debris, and suddenly you are no longer watching the evening news. You are there again.

My heart aches for the people of Venezuela because I know, at least in some small measure, what they are living through. I remember the disbelief that follows the shaking, the strange silence that descends after the noise stops, the desperate hope that someone beneath the rubble is still alive, and the emotional exhaustion that follows days spent searching, treating, comforting, and grieving. Long after the television cameras disappear and the headlines move on to another story, survivors continue carrying that day within them. Every earthquake that follows becomes a reminder of the one that changed their lives forever.

Some moments divide life into two chapters. There is the person you were before, and there is the person you become afterward. Most of us never recognize those moments while we are living them. Only years later do we understand that the person who existed before a certain morning never truly returned. For me, that morning was September 19, 1985. It was the day I stopped being merely a young medical intern and began learning lessons that no classroom, no residency, and no textbook could ever teach. The last ordinary evening of my youth began with dinner.

On September 18 1985, three other people and I crossed the street from the Hospital General de Salubridad in Ciudad de México, to a modest Chinese restaurant that had become our refuge during internship. There were two fellow interns, my girlfriend Sara who, more than forty years later, is still my wife, and me. Ironically, we rarely went there for Chinese food. We went for what we affectionately called orejas de Elefante (“elephant ears”), enormous veal Milanese cutlets that extended well beyond the edges of the plate. They were inexpensive, delicious, and large enough to satisfy four perpetually hungry interns who spent far more time inside the hospital than anywhere else.

Like every generation of young physicians before us, we were convinced that nobody had ever worked as hard as we did. Internships have a remarkable way of making young doctors believe that they have discovered exhaustion for the first time in history. We complained about the endless hours, the overwhelming patient load, the lack of sleep, and the fact that we barely had enough time to sit down and eat before another patient needed us. We laughed because sometimes laughter was the only thing that kept us going. Looking back now, I smile at the innocence of those conversations. We believed we understood fatigue. We believed we understood responsibility. We believed we understood stress. We even believed we understood fear. We did not.

The following morning, at exactly 7:19 a.m., the earth decided to teach us otherwise. At seven o’clock I was sitting in a classroom located in the basement of the hospital. Even now, writing those words feels surreal. The basement. The very building that, within minutes, would simply cease to exist. It was another lecture, another ordinary morning in the life of a medical intern. Upstairs, patients were being examined. Nurses were changing shifts. Families were arriving to visit loved ones. The hospital pulsed with the familiar rhythm of medicine. None of us questioned whether the building around us would still be standing at the end of the day. Hospitals are places where lives begin, where lives are saved, and where physicians are trained. We instinctively believe they are among the safest places in any city. 

Then the ground began to move. There was never any doubt in my mind about what was happening. I knew immediately it was an earthquake. Mexico City has always lived with the possibility of seismic activity, and the sensation was instantly recognizable. But recognizing an earthquake and understanding its magnitude are two very different things. The image that has remained with me for four decades was not the movement beneath my feet. It was the pizarrón (the large classroom blackboard) moving with a violence I had never imagined possible. At that moment instinct took over. I remember thinking only one thing: “Get the hell out of here.”

Our instructor told us to stay where we were. I have never blamed him. He was trying to do what he believed was right. But there are moments when instinct speaks more loudly than authority. Several of us looked at one another without saying a word. We simply ran. We ran toward the stairs because every instinct told us that remaining underground inside a violently shaking building was the wrong place to be. I cannot........

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