“Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.” – Susan Sontag
Some years ago, I chased the dream of becoming a doctor. Part of that pursuit involved weekly volunteering from 8 to 11 p.m. in a hospital burn unit. Most nights, that meant answering phones, restocking supply carts, and peppering nurses with questions about diseases and treatments. Occasionally, I was called into patient rooms to assist with bandage changes.
One night, I learned a valuable lesson.
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I was sitting at the reception desk when a nurse called me into a room to “turn” a patient—a routine procedure where we roll a patient in a medically induced coma to one side to change dressings and bedding, then turn them to the other to finish. I put on the requisite gown and gloves, and asked the nurse why the patient was sedated.
“She has TEN, which is short for Toxic Epidermal Necrolysis,” the nurse explained. “The body is attacking the skin as if it’s a foreign substance. She’s sedated because the pain would be unbearable. Our job is to stop the immune response and act as a second skin, layering bandages to protect her while she heals. That’ll take a few weeks, if things go well.”
As I helped roll the patient to one side, I was absorbed in the science at play in the room. I had never heard of TEN. I wanted to know the cellular and chemical mechanisms of the body’s immune response, the treatment protocols, and the stages of healing. I wanted to know the history of innovations that had made diagnosis and treatment possible. I was in awe of the human body, this marvelous machine, and the life-saving power of modern medicine.
As we turned her to the other side, something on her right hand caught my eye – her thumbnail was painted a brilliant, glittery blue, sparkling under the sterile hospital light.
In that instant, my perspective shifted. I wasn’t looking at a case of TEN; I was looking at a person. She was a daughter, a sibling, a student. She had likely painted her nails for a school dance or a Friday night out with friends. Her routines, her relationships, and her dreams had all been interrupted by a terrifying disease.
I wasn’t just assisting with bandages. I was helping a person get back to her life outside the hospital.
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That quiet moment changed how I think about healthcare. It’s not just about medicine – it’s about people.
Healthcare is a complex, $5.3 trillion industry. It brings together some of the most advanced science, powerful technology, and sophisticated business models in the world. What modern medicine can do today is nothing short of miraculous. We can replace failing organs, rewire hearts, and decode strands of DNA.
But if these tools and innovations aren’t designed and delivered with people at the center, something essential is lost. Excellence in business, science, and technology is necessary, but it’s not enough. True success means building systems where every interaction is human-centered, seamless, and supportive.
Because most of us will find ourselves in the hospital at some point, whether for a checkup, a surgery, or something far more serious. As Sontag wrote, we all hold dual citizenship in the kingdoms of the well and the sick. And when we’re called to present that second passport, what matters most isn’t just the care we receive, but how we experience the journey through that unfamiliar land.
That flash of glittering blue nail polish stays with me. It reminds me that behind every chart, treatment plan, and policy is a person, hoping to return to their life. Every strategic initiative, technology rollout, budget conversation, and operational redesign should begin and end with that person in mind.
Why?
Because people are the heart of healthcare.
Hugh Spackman, MBA, MHA 