The Cuba Mission

I went to Cuba in 2019 as part of a medical mission organized by a nonprofit that provides healthcare to underserved communities. I went because I was burned out — exhausted by the productivity metrics of American medicine, the fifteen-minute appointments, the electronic health record that consumed more of my time than my patients did. I needed to remember why I had become a doctor in the first place.

The clinic where I worked was a converted schoolhouse in a rural village in the Pinar del Río province. We had two exam rooms — partitioned by curtains, not walls — and a pharmacy that consisted of medications donated by American hospitals, many of them nearing expiration. We had no CT scanner, no MRI, no blood culture capability, no telemetry. The most sophisticated diagnostic tool we had was a portable ultrasound that one of the surgeons had brought in her luggage.

And yet, for the first time in years, I felt like an actual doctor.

Not because I was diagnosing rare diseases or performing complex procedures — I was treating hypertension, diabetes, asthma, urinary tract infections, the everyday conditions that make up the bulk of primary care anywhere in the world. But because I had time. I spent thirty minutes with each patient — sometimes an hour. I listened to their stories. I learned about their families, their work, their fears, their hopes. I held their hands when they cried. I hugged them when they left. I was present, fully present, in a way that the fifteen-minute appointment slot and the tyranny of the EHR had made impossible back home.

I learned things in Cuba that I had forgotten in the United States. I learned that the most powerful therapeutic intervention is not a drug or a procedure — it is attention. The simple, undivided attention of one human being for another. I learned that patients will tell you what's wrong with them if you give them the space to say it. I learned that the scarcest resource in modern medicine is not technology or expertise — it is time.

When I returned to the United States, I changed my practice. I reduced my patient volume. I extended my appointment slots. I started sitting down with my patients and looking at them — not at my computer screen — while they talked. My productivity numbers dropped, and I took a pay cut, and I have never been happier or more effective as a physician. Cuba taught me that less is more. Fewer patients seen more deeply. Shorter days lived more fully. Medicine as a relationship, not a transaction. It was the most important lesson of my career.