He who saves one life saves the world entire. (Talmudic)

Because of the film Schindler's List, this saying is popularly familiar.  It held an enigmatic attraction, even though I did not understand its meaning.  If I help one guy, that's the same as saving the planet?  I thought of The Martian Chronicles, with just one survivor roaming around.  That scenario did not strike me as equivalent to protecting a whole civilization.

Only later did the verse's truth and power become plain.

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Freddy is not from Malawi.  His brother brought him here when things took a turn for the worse.  HIV-infected, Freddy had suffered from TB and was now confused and breathing poorly.  The x-ray showed damaged lungs, and perhaps a new, dangerous pneumonia.  He wheezed, and made little sense, an intelligent man trapped in a cage of delirium.

Tests confirmed that the antiretroviral cocktail was failing.  Given the cognitive impairment, he likely missed doses frequently.  We administered antibiotics, oxygen, and steroids to calm down irritated lungs. 

Just as the breathing improved, the vision worsened.  In the back of the eye were tell-tale signs of an infection common among those with flagging immunity.  It may have been that the same infection was in his brain, or that HIV itself had simply devoured his mind.  Intravenous therapy for the eye lesions was commenced.

Here I will pause to comment on the diagnosis and treatment.  Before leaving Dallas five years ago, colleagues at the Amelia Court HIV clinic gave me an expensive instrument which allows visualization of the retina without eye drops (or expertise).  The Clinton Foundation had earlier delivered the medicine which saved this man's sight, and perhaps his life.  Freddy is one of two patients whose vision was maintained because of these items.  There is a direct link in this work between resources and outcomes.  Without the former, I am merely a bystander.

"All is like an ocean.  All flows and connects.  Touch it one place, and it echoes at the other end of the world."--Elder Zosima, The Brothers Karamazov

Freddy's condition improved enough that he returned to his home country, now taking a new medication regimen. Upon returning to our clinic a few months later, a report from his doctor indicated that the combination might again be failing to control the virus.  More likely, I suspected, is that without the support from his brother, Freddy was just not remembering to swallow his medicines.   I told them both of my suspicions, directly.  A grudging admission was made that maybe he had missed some doses.  Everyone promised to do better.

Later Freddy gave me one of his paintings, as a token of appreciation.  I had not known he was an artist.  His sight is still not normal but that has not stopped him from painting professionally.  And recently a company offered Freddy a job managing its commercial operations.

After several months, we received a new report of his viral load level.  The second combination is working fine, controlling the virus perfectly.

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They who save one life save a world entire.

Some years ago the puzzle of the Talmudic verse was solved for me.  A Jewish commentator in a documentary explained that, for the rescued person, a whole world of poetry and literature, of art and beauty, has been preserved.  

And the popular translation is apparently a little off:  The definite article is a, not the.  (So The Martian Chronicles alternative is out.)

Medical care is rarely provided by a lone individual.  A team of doctors, nurses, lab technicians, and others saved Freddy's life.  For him, they saved not only his life, but his art and the pleasure it has given others; his job and the contribution it will make to development; his warm personality and the love it pours out to, and calls forth from, his family.