The Muralist: Healing Transcending Hospital Walls
By: Sophie Goldman, MD
The muralist who drew me had lost his housing. He had undergone repair of an abdominal aortic aneurysm, but the procedure was complicated by spinal cord ischemia and paraplegia. He was still learning how to adjust to his new reality, and it was too difficult. After missing a few months of rent, he was evicted. He stayed on the street, sleeping in shelters when he could and trying to stay awake when he couldn’t. His wheelchair was falling apart, and he fell often; the police brought him into the ER one day when he couldn’t get himself back up.
In the hospital, his pain was uncontrollable. Despite minimal complex medical needs, he remained in the hospital awaiting rehab placement: a narrative not unfamiliar to many of our patients. There had been pressure to discharge him and make room for patients requiring “quaternary-level care,” but he threatened to overdose on fentanyl if we pushed him back onto the street. He didn’t have an opioid use disorder; his pain was all-consuming.
He needed high doses of IV opioids—“out of proportion to his injury,” the adult pain service said. We should start a taper and transition to buprenorphine. I get cross-eyed and my head hurts scrolling through different taper schedules online and trying to align all the doses and dates. I pend the orders for my senior to sign—a safeguard I sometimes take for granted. As long as there were no glaring mistakes he would sign it, though unfortunately he was spread too thin to untangle it all.
But I messed it up. The taper was too abrupt, or the orders were wrong or unclear. The muralist moaned and cried out, and all I could do was apologize and wish desperately that none of this was happening to him.
Things settled after a couple days, and our daily routine resumed. Every morning, I would squat next to his bed, apologize for waking him, then struggle to move his bedside tray, spilling colored pencils onto his bed as I attempted to do a good exam. For three more weeks, I reported his labs, started and stopped antibiotics, and exchanged messages with the case manager. On my last day of the rotation, he was still there—still waiting for the final word on placement, his new wheelchair supposedly on its way. I woke him up, asked if he’d had any fevers or chills, listened to his heart and
lungs, and as I said goodbye he handed me a drawing he had made of me. Tears welled up as I looked at the drawing; I felt grateful and heartbroken. I thought about how isolated he had become, sitting in the hospital for weeks, unable to get out of bed while we tinkered with his medications for seemingly no reason, delivered broken promises, and asked the same questions over and over to see if maybe today he had had shortness of breath or chest pain. Meanwhile, we gave him potassium and magnesium and told him that hopefully the physical therapist would be able to see him that day, a whole part of him—his art, his lifeblood—was atrophying.
He starved for community, for friends and collaborators. I pictured him fighting to hold onto the beauty and color that had infused his murals; to maintain the pride he felt in sharing his art with the families, tourists, houseless folks, and tech bro’s in the Mission. Walking home down 24th Street, admiring the art swirling across the walls and bouncing between buildings, I wanted to believe he would regain it all. I hoped he would paint again, join a residency, or build a new collective for artists with disabilities—he had the spark and the energy to rally people; I felt it.
Even now, when I find myself in the area, I detour through Balmy Alley. I pause in front of murals depicting the slow strangulation of the city: tech buses, rising rents, police presence—each stroke illustrating a community under siege. Standing there, working at Zuckerberg (San Francisco General) Hospital as a “healer,” I feel guilt prick at me. The muralist was a healer, too. His vibrant images nourished the neighborhood.
And so, he became, for me, a symbol of what gets lost when people are pushed out: the soul of a city, the storytellers, the sense of collective care. I have a responsibility to my patients but also to the community that shapes—and is shaped by—their struggles and wins. I imagine the muralist returning to 24th Street in his electric wheelchair with paint brushes in hand, reinfusing San Francisco with color and life. As I step into the hospital every day, I hold onto that vision and remember that healing transcends the physical exams, medications, and procedures; it also must tend to the imagination and communities that make us human.
Sophie is a second-year Internal Medicine resident who grew up in San Francisco eating burritos and getting lost in science museums. She watched the city transform and leave behind its most underserved. Now in Portland, her passion for collective care and equity motivates her to serve the communities that have welcomed her most. She plans to pursue fellowships in Addiction Medicine and Gastroenterology and hopes to continue supporting the most vulnerable wherever she lands.
