In my hands, a glimpse of war
Editorial Commentary on The Human Experience

In my hands, a glimpse of war

Miguel Julião^

Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal

^ORCID: 0000-0001-9283-5045.

Correspondence to: Miguel Julião. Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal. Email:

Keywords: Essay; personhood; war

Submitted Nov 25, 2022. Accepted for publication Dec 06, 2022. Published online Jan 31, 2023.

doi: 10.21037/apm-22-1347

We lose the battle when we forget to remember” (1).

At the age of 41, notions of war are but echoes. Echoes from history books; from war survivors I was privileged to meet; from relatives of survivors whose stories were passed through generations; echoes from my great-grandfather’s watch, which he carried on his wrist after leaving his country to battle in the First World War; tributes to soldiers, to ordinary men, and women and their children all over the world.

Echoes echo from afar.

Even these days, when I close my eyes, I can vividly hear them and feel their stories, and their silence; a distant shadow of their feelings, anguish, fears and hopes. Life has given me this precious gift to open, carry and revere. My great-grandfather’s worn brownish watch around my wrist marks time moving forward, while turning my thoughts to the past. It has a peculiar weight, laden with memory, respect, and gratitude that lives in my body and soul.

But echoes echo from afar.

For me, as for many, the horrors of war are vague, remote stories, passed along from survivors, one generation to the next; or contained in lifeless pages bound in volumes that adorn my bookshelves, endangered by neglect, the passage of time and our collective memory loss. While we strain to take in these fading sounds of human suffering, horror, survival, love, and hope, what are we truly able to hear? And as we try to watch those unfolding events in our minds eye, what are we really able to see of the inhumanities of war?

This is the story of a man, a war refugee from Ukraine, dying from advanced metastatic gastric cancer whom I was honored and fortunate to care for in his last month of life. This is also my story as his witness. What he helped me hear and see did not arrive through the pages of a book or hand-me-down memories. For him, war was first-hand, as fresh as the previous few months before we met.

These were not distant or fading echoes, so I will talk to you directly, as if you can still hear me the way you did during the time I got to know you and you allowed me to be your witness. While I saw you lying thin and sleeping in your bed, your presence transported me to the Ukraine, from city to city, and the rugged roads and endless miles that brought you here to this place to die. You helped me imagine the bombings and how you struggled between fear and the desire to stay home; your lifelong house, the neighbourhood where only you and your wife resisted amidst the missiles’ fog. You helped me see you closing the door for the last time, leaving everything behind.

What do we carry within ourselves when we are forced to leave our home behind? What memories can our hearts accommodate after we close the door shut? What load could you carry, given your weak, thin, cancer-consumed body? Perhaps some warm clothes to prevent freezing to death, and some crackers and a bottle of water to delay hunger and thirst.

As you lay on your deathbed, closing and opening your eyes, in absolute silence that filled around us, I tried to imagine the scenes of destruction and loss your mind took you to. Fatigue within your soul. Bruises in your heart.

While encountering you, I was the witness, and you were the presence. War was yesterday and today, not a recollection of the past. You were a living presence of war, a living memory of the shrapnel of war in the body and soul of humanity.

No words were needed. I didn’t speak your language, nor did you understand mine. There was a vocabulary of silence, respect and compassion, and we made do. You spoke with your eyes. Trying to fathom if your silence was tinged with fear, anger, and acceptance? Did you hear echoes of bullets piercing the body of humanity? All you wanted to say to me and ask was a speech of the eyes. Yes, I will never forget your deep dark pupils staring at me. Like when you stare at a painting in a museum of fine arts and freeze, captured by it, imagining millions of stories, words, and messages pouring out from an image of a woman, a man, a child. There are no barriers to human connection when we allow our eyes to do the talking.

I asked for your permission to uncover your body to perform the physical examination, and you nodded with your head. While exposing your body slowly, I found there was more to witness than the consequences of cancer.

On your deathbed, your body and your soul detached, far away, from where home was.

Let’s start with hearing your heart and lungs.

May I?

You blink your eyes twice.

When I listen to your lungs, I heard so much more.

Your breath once carried the wind and breeze from abroad.

When I listen to your heart, each beat is solemn, marking time that further separates you from friends, family and reassuring voices.

Your body has pain and discomfort that have nothing to do with cancer, and your scars and bruises extend beyond those from cancer surgeries. Examining your body reveals a battleground of your soul.

I imagine your weak and pale legs still walking—escaping from war, the bombs and the sirens and returning to the Ukraine, to your home. In your pocket, I imagine the key to your house and you entering it again and sitting on the couch where you used to read or fix your old radios.

I’ll cover you again. Thank you.

You blink your eyes twice, nod your head, and say “Спасибі”—“thank you” in Ukrainian. The only word we ever say to each other.

I never felt so sure of not wanting to wash my hands after examining a patient. My hands held no clues to clinical findings of your physical exam.


This time, my hands held a glimpse of war.

Deep, persistent, profound.

I backed away from your bedside as if I felt an electric shock.

My hands have traced the outline of battles you fought, trauma you endured.

Running away from home to seek shelter, food and water, safety, compassion and humanity.

My hands are a treasure box I wish to show the people I love.

I held them together firmly, hoping it would create a lasting imprint of war.

In my hands, a glimpse of the horrors of injustice and war. Bombing, violence, destruction and fear.

In my hands, a glimpse of instinct, survival, love and hope.

I kept my hands held tightly together. Firmly tight. Refusing to let go of your legacy and your gift to me.

In my hands, a glimpse of war.

In my hands, a glimpse of you.

In my hands, a glimpse of gratitude.

In my hands, a glimpse of remembrance.

To you, Спасибі.

On your deathbed, far away from your Ukrainian home, your body and your soul detach.


Funding: None.


Provenance and Peer Review: This article was commissioned by the Guest Editor (Paul Rousseau) for the series “The Human Experience” published in Annals of Palliative Medicine. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at The series “The Human Experience” was commissioned by the editorial office without any funding or sponsorship. The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See:


  1. Li SL. Witness. Palliat Support Care 2022. [Epub ahead of print]. doi: 10.1017/S147895152200102X.10.1017/S147895152200102X
Cite this article as: Julião M. In my hands, a glimpse of war. Ann Palliat Med 2023;12(2):418-420. doi: 10.21037/apm-22-1347

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