The Doorsill Where Two Worlds Touch

The breeze at dawn has secrets to tell you.  Don’t go back to sleep.
You must ask for what you really want.  Don’t go back to sleep.
People are going back and forth across the doorsill where the two worlds touch.
The door is round and open.  Don’t go back to sleep.

- Rumi, from the poem "A Great Wagon"

There’s a unique terrain we travel as physicians—a space between two worlds. One world is tangible, full of facts, finances, diagnoses, and protocols. The other is less defined, yet always present: the world of meaning, birth, death, suffering, and questions without easy answers. Rumi names this place “the doorsill where the two worlds touch.”  This doorsill is the place where we provide care to our patients.  And we cross it daily, often without pause, moving between the physical and the profound.

Consider how many times each of us has found ourselves on “clinical autopilot” in the midst of a busy day only to be snapped “awake” as we are called to help someone who is intellectually and emotionally trying to process an unexpected diagnosis, abnormal test, or unexplained symptom.  No textbook prepares us for those transitions. They require not just clinical knowledge, but deep presence—and often, deep reflection afterward. It’s in these threshold moments that I most feel the need to slow down, to ask myself what I’m really feeling, and to appreciate the deep mystery of the work we do. 

It is also in these moments that Rumi’s refrain, “Don’t go back to sleep,” speaks directly to us. We can easily become numb to the weight of our work, to move quickly from one task to the next without allowing space for meaning to settle. Indeed, staying awake—intellectually, emotionally, spiritually, relationally—requires intention. It means creating regular space to ask ourselves the deeper questions: What do these experiences ask of me?  What do I truly want for my patients, but also need for my own wholeness?

It's not easy to create this space during our work.  That is why it is essential to invite others into these questions as well, especially peers who understand the terrain. Such regular connection helps us stay awake at the doorsill.  In conversations where we can be honest and reflective, we remember that we’re not alone in navigating these two worlds. Together, we can hold each other accountable by bearing witness to each other’s experiences, asking challenging but important questions, and sharing insights that come only from those walking a similar path. In doing so, we keep that door between worlds open—not just for our patients, but for ourselves and each other.

So here’s your invitation for this week: pause at the doorsill both literally and figuratively. Don’t rush past the sacred thresholds of our work. Stay awake—not just to the demands, but to the deeper truths they reveal to you, and about you.  And let your peers walk with you.  Remember, they’re on this journey as well, and they, like you, also recognize there is great wisdom in remembering that No One Should Care Alone.  Don’t go back to sleep ....