Tiny Things

They’re invisible to us. But they can lay us low.

His body was like a bent reed. His face little more than a skull covered in papery skin and a few stray hairs. The only round thing on his body was a tumor. It protruded like a pale brown tomato on his neck.

The doctor, a young woman, convinced the man to follow her up the dusty path to his house. She needed to talk to him about his diet and medications.

I was in India as a volunteer for a palliative care organization, Pallium India. The team was made up entirely of Indian doctors and nurses. I was there to observe and help where possible.

The house was really just a shack. A wisp of a child peered out from its dark recesses. Her long hair was lank on her shoulders, her brown eyes enormous. She seemed swallowed up by her multicolored dress.

She gripped a doll in her fist. It was ragged, the plastic features of the face worn away, the body nothing but frayed fabric. My heart gave a jolt at the sight.

I was so caught up in what was wrong with the scene, and the situation, that I didn’t notice the little girl’s shy but unmistakeable smile.

I found myself getting frustrated with the man. He didn’t want to hear anything about medicine or anything else the doctor had to say. All he wanted to know was when he would be allowed to eat seeds again. I learned this from the doctor, who translated for me from Malayalam.

“He doesn’t understand that he’ll never be able to do that again,” she told me in a low voice. “It’s his favorite food. But it can’t get past the tumor. The seeds get stuck in his throat and make everything worse.”

The little girl, his granddaughter, hung about as the doctor tried to reason with the man. I wished he would realize he had to take care of himself — if not for his own sake, then for this vulnerable child.

I couldn’t imagine what it would be like to grow up in a place like this. No running water. A stinking outhouse that sat perilously close to the well, where drinking cups and toothbrushes sat out in the open. Inside, the house had not one stick of furniture. The beds were nothing more than stone slabs. And only one toy. One.


I couldn’t imagine what it would be like to grow up in a place like this. No running water. A stinking outhouse that sat perilously close to the well.


I recalled the shelf upon shelf of stuffed animals, dolls, games, and figurines in my childhood home growing up. The casual way I tired of one toy and cast it aside in the hopes of getting a new one for my birthday or Christmas.

My thoughts were interrupted by the growing number of mosquitoes that buzzed all around us. I was terrified of picking up a mosquito-borne disease. Not so much because I didn’t want to get sick (though of course I didn’t), but because I would be a burden on the organization that I was supposed to be helping.

As the sun beat down on my head, I tried to swat away the mosquitos as best I could. For the first time since arriving in India, a feeling of despair swept over me.

I thought of tiny things. They’re invisible to us. But they can lay us low.

A virus like dengue fever could turn my volunteering trip into a horror show. And this man, who though a grandfather was probably forty-five, would never eat seeds again. All because of some microscopic thing in his body that was never going to stop spreading until it killed him.

Why?Why should things that are invisible be so cruel and unforgiving? If there’s a god or gods, why would they make things this way? And if there aren’t, what’s the point of living in a world like this?

After a month in India, I flew back in the San Francisco Bay Area. My life picked back up, and despite my desire to somehow enter the field of palliative care, I didn’t. Instead, I went back to tech marketing and PR. I tried to do some volunteering, but it didn’t pan out.

And then something happened to me that changed everything. I was in an accident. For two years, I struggled to recover. And then things got worse. Much worse.


Why should things that are invisible be so cruel and unforgiving? If there’s a god or gods, why would they make things this way? And if there aren’t, what’s the point of living in a world like this?


Five and a half years after my trip to India, I was now the one laid low by tiny things. In this case, a nerve that had stopped working.

The result was that I couldn’t move my arms or legs. The doctors had no idea what was wrong with me. It seemed to be caused by the neck injury I’d sustained a couple of years before that. But no one really knew.

My life had been difficult for those two years as it was. I was debilitated and dependent on my husband. I’d been hospitalized once before for pain so severe it had nearly killed me. I’d survived that episode. But now it looked this as if my time really was up.

All I could do was lie there and wait for either salvation or death.

This was me last July, with my husband by my bedside

One afternoon, a nurse’s aide came to my hospital bed. She was young, maybe twenty-three or so. She had short hair and wore one of those woven, hemp style hats that made her look out of place amid the starched nothingness of the hospital.

She sat down in a chair, which was unusual. She seemed to want to make a speech. She told me that I shouldn’t despair. Somehow, I would get through this, she said. She looked incredibly sad and concerned.


All I could do was lie there and wait for either salvation or death.


I told her not to worry about me. Somehow, I said, this was all happening for a reason. I didn’t know what was, but I hoped to live long enough to figure it out.

It was a ridiculous situation, in which I ended up having to be the one to reassure her.

I also told her some of my problems. The biggest at the moment being that I wanted to be able to eat more interesting food. I was stuck with these horrible vegan shakes, which were basically all I could digest.

I recognized the look that crossed her face. It was similar to the one that must’ve been on mine that day in India. Surprise that I could be focused on anything other than my doom. Fear for what my situation said about life, the world…our shared fate.

And there it was, just for a moment. A flash of anger. I wasn’t acting the way someone in a terrible situation should act. I was thinking of my stomach rather than the kinds of things dying people were supposed to think about. In short, I wasn’t taking this in the right spirit.


I was thinking of my stomach rather than the kinds of things dying people were supposed to think about. In short, I wasn’t taking this in the right spirit.


And in fact, miraculously, I did recover. No thanks to the doctors, who were clueless. It was my chiropractor who diagnosed and treated the problem.

What has come home to me since then is that those tiny things that can lay us low are there for a reason.

They’re there to remind us of our vulnerability. Like that little girl, they hang in the background, smiling at us, teaching us not to take life, or one another, for granted.

Me three months after my last hospitalization

When we stop making the world up in our heads and start meeting people where they are, we meet…ourselves.

It turns out, then, that empathy is the most important thing of all. Not because it helps the other person — although sometimes one person can make a great deal of difference with one small act of kindness.

But empathy has a much greater purpose. It helps those of us who are doing the empathizing. It’s the way we engage in the project of being fully human. Fully alive.

The tiny things are there because they are the big things. And the big things…well, most of the time, they don’t exist at all.

Top photo: Taken at the Sree Padmanabhaswamy Temple, Thiruvananthapuram, Kerala, India.

Sunshine Mugrabi is the author of the memoir When My Boyfriend Was a Girl, which The Advocate called a “must read.” Learn more at sunshinemugrabi.com.