AUGUSTA – I’d like to tell you a brief story about Nikhil Indukumar Pathak, who melted out of consciousness, and into whatever comes next, on Wednesday July 6, 2022 at 8:53 a.m., at MaineGeneral Hospital in Augusta. He died from a stroke caused by complications in a rare form of vasculitis.

He lived by these twin pillars: Gratitude and Hard Work. The latter he saw as a basic necessity to fulfilling the social contract, irrespective of where in the world you happened to grow up, or what region it is you now inhabit. Most of us try to live through the efforts of our Hard Work. The Gratitude pillar is something he viewed with a great deal more humility than anyone I’ve ever met. Some folks take this to mean how we should respond to the bounty that God has given us; others see it as a good attitude to hold towards the secular cosmos; some among us, however—the ones Dr. Pathak truly disdained—feel that Gratitude is reserved solely for one’s own efforts, as a testament to one’s own Hard Work. This he called hubris. He made it no secret that he saw this form of hubris as a dominant theme among the most wealthy and successful individuals in our society. But the distinction here is important. He held Gratitude and Hard Work as two separate pillars, for they needed to be kept apart in order to provide a solid architectural balance to our lives, which they kept aloft. The farther apart that one could hold Gratitude and Hard Work as constructs, the more tranquility and resilience one could hope to enjoy.

Dr. Nikhil Pathak arrived in America as a physician embarking on two specialties, nephrology and cardiology, from Vadodara, Gujarat, India, in 1967, just a few years after LBJ had signed the Immigration and Nationality Act of 1965 into law. He bought himself a Ford Mustang (that was stolen a week later), and promptly got to work. He settled first in Salem, Mass., and then in New York City, NY., before taking up his long-term roles as the director of both the Renal Dialysis Unit and the Special Care Unit at the VA Hospital in Togus, where he worked for 37 years. Taking into account his time at the VA in Jamaica Plain, Boston, Mass., he completed a full 41 years of service for the federal government before his retirement.

Here’s an example of what Hard Work looks like in the wake of Nikhil Pathak: when he first retired, two full-time physicians needed to be hired in order to replace the services he had provided our nation’s veterans across four decades. And when the two young replacements departed Togus less than six months into his retirement, Dr. Pathak returned to his post at the hospital with nary an eye-roll. When he finally retired for the second time, it was a matter of only a few years before the entire dialysis unit was permanently shut down and outsourced to the clinics offered up by people more interested in worshiping at the altars of their own Hard Work, rather than seeking with humility, as Dr. Pathak had done for over 40 years, to address the health needs of people who sacrificed their bodies and minds to war.

So then, the story I had promised: the 1960s saw the introduction of sweeping legislation on numerous fronts in our nation, but it also saw the deadly entanglements of the latest global conflict. Dr. Pathak—Nik, as his friends and colleagues knew him—was doing rounds in Manhattan one day in the late ’60s while wrapping up his residency in nephrology when a heavyset, ruddy-faced patient staggered into his exam room, evidently suffering his latest in a series of heart attacks.

The young nephrologist did what all the great diagnosticians do: he shrugged his bony shoulders and tugged his brawny brows at the inappropriate, unscheduled incursion to his workday, and he began to listen. Then he started to ask questions. Countless questions. He performed old-school medicine, studying the patient, administering what we might today consider a highly rudimentary series of simple tests involving only his eyes and ears and hands, and that tender, massive organ lodged between his ears.

Judgment put to sinuous use, he quickly came to the diagnosis that none of his patient’s prior physicians had been able to uncover: a renal pathology that traveled a cardiovascular path. Did I mention dual specialty? This pattern of solving complex pathologies recurred throughout his career. Nik Pathak was what we might call a “Mad Libs” specialist: insert the type of provider you needed, and he could solve for X every single time. “It’s how I was trained,” he would say with humility about his truly holistic approach to medicine. In a final bravura performance he even self-diagnosed the rare rheumatological condition that would end up taking his life.

Back in Manhattan, accurate diagnosis at last in hand, the ruddy-faced patient eventually left the hospital a fully recovered man. He was so enthusiastic about the care he received that he came back the following week announcing to all that Dr. Pathak was his new PCP (which he was not). Something about that man, however, kept anyone from contradicting him.

About a year later, on an unscheduled annual physical, this patient asked Nik why he was looking glum, to which the doctor replied, “It’s this letter. I’ve been drafted to the frontlines in Vietnam. I’ve only just arrived here…and…I don’t believe in war in any case!” So the ruddy-faced one reddened a bit more for good measure, chuckled from some deep recess full of meatballs, and then boomed, “Is that all, Doc? Lemme see dat. Ahhh, don’t worry about dis! Just you fuggedaboutit.” Ten days later a new letter arrived in the mail for Dr. Pathak. It superseded the one he had handed his patient earlier. This one read: “Due to a clerical error you were mistakenly drafted to the American war efforts in Vietnam. Please disregard the prior notice. Humbly accept my welcome to this great country.” It was signed by a U.S. Senator. A brief moment of incredulous Gratitude flashed across Nik’s face and happened to last the rest of his life. Implausible outcomes like this were not why he became a physician, so how else should one receive such news but with sincere Gratitude?

On account of the “clerical error” being corrected, Nik was free to marry an arrestingly beautiful girl from his Indian hometown, have two children, and eventually settle into a quiet private life—and a formidable professional one—in the small government town that straddles the banks of the Kennebec River. His desire to improve health outcomes in an underserved rural community is what drew him north in the first place. That he rebuffed numerous overtures from afar for over 50 years is a testament to the kindred ethos he found among the people of northern New England. His ashes were scattered by the shore of his favorite place in Maine.

In lieu of any formal service, we ask that anyone interested in paying their respects to Dr. Nikhil Pathak simply transfer that desire to Mother Nature. “It’s a humbling experience,” he once said, “to ponder the smallness of human existence against the grandeur of the slate-gray metamorphic rock at Pemaquid Point. Take me there when I’m gone.”

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