“Why didn’t you quit?” a young medical student recently asked me. Her eyes suggested she could relate to the med school challenges I had just shared with her. “I knew being a doctor was what I wanted to do, and that made the difficulties just bumps in the road,” I explained. Later, as I thought about it more, I realized it was also because there were people along the way who made it worth all the struggles.

One was an 8-year-old boy whose cancer was advanced by the time I met him. Hospitalized for a bone marrow transplant at the university where I was an intern, his body had rejected the treatment, and he was dying. I was the one assigned to draw his blood every morning, and I was terrible at it. My only saving grace was that he was so sick he didn’t always wake up as I stuck and re-stuck every morning.

One afternoon, the head nurse on his floor relayed the message that he wanted to see me. Afraid he was going to shame me for hurting him so often, I took my time heading to his room, stopping to talk to another patient and review a chart on the way. My Dr. Scholl’s sandals clicked loudly on the tile floor as I finally entered his sterile room. I was grateful he appeared to be asleep as I sat on the hard chair at his bedside. I touched his bruised hand, and his eyes opened, looking more alert than I had ever seen them. “Oh hi,” he said. “I have something for you. It’s in the top drawer.” I reached in and pulled out a little bear, wearing a pink ruffle and a pointy pink hat, with pinching paws designed to hook onto a stethoscope. “I want you to have it,” he smiled, as he drifted back off to sleep.

I hooked it onto my stethoscope, admiring it but also confused as to his purpose for sharing it. Was it because I was so terrible he thought it might help other kids to relax around me? Or did he like me for some reason and want to show it? I tried to ask, but his eyes stayed closed and I couldn’t reawaken him. I tiptoed out of the room and back to my charts. The next day he died.

I’ve never understood why he shared that little bear. I still have it – old and faded now, too precious to wear on my stethoscope. He couldn’t have known what a huge impact his gift would make on my life. Looking at it always encouraged me to persevere: to keep studying when I didn’t understand the topic, to keep trying when a procedure was hard for me, to go back every day even when I felt shy or out of place.

Now it also reminds me about the ripples our small actions can have in other people’s lives. The smile I give to the grocery clerk might turn her frustrating day around. Letting another driver pass me on the highway might dissolve his hurried mood. It doesn’t take much – a simple smile, a wave hello, an attentive look – these little actions can have profound effects and ripple out into the world.

So, let’s all go make some ripples.