Every morning begins the same way.
The alarm cleaves the dark, and I rise with fatigue still wrapped around me like a second skin. In the mirror, I reconstruct the man the world expects: the pressed shirt, the precisely knotted tie, the Rolex ticking at my wrist like a heart that no longer beats for me.

There is a moment—brief, almost imperceptible—when I meet my own gaze and feel the faintest tremor of disquiet. I watch the man in the reflection take shape, and I’m never entirely sure which one of us will walk into the day.

Somewhere along the years, the white coat stopped being armor and became costume. The clinic—once a sanctuary—has grown into a dimly lit theatre, and I, its most dutiful performer. I have learned the choreography by heart: the authoritative nod, the rehearsed compassion, the practiced certainty. The role holds even on days when I feel hollowed out.

We used to speak of the seven Ps of medicine—Product, Price, Place, Promotion, Packaging, Positioning, People—as if they were commandments. Only now do I understand them as a kind of secular liturgy, the slow alchemy through which a doctor is turned into something glossy, saleable.

Product: myself.
Price: worth lacquered as value.
Promotion: the illusion of indispensability.

I perform these rituals with the faithfulness of an old believer, though the faith itself has thinned. Some mornings it feels as if my real work is not healing but maintaining the fragile coherence of the persona I’ve built—holding together the seams of a man I no longer fully recognize.

When I was young, I believed medicine was a calling—pure, almost sacerdotal. I carried the sort of idealism that embarrasses adults but feels sacred to the young, the conviction that goodness was a muscle one could train into permanence. In those pre-medical years, I walked through the university like someone chosen for a pilgrimage, convinced that to heal was to prove that light still had a place in the world.

It was around that time I discovered Freud’s bleak declaration:
Homo homini lupus—man is a wolf to man.

I remember how violently the sentence struck me, as if someone had slapped me across a threshold I wasn’t ready to cross. I rebelled in the only way a romantic boy knows how—impulsively, dramatically, with the certainty of someone still unscarred. One night, I stole into the philosophy department with a pot of red water-based paint and wrote across the wall, in letters large enough to drown out Freud:

“Man is not a wolf to his fellow man, but a man.”
—Ovid

It felt, in that moment, less like vandalism and more like an attempt to correct the world’s moral axis, as though a single sentence could tilt the balance toward mercy.

Of course, the university did not share my sense of mission.
I spent three days suspended, scrubbing my own words from the wall while the dean watched, unmoved. But what remains with me is not the punishment—it’s the way the water turned pink as the paint dissolved, the way it slid down the tiles like a small, private omen.

I didn’t know it then, but I had begun the long journey from enchantment to disillusionment. And disillusionment, unlike paint, does not wash away.

Years later, after enough nights in call rooms, enough murmured lies told for convenience, enough small acts of self-preservation disguised as professionalism, I found myself wondering whether Freud had simply recognized his reflection sooner than I had. Perhaps the wolves he spoke of were not external at all. Perhaps they were the shadows cast by our own unexamined hungers.

Some days, between one surgery and the next, I feel the two halves of myself circling each other like rival spirits in a narrow corridor. One still clings to the early faith—light, tenderness, purpose. The other has learned to survive: to calculate, to conceal, to offer immaculate courtesy while feeling nothing at all.

The introvert seeks silence; the extrovert performs compassion.
The believer builds altars; the cynic dismantles them.
Jekyll and Hyde live in one body, trading dominion without warning.

No potion is required for the transformation—only years.

With each one, a thin layer of softness peels away, replaced by efficiency, resilience, and the quiet, necessary cruelties that modern medicine demands. It is a strange fate: the traits that help a doctor endure often hollow out the human within him. And I still do not know which part of me endures and which part is being carved away.

Once, in the middle years of my training, I realized that hospitals themselves are built on a kind of duality — cathedrals of hope that smell faintly of failure. Everything inside them seems to exist in twos: the living and the dying, the healer and the harmed, the soft pulse of mercy and the cold hum of commerce. You learn quickly that medicine is not one path but two parallel corridors, each pulling you in opposite directions.

There is the corridor of the idealist — the one who enters rooms gently, who still believes that touch can carry meaning, who lingers for a moment longer at the bedside of a frightened patient.
And there is the corridor of survival — where time is currency, where efficiency is praised, where tenderness becomes a liability.

Most days, I walk both.

I used to believe these two selves could live in harmony, but hospitals teach you otherwise. The Red Queen effect rules here: you must run simply to stay in the same place. The world accelerates, expectations rise, and with each passing year, the part of you that once paused to admire the dignity of a human body grows quieter. The dreamer whispers; the pragmatist answers.

Sometimes, while scrubbing for surgery, I catch my reflection in the steel beneath the tap. The water runs clear, then pink, then clear again, as if rehearsing the cycle of grace and harm. In the reflection, two faces stare back:
one precise, practiced, unflinching;
the other a little frightened, a little too human.

There are days I wonder which of them entered medicine and which only learned to wear the coat.

Behind every surgical decision is a private argument:
between healing and calculation,
between compassion and exhaustion,
between the vow I made and the life I built around it.

I have stood with my hand still warm from a successful operation, feeling pride swell in me like a hymn — only to check my messages and be reminded of invoices, competition, reputation, the economy of the profession. It is jarring to move so quickly between transcendence and ledger sheets. But this, too, is part of the anatomy of a modern doctor.

In medical school, we are taught that anatomy has layers — skin, fascia, muscle, bone. No one tells you that a person does too. And somewhere beneath the layers we present to the world lies the darker twin, the one who emerges under pressure, the one who knows how to survive even when it costs a piece of the soul.

The mistake is thinking Hyde appears suddenly.
He doesn’t.
He arrives slowly, politely, slipping into the spaces where fatigue and ambition meet.

You don’t notice the transformation because you are the transformation.

Perhaps that is why so many surgeons live with a kind of hauntedness.
We are always standing on the border between life and death, between making someone whole and leaving someone broken. It is impossible to touch mortality so often and not carry its residue on your hands.

We begin as dreamers.
We end as functionaries.
And yet — some nights, when the corridors fall silent and the day has not yet claimed me — I glimpse the earlier self, the idealist still flickering beneath the practiced exterior. For a moment, the two halves of me breathe in unison, as if remembering they were once a single life.

In those hours, my mind drifts to the mystery at the center of Stevenson’s novella — that locked laboratory door Jekyll kept between himself and Hyde. For years I believed it was a barrier meant to keep the monster out.

But the truth is far more brutal.
The door existed so Jekyll wouldn’t have to face the fact that Hyde was not invading his life —
Hyde was already growing inside him.
The lock was never on the monster’s side.
It was on the man’s.

And in the dim reflection of the steel basin, in the trembling moment before morning erases everything, I finally feel the weight of that revelation settling over me.

Who is hiding Mr Hyde?

© Eugene Tkachenko