A pediatric physician specializing in palliative care shares his deeply personal journey through the challenges of treating terminally ill children. Robert Macauley, one of the few doctors in the U.S. certified in hospice and palliative care for children, has written a memoir titled "Because I Knew You: How Some Remarkable Sick Kids Healed A Doctor’s Soul." In this book, he reflects on the profound questions that arise when caring for sick children, blending his experiences as both a doctor and an ordained Episcopal priest. The memoir delves into his own struggles with childhood trauma, which shaped his career path, and recounts stories of young patients who left indelible marks on his life.

Macauley’s memoir explores the intersection of faith and medicine, questioning why suffering exists and how it can coexist with belief in a higher power. Drawing from his theological education at prestigious institutions like Oxford and Yale, alongside three decades of experience as a physician-priest, Macauley admits to not having definitive answers about divine purpose in human suffering. Instead, he focuses on offering presence and compassion to those facing incurable illnesses. His work at OHSU involves reframing expectations for families whose babies may only live for days rather than years, ensuring every moment counts while honoring parental love.

One poignant story shared in the memoir is that of Grace, a teenage girl battling neuroblastoma. Despite knowing her time was limited, Grace achieved a lifelong dream of seeing Broadway thanks to the kindness of strangers. Though her condition worsened shortly afterward, she remained resilient until her final moments. Such tales underscore Macauley’s admiration for the bravery exhibited by these young patients.

The memoir also addresses the emotional toll of losing infant patients, emphasizing the importance of leaning on community support—family, friends, colleagues—to sustain him during difficult times. Macauley finds solace in witnessing extraordinary acts of courage and generosity among those he serves. Ultimately, writing this book became an act of gratitude toward the patients and families who restored his faith in humanity.

In reflecting on his journey, Macauley reveals that his memoir is more than just a narrative; it serves as a heartfelt thank-you note. Through their strength and resilience, the children and families he cared for rekindled his belief in the goodness of people. This revelation underscores the transformative power of compassionate care and the enduring impact of human connection, even amidst profound loss.