George MacDonald challenged the idea that truth must justify itself through immediate or dramatic results. He taught that truth is known in the doing, through steady faithfulness. Healthcare often struggles with a similar expectation. We tend to equate healing with rapid improvement, clear lab changes, and visible progress. Yet for many people living with chronic illness, healing is not an event but a daily practice. It shows up in refilling medications, attending appointments, and continuing routines that sustain health even when change is gradual. These ordinary acts are forms of hope in motion.

Public health models now recognize this reality. Approaches that emphasize self-efficacy and continuity acknowledge that sustained engagement shapes outcomes as much as clinical intervention. Precision public health directs attention and resources toward those who most need them, allowing care to adapt to real lives rather than asking people to fit rigid systems.

This is true for clinicians as well. Burnout often arises when effort feels disconnected from meaning. When care is reduced to throughput, the deeper purpose of the work becomes obscured. MacDonald reminds us that presence, patience, and integrity are not peripheral to healing. They are part of the healing itself.

“She seemed to shine with an inward light, but the marble gleamed through it like the white tone through the flush of the rose.”
—George MacDonald, Phantastes

There is a moment in Phantastes when Anodos encounters a marble woman in a quiet glade. The figure appears still, yet undeniably alive; carved form and living presence intertwined. He senses that there is more before him than he can understand, but his sight is not yet prepared for such recognition. MacDonald is not illustrating ignorance. He is illuminating development. Perception, in his world, is something the self must grow into. Modern healthcare lives within the same tension. Clinicians and patients sit together every day, exchanging symptoms, explanations, and plans. Yet both can walk away unseen and unseeing. The chart may be complete, and still the story misunderstood. A diagnosis may be accurate, yet the meaning of illness remain unspoken. To care well is not only to know, but to learn to see… to cultivate the ability to notice what is quiet, interior, or unfolding. This requires attention. It requires time. It requires companionship. The work of healing begins not with expertise alone, but with perception that is continually being formed.

Goodman Brown lost his faith when he saw the flaws in the people he once trusted. In healthcare, disillusionment can lead to something similar; moral injury, detachment, even cynicism. But the challenge isn’t to stay innocent. It’s to stay human, even after we’ve seen too much.

Hawthorne’s The House of the Seven Gables reminds us that injustice doesn’t disappear. It settles into the walls. Our healthcare system, too, is an inherited house: intricate, costly, and haunted by the wrongs that shaped it. From racial inequities to misaligned incentives, today’s fractures trace back through generations of policy and power. But as Hawthorne suggests, curses aren’t lifted through destruction; they’re healed through humility, compassion, and connection.

The Scarlet Letter might not feel like a Halloween story. There are no ghosts, no Gothic mansions. Sometimes, though, the banality of a hell is still a hell. Hawthorne’s world is one of polite systems that confuse shame for morality and call it order. Modern healthcare has its own versions of that. Providers get branded “difficult,” “too idealistic,” or “not a team player.” And yet, like Hester Prynne, many stay. Not to defend the system, but to redeem what’s still good inside it… the quiet, stubborn act of care that changes what the letter means.