When you set out on your journey to Ithaca,

pray that the road is long,

full of adventure, full of knowledge.

Konstantinos Kavafis (1863–1933)

What happens physically when you feel that you have it all, an unlimited future, high expectations, but nevertheless there is a strange restlessness in your soul? It was 1985, and I was a young intensivist, acting as civilian coordinator of the critical care unit of a major hospital in Buenos Aires. I had plenty of opportunities ahead, a great infrastructure, many teaching and research opportunities, as well as the nearby presence of my master teacher, Dr. Francisco Maglio.

However, each man may have a hidden Ithaca in a remote location of his dreams, which in me was mixed up with an increasing feeling that destiny was calling me to other missions. And just as in The Odyssey, the way to Ithaca can be long and hard, but also full of rewards and surprises. My personal Ithaca was a wife and two small children who wanted the peace of infinite meadows and green fields. My Ithaca appeared as a small coastal town, Necochea, 500 km southeast of Buenos Aires. My Ithaca was a long waterfront buffeted by relentless winds and occasional whale-watching.

And so we made a drastic decision and left the big city behind. Twenty-six years ago, Necochea had 80,000 inhabitants and no intensive care unit (ICU) in town. We made herculean efforts to build and inaugurate our ICU at the Necochea County Hospital, a materially poor hospital with gloomy corridors, water leaks, and six isolated critical care beds under the cold southern winter. At first, nobody believed in us at the hospital, starting with the authorities and of course including surgeons, anesthesiologists, and so on. They even preferred to transfer patients to an ICU in Mar del Plata, 120 km away from Necochea. We were somehow considered as strangers to the local hospital culture, and this resulted in frequent reductions in budget and plenty of obstacles and roadblocks. An ICU in this setting was considered as an expensive toy for a hospital with so many structural problems.

Over the years, I felt many times like Odysseus confronting the Laestrygonians or the Cyclops, and similarly to Homer’s immortal character, I experienced moments of bitterness, frustration, anguish, and doubt. I even thought about abandoning the voyage to Ithaca and returning to the big city.

However, there was a decisive factor to win this battle: the human factor. Indeed, we were able to build up a team of people working with love, passion, and an almost unbridled fervor. We bought ventilators, ultrasound devices, and monitors, thanks to donations and collections. We trained physicians and nurses with interdisciplinary courses for almost two decades, and more recently started a residency program that continues to bloom in the midst of adversity.

Since then, hundreds of humble people of this, my city, have been treated in our modest ICU. I even think that these people are an essential part of my Ithaca. Of course, they suffer, laugh, cry, pray, or dream like people everywhere, but in contrast with what happens in the big city, they have faces that I recognize outside the hospital. I frequently find them or their families just walking along the wide, tree-lined avenues. I see them getting married, playing with children or grandchildren, building their houses, or simply enjoying the immense opportunity to live.

When I look back, my prevailing memories are of epiphanies and joyful moments, such as my children, nowadays both medical doctors, growing as birds spreading their wings at dawn over the marine horizon. Paradoxically, and not less importantly, in these six modest ICU beds, I found my fulfillment as intensivist, as teacher, as researcher, but mostly as a man. And now, as I am getting older, I finally understand the final words of Kavafis’s poem,

“Always keep Ithaca in your mind. To arrive there is your ultimate goal. But do not hurry the voyage at all. It is better to let it last for many years; and to anchor at the island when you are old, rich with all you have gained on the way”.