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I couldn't stop thinking about him. He was sitting on a bench outside of Whole Foods, wearing a grey T-shirt and striped beanie, his guitar case stretched flat by his side. He had hair the color of Wheaties that grew past his ears and a beard that needed a trim. His blue eyes seemed sorry.

"Can I talk with you?" I asked him, shifting my bag on my shoulder. I smiled and held out my hand. "I'm Susan."

Looking a little startled, he said yes and cleared a space for me beside him. It was a beautiful morning - windless blue skies, light-sweater-cool.

His name was David. He was 24 years old. A former skater and foster kid, he was sitting out the winter in this small North Bay community before heading east, maybe to the Florida Keys. He told me a story about his grandpa, and said he had a cavity that badly needed to be fixed. He was homeless.

I was there doing work on the health needs of the small community where he lived. At the Stanford d.school, where I'm a fellow, we learn and practice human-centered design, creating things and experiences for people only after we spend time getting to know them and understand their needs. It's a methodology that works, but here I am with David, and I'm beginning to lose myself. I'm taking notes, and listening, doing all the right things -- but every line in my heart begins to blur as he shares his story.

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I have a purpose. I'm here to learn, but the simple act of reaching out can split your soul wide open. It's raw and precious, and leaves you feeling both wonderful and desolate, alive with hope and pain.

At night, when the temperature falls and I hear the spiking of rain on the roof above me, I open my eyes and stare into the spaces I can't see. Where is he? Is he cold? Are his socks wet? Have I, too, left him behind?

I carry him in my emptiness like a son.

With a Perspective, I'm Susan Dix Lyons.

Susan Dix Lyons is founder of a nonprofit health organization in Nicaragua and a fellow at the Hasso Plattner Institute of Design at Stanford.

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