View from the Top

In my former life (of five months ago), a huge chunk of my world revolved around climbing - literally, and figuratively. Largely, I've carved out my sense of a place in the world through defining the metaphor of committing to uphill terrain, tapping into significantly deep motivating forces to stay the course, and reaping the benefits of conquest. I've defined by concept by expending so much effort to coaching people to do the same.

In my former life, I derived so much comfort and confidence from this construct. Conceptualizing challenges in my world akin to particular stretches of road that I know how to endure and sustain by bike despite discomfort has given me the sense that I really can do anything. But more importantly, it gave me the sense that I really LIKED to climb. Not just because of how awesome it was at the top; it was always moreso that I was proud of the process.

And then, I stopped. I stopped climbing, literally (I avoid my bike - despite three Centuries under my belt and no accidents in a year, I've again begun to fear falling or make other excuses why I don't want to do this "thing" that was very recently my favorite thing ever) and figuratively. I don't seek out adversity in efforts to demonstrate my strength; I avoid it.

My fiance is a third of the way through a 270-mile hike across the entire length of Vermont. With nothing but 35 lbs on his back, he sleeps on wooden planks with mice crawling all over him every night. He, too, likes to demonstrate his ability to survive. But he also does it for the perks along the way -- the epic views from 4000+ feet, the neat wildlife, the breathtaking sunsets.

Tonight, I got my breathtaking sunset.

On the last day of my Ob/Gyn rotation (nearly daily 4:30AM wakeups, total awkwardness all day long because of completely undefined expectations from supervisors, frustratingly useless all day long), I watched my fourth birth: a beautiful baby girl. I cried through my mask. The baby's father bawled, which made me cry more. He stroked his glowing wife's head and snuggled her close. It was one of the most beautiful moments I've ever had the privilege to witness.

I started my third year clerkships with nephrology, where the goal was to situate people on either a road to dialysis or to death. Often, their end destinations were reached. It was depressing and awful, and I instantly decided that I hated hospitals - just because stuff like this actually happened. Turns out, this was largely an artifact of being on the service that takes care of the body's most important organ at a tertiary hospital that cares for the sickest of the sick for the whole state (and a lot of the state next door). Even so, the majority of my third year has been more about preventing imminent death than promoting health and wellness.

On Internal Medicine, none of the people I helped take care of are actually going to get better. Their hearts were failing; their livers and lungs were not far behind. On Gyn, I helped surgically reduce cancer loads from uteri, ovaries, and pelvic walls of women for whom the cancers would largely grow right back. On Ob even, I saw more suction dilation & curettage procedures for spontaneous abortions (miscarriages) than I saw live births. I even performed the suction of an embryo myself. I felt nothing. It was like cutting off a human head in gross lab all over again: just another day in the life.

That just shouldn't be.

It's hard not to get caught up in all the suffering and sadness without the energizing balance of primary care preventive health efforts. Even obstetrics is a chaotic, scary world where so much can go wrong in an instant. A shoulder can get stuck. An umbilical cord can rupture. An amniotic fluid embolism can launch, flying straight to the lungs or the brain. You never know that someone is going to be ok, until they're ok.

But then there's a clearing. Through the wet, mucky branches, we glimpse a moment of perfection -- a tiny new life entering the world. She is peaceful and perfect, the reward of intense dedication and commitment. Not mine, of course. But the fact that I have the opportunity to be present for the most special day in people's lives -- for a moment, to share the greatest joy they will ever know...

In an instant, it all becomes worth it.