I sometimes think that being a physician was a dream born at the end of another life when I was a different person. I sometimes wonder how I came to that decision being who I was then because it is inly a memory to me now. Perhaps the process of becoming a physician brought about a new life of its own creation. I am starting to feel that we do truly have multiple lives shaped and created by choice and chance. Some people seem to have fewer than others and often I envy those with only one or two. They seem to start out knowing which direction they will go and the wind blows their course steady. For others the currents shifts, our masts break or the stars lure us in very different directions than we once imagined. This is not about my many career shifts thus far but a realization that the way I view the world, and myself, has changed radically throughout the course of my life. The moments around these changes seem small until one day you find yourself in different clothes and living in a different world. Suddenly the man you were before is only a memory in the mind of the person you are now and you wonder how that happened.
These memories of past lives are often somewhat one-dimensional for me. Often the emotional aspect of who I was escapes my memory and it takes something to bring it to the surface. I see images of places, people and have memories of activities and events, but not the feelings. The other night I stumbled onto a photo of someone who was very important to me once. I had not seen this person in over 15 years. Upon looking into her eyes, pixels on a screen, I was transfixed - I abruptly found myself feeling something inside that I thought was just a memory. More accurately, I felt the absence of something inside that I knew was once there, something lost, something very dear but also something that caused me much pain. It was not her per se, it was some part of me - inside. She was the woman I first loved and although she had aged she looked exactly the as she did the last day I saw her. I had a few girlfriends previous to her, but she was my first real love as an adult and a young man. She represented everything to me back then that I was trying to become, trying to grow into. I fell for her instantly, in the corridor of a physics building in my early twenties. More accurately, I fell for the idea of her and it was the loss of that idea that shaped a large part of my coming life, for better or worse. I was ill-equipped at that age to understand my feelings or deal with their repercussions and nearly 15 years later I finally am beginning to understand. I did not even really understand how those moments shaped my decisions in the years to come, but looking back it is clear. Looking into that photo made me also realize that the part of me that existed back then, the part I thought I had left behind, was not gone despite my desire. It was both upsetting and reassuring.
It is easy to reflect on life and see what was lost. Misplaced. Mishandled. It is seems odd to also realize that these moments are also part of what created your current life that you value and treasure. The future is not all joy or sadness but a mixture of both made from the moments of the past. Stumbling across those photos suddenly threw me back into those moments of my early twenties and reminded me of a few things I have lost in this journey, important things. I can't go back, I can't even change the moment I am in. It is already rolling with its own momentum, but I can think about the future and as we get older I like to think we gain some control over this process. It becomes less about chance and more about our will and decisions. Looking at that photo reminded me of important pieces within me that made up my life then. Some of these traits I was happy to leave behind at the time for I felt all they brought was pain. They planted rugs under my feet that were sure to be pulled out. Perhaps I felt I was protecting myself. Perhaps I felt they were immature and unnecessary. I see now though that despite the problems they caused they are necessary for many of the other remaining aspects of who I am to have meaning. Seeing that photo gave me hope that despite the many paths I have taken and choices I have made, these traits are not gone. That feeling gave me hope that somehow they may be rediscovered - perhaps along my next path and with the greater understanding my journeys thus far have given me.
The path that led me from one life to the next and now recently into my life of medicine, the path that I have been traveling for nearly 8 years, has fatigued me greatly. It has created great holes in my life, strained my heart and mind beyond what I thought possible. I see much of what I have lost and some of what I have gained. It is hard in the middle of this journey to see the gifts it has also bestowed. Like training for mountain climb, you don't feel the new muscle fibers growing or the efficiency in your lungs increasing. You feel the pain of each step deep in your thighs, the sharp burn in your chest with each pounded out breath. But one day you find yourself standing on that mountain that you set out to climb and you understand the achievement. In several months I will be at the half-way point of my residency and thoughts of my life after this are starting to trickle in. Perhaps part of it is survival. I need to focus on what might be possible to help bear the weight of what I am sacrificing for it right now. But if I look back I see that there have been moments, defined by choices, that led me into the next journey. I see that perhaps some of those moments are finally approaching again, like a train. Before I know it I will be speeding towards another destination. I am hoping that with some careful planning and a little will power I may do a better job of directing those moments, leaving less of the decisions to chance.
It is actually quite a hopeful thing and a little frightening. As I grow older I understand myself better. I know what lasts and what doesn't. I see where my joys lie and I also see where many of my false fears and insecurities rest. I have found that some things I abandoned for fear they were malfunctioning are some of the very important and necessary aspects of who I am. I feel that I am getting better at choosing and shaping the moments that shape me and feel more confident in my decisions. As I approach my 40th birthday I also grow concerned though. I realize time is not infinite and that just as I may be entering a period of renaissance for my life in some ways it has come at the cost of many good years. My choices so far in life have left me with little solid, sustainable or durable. As all my close friends spend their time with their children, the families that they are building, I see some of the lost opportunities in my life with the family that came before me or the one I could have created ahead of me. These choices are often viewed as losses from my perspective but I remind myself that they offered me freedoms many of my friends did not allow themselves. I also remind myself that these opportunities are not totally lost, but definitely more difficult as the years pass. As I get older I see happiness in simpler acquisitions. I have been around many of the bends ahead in the road and know what they offer, and what they do not. I yearn now only for a few simple things and the chance to create something lasting - permanence in a life of impermanence. I see that my skills as a physician may make impacts for others that will having meaning for many for years to come. That is a good thing and something of value that these choices in my life have afforded me, but I also want a greater impact in my own life.
In these next few years I plan on shaping my moments for the inevitable change they will engender. One day I expect to wake up and remember writing this. I will remember that my small desk was illuminated with a single small lamp and that a cool breeze from the window filled the room as I tried to type out in these words which were barely making sense in my head. Much of my writing is just that, merely an attempt to clarify some vague feeling. The important thing will be that this night will be a memory. A memory in the head of a man with a life that is simple and satisfying because he learned these lessons over more than four decades of change and sacrifice. He will have realized that much of the change was necessary only in that it showed him the parts of himself that needed no changing. He will understand life has holes, is not perfect, and he will be happy for the parts he possesses for the first time. His life will be stable . . . until the next change.
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