It’s a particularly strange thing to think about how you’ve changed. Requires three things really – an initial realization that something is different, an understanding of where you are and an understanding of where you were. Each of those three are exceedingly rare. Together, they are well nigh impossible.

I think I’m vaguely aware of the first piece, that I have changed in some way or ways, over the last year. Some of those changes have been hoped for, even intentional. I remember the first time I stood over a patient of mine that was coding and realized that I wouldn’t rather be anywhere else. I mean, of course, every instinct and fiber was screaming at top volume that I should up and run. But it was surprising to me that I knew at some visceral level to just take a deep breath and pay real close attention to what was going on at the bedside. I used to wonder how I would react in such a situation, hoping, really. Then I knew, and it was good.

There are consequences, though. Death becomes much more terrifying (when you are confronted with mortality all day, it’s impossible to escape the realization that you will die someday. I don’t think most people in their mid 20’s think about that. I hope everyone else thinks they are pretty much invincible. I think about it many days, most weeks) and much less alien. I have no idea what someone experiences during the moments that they die, but I can tell you exactly what happens to their soul’s physical container as it leaves. It doesn’t bother me (it terrifies me), but I’m acutely aware that someday it’ll be time to fold.

It’s unnerving to be able to look back and pinpoint the years in which you matured, and to simultaneously look forward and know that there is so much more to come.

I’ve missed a lot of writing over the last two months, when I have had the most material to write about. I’m going to try to dig up some of these stories from the memory banks and from my notes, as I’ve said before. Bear with me and my sophomoric ramblings … there is more yet to come …

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