Midlife, midnight...

I spent yesterday afternoon accompanying my beautiful girl to the funeral of her friend. Our friend really, but U knew her much better than I. She was only 40, and had 2 very sweet and brave boys. Like many others I have met over the last 12 years, she fought a long, impassioned battle against her disease before finally succumbing.She was lovely and sweet, enjoyed her kids, really felt at ease in her own skin. She, like my wife, was the kind of woman the line "she walks in beauty" was inspired by.

My wife and I met her because she was the wife of a colleague. As a man who loves his girl, and a Dad who lives for his kids, I recognize a kindred spirit in my widowed friend. I tried to process the idea of a life without my wife, having to guide my kids through the unsettled waters of adolescence without her there to steady the oar, and my brain refused to cooperate. It is simply not possible she could ever die. I will not be without her. And it wasn't to willing to contemplate my own mortality. But with the image of our friend's 6 year-old boy constantly going over to the open casket to check on his mom, his photo resting gently in her hands, it didn't seem much of a reach to imagine my son, now 4, looking on as I lay there without motion, wondering why I wouldn't open my eyes.

I will remember that funeral years from now, for the weather colluded with our little tragedy to try to show me something. The sun was bright, and the sky peppered with clouds, but open to the blue canopy freshly tinted. It should have been a perfect day. Beneath the vault, at ground level, as I walked arm in arm with U, a wind both chilled and unflinching bored straight through us. Its pierce did not relent the entire walk; a monotonous, clinical ache that even the van door could not quite deny. That instructive, unhappy walk felt much like life broken down to its truest units. Beautiful yes, but also painful, unsettling, and intrinsically unknowable. Almost every religion I have studied, including Islam, has made the somber observation that our life is a veil, an illusion. Pitifully, that is about the best we mortals can do; that God is real, and waiting to transform us into something immortal. We then allow that all the suffering we encounter (and I have encountered plenty in the last decade), and all the love we struggle to learn to give and receive approaches only the smallest part of our truer reality, a single star held up against the backdrop of the cosmos we become. We inherit infinity, rendering mortality a consummation devoutly to be wished. Assuming, of course, we don't spend that infinity on a lake of fire or in a river of tears. After all, what mortal crimes exist, which when held up against an infinite suffering would not lead even the faithful to wonder at the code of justice the stars wheel upon?

The alternative saddens me every time I allow an eye to turn to it. That I and you, and those miracles we raise and love beyond ourselves are each of us doomed. That there is just this one quick breath, fleeting, inspired, frantic, and then it's back under, into that unspoken dark we were briefly rescued from. Each of us fundamentally lost to each other; our only consolation being our inability to speak the name of that loss any longer.

We sat in our seats, lost in our thoughts, she weeping softly, I fighting off my training, which insists on intellectualizing my sorrows. It can be a useful skill when you take care of people who die, but it has no role when you are a participant in the drama - one who cares and should care about the lost, and moreso, about the ones grieving the lost. I was eventually unsuccessful in that battle, and felt my inner light growing smaller, my mind calmer and detached in a heartless, infuriating way. I did my best to hide this from U, but she knows me too well, and didn't seek me out once the whole way home.

I didn't see her smile again until she held our daughter later that evening. M is the very imbodiment of a grand, flamboyant soul who exists to take a huge chomp out of life. She possesses the innate, robust confidence that comes from understanding we are by definition immortals, and are sojourning together now in order to chose companions for a longer travel to be embarked on down the road. I too felt warmed by her presence and held her face close to mine for reassurance and comfort. I was rewarded with her singular laugh.

Today I turned 35.

Beyond the beginning of an end...

Another lunar orbit and I find myself missing my blog enough to put digits to keys and make the out-of-tune music that passes for an entry.

This is my life after telling my mentors I am leaving academic medicine to take a job closer to home (Toronto). My current status as a wayward son came about unevenly. Considering my strength has generally been an ability to understand people's needs and communicate mine clearly, I am disappointed in how poorly I drafted my exit. The dread of the complexity paralyzed me. Instead, I allowed circumstances to dictate the moment of my announcement. My plan was to craft a goodbye that was considered and considerate. I did not.

It went wrong from the start - with me breaking a promise. I had told my program director, who has come to be a mentor and friend, that I would tell her first whether I was turning down the job with them. It wasn't to be. Although there were no new developments (in fact I still haven't signed on a dotted line), my chairman, called me into his office to touch base. I had promised him I would let him know by the 15th of April and hadn't done so. I procrastinated a week because I just didn't want to deal with hanging around for 2 months with everyone feeling I let them down, or was rejecting them. But I could dodge it no longer, and to his inquiry of "any developments?" I told him the simple truth. "Yes - I haven't signed anything, but assuming they deliver a contract that looks like what we discussed in our last meeting - I am going to take the job in Buffalo."

I know. Buffalo. I am in one of the most in-demand subspecialties in Medicine and could go anywhere in the U.S. My wife is in another such field, so presumably the world is our oyster. And I am moving the oyster to Buffalo. The answer isn't in the doubling of compensation - though a few have made that somewhat snide assumption. The answer lies in who I am, and what I always wanted. I am getting to live 2 hours away from my Canadian home, and be closer to my mom & dad, at a time in my life when it feels like that's the right place to be.

Plus, as a Torontonian, I've been a Bills fan since before the streak of Superbowl heartbreaks began. So that's something. And the fact that I'll have my weekends off and 6 weeks a year to get my life back. If it unfolds as hoped, it should be a great deal. Mind you, I still haven't signed anything. So I could just as easily be back in the boss' office, asking for the job back...talk about humiliations galore...

Anyway, I told the Big Man I was going, and he was warm and kind about it, indicating the door would remain open just in case. But he also emailed my other mentors the minute I left the office to tell them they would need to press on with recruiting because I have given them an official "no". Understandable, but put me in a tough spot since I was unaware of this fact.

Needless to say, you can't tell everyone something first. But if you tell someone you're going to tell them first, you can expect them to be fairly cold when in fact you tell them second. Or can you? I am still conflicted about my director's chilly reception the next morning when I went to her office to tell her. "Yeah I already heard. That's fine." was about the gist of it, only half-facing me before returning to her monitor without a goodbye. We've since patched things up, but that response really confirmed for me that I was taking a necessary step; out of fellowship and way out of my comfort zone to go it on my own for the first time in a long time. I think I needed a little nudge to pull the trigger, and that interaction was the key. I smiled as I left her office, and was actually laughing like a parolee as I left the hospital that day. "Onward and upward", I thought. And still so hope.

The next day I arrived earlier than usual and packed up the vast majority of my books and folders and moved them to my '99 Camry [don't mock the ride - for the brunt of training I've been cruising in a '93 Maroon Corolla]. I had two months to go, but in the pre-dawn light I tore down a cluttered and memento-rich cubicle I had occupied for five out of the eight years of my training in less than 2 hours. I intend to walk out on my last day without even a lab coat, not even an extra piece of paper in my pocket. And I want anyone wandering by my desk from now on to be clear on the idea that I might be here, but I am going, going, gone.

And so I float through these days, calling patients I've known for years, telling them what an honor it was to know them and try to help them a little. I listen (patiently I hope) as they express regret over my departure, and concern about who will care for them now.

I have seen this Departure Play before, and I know with certainty that I am eminently replaceable. This hospital has stood for a century or so and will stand for many more to come. I was part of a great idea and was proud to be so, but I am going nonetheless, without a worry that things will work out fine at my medical alma mater.

I can't deny I feel good. I feel clean and free like I did when high school had finished, but university with its unyielding realities had yet to happen. Perhaps I am free to reconceive myself this one last time, before adulthood and its unrelenting hold finally settles itself on what it is that I am.

Fair enough.




Edit: on a related note, I am going to indulge my Peter Pan conception of retirement by visiting Vegas this fall, as well as playing in some live and online poker tournaments. To Wit:

I have registered to play in the PokerStars World Blogger Championship of Online Poker!

This Online Poker Tournament is a No Limit Texas Holdem event exclusive to Bloggers.

Registration code: 7330476