I am 47.  I am kind of tired. I've noticed that the visionary energy I once had has ebbed significantly and now the emotional energy to do things is a little more fickle.

I probably love my job as much as anyone could.  Having gone through personal difficulties over the past few years, my work has in many ways kept me sane.  It is hard to get lost in self-absorption when you are faced with what I am every day.  It's hard to wonder about your significance when you have so many opportunities to really touch people.  Something in my own nature makes it hard to cheat my patients when I am sitting face-to-face with them, and so when they open up about their needs I find it very hard to not enter in.  That's what I do.  That's my job.

And there is something very real about really helping people, and something very human about being a confidante to whom people reveal their deepest fears, pain, and doubts.  Yesterday I saw someone who had gone through incredible physical and emotional pain over the past few years.  I have felt sorrow and powerlessness as I sat in the room listening to her story.  But yesterday was different.  She had gotten a procedure done that had not only made things better, but had exceeded her expectations.  For the first time that I can remember I actually saw hope in her eyes.  Her husband was almost giddy giving me the story of how everything actually went right for her. While her husband talked, she sat with an expression of peace and hope that I never thought I'd see.

I was thrilled; really thrilled.  I had never felt her physical pain, but I saw its effect and shared the emotional pain with her.  So when she was smiling and hopeful, I shared in the joy she and her husband felt.

But my inability to gloss over things does come at a cost.  Each encounter like this withdraws some emotional capital and expends some of my emotional energy.  Each day is a little harder to get going.  It reminds me of a song by Bruce Cockburn (probably my all-time favorite musician):

Isn't it hard

To be the one who has to give advice?

Isn't it hard

To be the strong one?

I see the skyline blurred through the plastic on your back screen door

Not unlike the faces of the people who keep turning up in the places we go

The ones we'd never see if things weren't going so well

When I was a torn jacket hanging on the barbed wire

You cut me free

And sewed me up and here I am

Isn't it hard

To be the one whose phone rings all day everyday?

Isn't it hard

To be the strong one?

No, I am not feeling sorry for myself;  I couldn't imagine doing anything else.  I just understand now why people go through midlife crises.  The energy for life ebbs for a time and a person is faced with two options: change things or push through until the joy returns.  I've spoken with various people about this and they tell of a less intense, more contented approach to life that comes on the other side.  That is where I expect to be.  That's where I hope to be.

This is probably why I blog.  Blogging is another form of therapy for me.  Seeing patients allows me to connect deeply, while blogging allows me to express my own thoughts and feelings.  I don't pick up the burden of others, I let go of mine.  I don't delve deeply into the humanity of others, I open up about my own humanity.

Blogging is not my "trophy wife" or hot new sports car.  I intend to keep being a doctor, loving my wife (If she doesn't kick me out), and driving my beat-up Mazda.  Blogging is my outlet, my therapy.

Thanks for the therapy, folks.  I'll pay on my way out.