People are born, they live, and they die.  All people do this, with the cycle repeating again and again - hopefully for a long time into the future.  I am stuck here in my own perspective, living out the dash between the dates on my tombstone.

Two things this week remind me of that dash: Memorial Day tomorrow, and my 50th birthday on friday.  Both of these events give me pause to consider the lives lived in that dash, both mine and those who have already etched out the number after their dash.

First I consider those who have willingly chosen to put their lives at risk for other people: the soldiers, firefighters, and police officers who share my task have gone a step further than me by putting their own lives at risk for the sake of others.  It is humbling to think of others who have given up their right to life for others.  I can do a noble task as a physician without being a noble person; but those who lose their lives in the process have done such a great thing, it makes me see them as noble people.  I can't tell them I appreciate what they have done, but I can give them a memorial with these words - something to remind us all of the potential for nobility in life.

Then I think of the lives I have seen in my 18 years in practice. I've seen babies born, I've seen children grow, and I've seen people grow old. I have also seen many lives end.  Some of these people died peacefully, following the course we all hope for: coming to the end of their dash with a sense of closure and leaving a legacy to follow.  Their deaths speak to the strength of the lives they lived, and do not seem tragic or unfair.  These lives end with a period or an exclamation point.

But many don't follow that course, instead ending their lives with a question mark.  Why did there have to be pain?  Why did they have to leave so soon?  Where were their families and friends?  What will become of the brokenness they leave in their wake?

Finally there are those whose end comes unexpectedly, leaving their lives as sentence fragments.  They die by accident, by malice or carelessness of others, by sudden disease, or by their own hand.  They are the ones whose deaths send off shrapnel, wounding those around them, especially injuring those who are closest.

The nature of my work makes my list of these people longer than most.  It also gives me a perspective life: it's not fair, in our control, or predictable.  I don't know why my life is longer than others', and I don't know why I sometimes feel guilty for that fact.  But I write these words as a memorial to those whose lives have intersected with mine and whose dash has stopped growing.

This all gives me perspective on my upcoming milestone.  I didn't do anything special, just breathed for 50 years.  It's not an accomplishment as much as it is a time to consider the past and the future.  I am so grateful for my family: my wife, my kids, my brothers and sisters, and my parents.  They have seen me take my path and make my choices, sometimes well and sometimes foolishly, and yet they continue to love me.  I am also grateful for the others that have crossed my path: friends, colleagues, readers, and my patients.  My dash is, has been, and will be defined mostly all by these people.

So my final memorial is to the part of my dash already carved.  It is to all of the people who have made it what it has been, those who are still living their lives and those whose entire path has been trod.  What is in my past is done, set into stone.  It's been an honor to share that path with you and the others I've encountered on the way.

My memorial needs only two words: thank you.

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