Transformation

 If you want to live well, I think you must ask yourself if you are prepared to lose everything and reinvent yourself a hundred times. I am now old enough to look back on periods of my life with both gratitude and a deep sense of the bittersweet. 

I think of my first job in ultrasound, of my mentor, and of the team she constructed through diligence, hard work, and persistence. I am skeptical I will ever look up to another human being in the same way again. I think of the vibrancy of working there, the sense of team and mutual mission that drove us all forward. And at its core was a mutual devotion to the integrity of medicine and to care that held the humanity of our patients at the center of every choice we made. It was the best place I have ever practiced ultrasound and, of course, I had no idea of its rarity until I left.

Today I worked the floor again, covering a vacancy at a facility I helped to open as a sonographer several years ago. Our team there was devoted to patients, though it wasn't academic medicine, and we worked together. There were many, many competent hospitalists who had been recruited from other locations and for the first couple of years, I felt the same sense of home and belonging I did in my first job. It was less intellectual, less academic, and my practice was something of an outlier compared with others who worked there, but I worked with like-minded, kind human beings.

Working there again today left me feeling raw. I miss my friends. I miss caring for patients. I miss working with an exacting pride that is the result of arduous training, attention-to-detail, and never providing patients a service that is half of what you're able. I miss the pride of identifying a rare diagnosis or of attempting to piece together components of a pathological process for a patient.

Medicine, when it is not for profit, is infinitely filling. Medicine, when practiced at its high level and in collaboration with others devoted to the same cause, is transformative. I suspect my sense of bittersweetness is not only about a mourning and a wishing for days which are now gone but for a time when healthcare still held patients instead of profit as its core value. So many systems have made employees replaceable and made patients a commodity. So many systems have prioritized efficiency and productivity over the art of sharing humanity with the most vulnerable amongst us.

And yet, I cannot go back. I cannot time travel. And the place we have all landed now, different though it may be, can still hold moments of overwhelming beauty. Covering a cold patient with a blanket, offering a hand through a difficult procedure, and truly connecting with another in a dark room with the low hum of my machine is still infinitely transformative. 

It will all be different. The best moments of our lives will never be repeated. And we often walk through them without realizing we are in the midst of the extraordinary. And despite this, there is also beauty ahead. There will be untold moments of connection and ecstasy and bliss. The profound, though in constant evolution, is nearly always one courageous decision away.