THIS IS FORTY?

I could write about a lot of things tonight, especially since I have now officially spent forty years on this planet. I could write about each of these items shown on this hog's body from my futsal team's shirt, but I will spare you!

Indeed, when I thought about this post in recent weeks, I had very different ideas about what to write than I do tonight.

First, we will get the accounting out of the way.

I have been a parent for over twenty percent of my life - 8 years.

I have been a cancer researcher for over twenty-five percent of my life - 10 years.

I have been married to the same woman for over twenty-five percent of my life - 10 years.

I have been with said woman for over one-third of my life - 14 years.

I have been in medicine for nearly half of my life - 19 years.

Historically, I have thought of life as a continuous, mind and soul-numbing struggle for more years than I can count. Pico Iyer recently reminded us that there may be value in suffering, but try telling that to one who is suffering.

My adult world view can ultimately be distilled to a simple proposition - we have limited control over the outside world, but that does not mean we are powerless. Indeed, in a world devoid of God, we are responsible for everything we do. We are accountable to ourselves, to the ones we love, and the ones with whom we share this life. With this world view, a higher power becomes superfluous.

I came to see life this way through a variety of experiences - how others treated me (see high school and college years - you know who you are), through mistakes I, myself, made, and through the works of others - Camus, Kieslowski, Kundera, among others.

Thinking about this adult world view, reminds me of the perspective that my parents tried to instill in me as a child. I was trained to be thankful for what I had. I cannot count the number of times my mom said, "Look down and not up! Think of all the people who are less fortunate than you rather than those who are better off!" 

With all due respect to mom and dad, the past twenty years have been about constantly looking up. In college, I was motivated to get the best grades possible because that was necessary to get into a good medical school. 

In medical school, it was impossible not to stress out over grades, class-ranking, and standardized test scores because a great residency was at stake. 

In residency, I came to realize that I was quite good at doctoring. I went the extra mile not only because the patients deserved this and because that is the way I was raised. The opinion of my peers and my teachers was also at stake as was the spot of Chief Resident - an honor bestowed on the two top doctors out of each residency class at my institution. When I was named Chief Resident, additional opportunity and pressure followed. What top fellowship program would I apply to? 

During fellowship at arguably the nation's best hospital, I was surrounded by the best and brightest. It was hard not to look up at my peers who were more successful and more fluent in the language of research, especially since I was a beginner at science in such a competitive environment. 

Next came a faculty position and the pursuit of career development and advancement at my current institution. I recently completed my packet for promotion. For promotion, I wrote a three page letter describing why I thought I should become an Associate Professor. As I read the finished product, I found myself asking, "What was the opportunity cost of doing all the things I had done in the past six years to advance my career?" "What research opportunities had I missed out on due to administrative obligations?" "What family events  had I missed out on?" Two summer vacations my family took without me because of grant deadlines and countless seven day work weeks in the lab come immediately to mind. 

All of this is to say, that the past twenty years have been spent looking up - higher and higher and higher - almost to the point of vertigo.

Today, as I thought about writing this post later tonight, I considered how my experiences these past forty years have colored my vision and made me who I am. What struck me more than anything was how events in recent weeks have conspired or inspired me to write an altogether different account of my forty years than I would have written even one month ago. Indeed, these past few weeks seem more influential than nearly all the other weeks of my life combined. I think this ultimately comes down to a change in my perspective.

Recently, I have learned volumes from others' writings (e.g. George Saunders), others' songs (e.g. Neko Case), others' life stories (e.g. Emir Kamenica), and my own writing and my own experiences. I have learned that life is not not something to be suffered through. Life is a gift. Kindness is a lost treasure that can be shared and found. Beauty still exists on this earth. 

I am reminded by new and old friends alike (you know who you are!) and my family, especially my mom and dad and brother and sister, that I am fortunate to have people in my life who care about me and love me unconditionally. 

Despite the challenges of my marriage, I am fortunate to have a wonderful family and two loving, adorable children whose imagination and talents are equally matched by their potential to be forces of positive change in this world.

All of this brings me to to a revelation I had tonight on my way home. In the past two months, I have been riding my bike to work each day, which is a gift in itself. It is a peaceful ride that allows me to clear my head, get some exercise, and reflect on many things. Tonight, as I crossed the Willamette River I happened to look back - westward - at downtown. I saw the sunlight reflecting off the water and the buildings. I realized I was strong enough and well enough to ride 5.5 miles each way without difficulty due to my good health. I realized that I live in a place where it is safe to ride one's bike without fear of stray bullets or cars due to a caring populace and good urban planning. On this short commute, I saw my own life's journey of forty years in perspective. 

In short I took the time to look around, rather than looking up or down. What a novel concept! Indeed, appreciating what I have without regard to who has less or who has more, to quote Frost, has made all the difference.

I will leave you with the final number from Neko Case's show last night. 

I love Neko and this song, but I do not wish to be anything other than what I am tonight. 

May the next forty years be as sweet as the last forty year have actually been!