I want to write.  It’s a sunny day and the world is bright, there are kids cheering at a school across the street, the sidewalks are filled with people dressed like spring and with a spring in their steps.  I have the day off, which doesn’t happen very much lately, and so far I’ve used it to my advantage.  This morning I woke up at 6 as usual, with my cozy, sweet smelling four year old boy snuggling me and his dad still quietly sleeping nearby.  My beautiful, growing, pre-tween nine year old girl joined us a few minutes later, and the peace and joy in my heart almost made my inner balloon burst.  Lots of hugs and kisses and laughter later, with some loss of temper sprinkled in as per usual, the kids were fed, dressed, hair and teeth brushed, shoes on and out the door with their dad to start their days at school and daycare.  After waving goodbye, I closed the door softly on the chaos and fled back upstairs to my still warm, undemanding, restful bed.

A nap, then a cleansing, thought filled shower carried me to a lunch date with a best friend.  Lunch with a friend is underrated in the technological hullabaloo of this world; many of us have forgotten the quick ease of conversation and the value of a venting session with someone who knows us well.  I have not neglected the worth of good friends.  Though my life is packed and full, I make time like this in order to make space for calm in my soul.

Now here I sit, giving myself the gift of sunshine and a clear mind.  When I write, I open myself.  I reflect, I build rooms in my memory that get filled with words, accessible for a lifetime or more.  I take the stories around me and translate them from biochemical connections in my brain into tangible things that I can share.

For instance, today is a good time to digest the story of a young woman I met recently, who is not unlike many women I meet in the Emergency Department.  She came to see a physician because in her 6^th week of a very wanted pregnancy, after years of trying, she was bleeding.  The evening before, she had first presented to the hospital, and after an initial evaluation she was asked to return in the morning for a pelvic ultrasound.  Therefore, when I met her it was in the context of giving results.

In these moments, I often reflect before and after the visit, on the fact that the power I wield as a physician is astounding.  And not necessarily in a good way.  I can walk into a room, and change someone’s life profoundly.  When I entered this woman’s room, we had never met.  I was a stranger with all the knowledge and the answers; she was an anxious woman waiting for what would prove to be a harsh sentence.  I stepped into her world and ruined her life, shattered her dreams, brought tears and bitterness with my words.  Her pregnancy was an ectopic; the egg and sperm had joined in unity and created the spark of a new life, but that potential new baby had settled outside the uterus and alongside an ovary.  By getting lost in this way, the collection of cells though formed into a gestational sac and beginning to divide into a new world, would not have a chance to continue it’s growth.  An ectopic pregnancy if left to develop, could very possibly result in the death of both fetus and mother.  It is a leading cause of death in women in the first trimester of pregnancy, as it can cause rupture of the pelvic organs and massive bleeding.  Therefore, when I opened the door to her room, I closed the door on her dreams.

The responsibility I carry as a physician is not lost on me; every day I feel this acutely.  It is at once a burden on my soul and a blessing; I help, I heal, but I hurt as well.  However, I find myself often having to remind my heart that I am not the cause of a patient’s illness.  I am not the reason this cluster of sperm and egg took a wrong turn.  I did not choose to harm.  I am the messenger, and one whose face she may remember forever for the truth I had to tell.

So, writing out her story, I find my way to forgiveness.  I learn about why I feel so tired, so drained, when I finish a day at work.  I remind myself that the power I hold is not to be considered lightly.  I reflect and find insight, and I heal myself.

The sunshine outside shines too on my patient; I hope she finds her own way to heal, and to forgive herself and her body for the mistake she had no power to fix, and medicine had no power to change.