“Every time I see you, I feel like I’m lost, wandering around aimlessly” says the young, fresh faced new resident as we bump into each other for the umpteenth time on this night shift.

He is lost in this place, and I am lost as well.

Lost, because this year, for the first time, I feel old.

I turned forty, and suddenly mortality hit me in the gut like a linebacker on a football field. The sucker punch of age left me reeling, unable to catch my breath.

When I teach students these days I realize they could be my children. I am that old.

When I brush my hair, a thread of silver peeks out, laughing, from the most obvious part of my scalp, laying itself firmly in the sunshine for all to glimpse.

My hands, my face, showing weather and sun and the years of my life passing like the river that surrounds my city. The years pull away from me, stretched out behind like the shadow my son likes to make on the wall with my phone light at bedtime.  I play with my children and have to push myself back up to stand, partly due to obesity but also due to my old lady self.

Forty, I feel old, I feel sad, I see time speeding up and away and I don’t know how to slow it. And suddenly, this year, I no longer feel secure in what I always believed – that the end is comforting, present, that when we die our souls look down on family and friends and stay close. Out of nowhere I have started to doubt that anything truly exists when we die. Will the end just really be an end?

I watch his young back and unlined face as he strolls away down the hall, and I wish him many more years of youth and innocence and dark hair. I wish him joy and excitement and the wonder of discovery.
And I wish myself peace, as I kiss my own youth goodbye.

—————

Working a full moon night shift in a large academic tertiary care emergency department is an adventure.  The full moon brings out the worst in people, the crazy, the anxious, the sad. And those people bring all that to the EDs in cities across the continent, where people like me have to help them come to terms with and deal with what the moon brought out. Well, not the moon really, but that’s how it feels.

Doing what I do, I am confronted by mortality – my patients’ – but also my own – every shift.

Tonight, teaching young residents, I felt old. So old. I visited the darkness of age in my mind. Then a few minutes after composing an ode to my own angst while taking a bathroom break, I reassessed an older lady I have met multiple times in the ED. She, a strange cat, but kind, told me that every time she sees me here I grow better looking and get younger. Suddenly, my hair felt full, my face clear of wrinkles, my steps a bit lighter. In her own bizarre but sweet way of self she gave me a gift. Mortality moved further from me and quieted its steps on my soul.

Ruthlessly however the spectre returned later in the long night, when a psychotic, angry, awful man began screaming obscenities at me from his locked room. As he called me unrepeatable names and told me to get on a treadmill, I forced myself to type my notes and keep my cool.

When he yelled “I’ll remember your face”, and threatened to harm me, the knot in my gut twisted. Fear returned, took hold, solidly placed its’ teeth in my belly. This man and many like him walk our streets. We don’t know who they are. Tomorrow, he could be next to me in a cafe, or behind me on the street.  Him, or someone like him. Maybe he will remember my face, maybe he will just see a woman and want to hurt her. This man, and others like him, are the reason I fear. And I see them, every day. They come to me, where I work, and they demand to be acknowledged. Maybe they are sick, maybe they are just mean, maybe they should be in prison. But I, and those like me, must treat them with respect, kindness, like any patient who comes through the door. So I do, and I pay the price by hearing his abuse echo in my ears. I carry a “screamer” on my ID tag, an alarm that emits a high decibel siren if I pull it; it’s sad to think I as a doctor feel at risk enough to carry such a device. But just last week, a health care worker in my department was attacked in a horrific way, out of nowhere. So I take no chances.

Mortality. Death. I know it, I walk with it. I recognize it. I fear it.