Uphill l Downhill
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On the Fear of Death
Let me not pray to be sheltered from dangers but to be fearless in facing them.
Let me not beg for the stilling of my pain but for the heart to conquer it.
Let me not look for allies in life's battlefield but to my own strength.
Let me not crave in anxious fear to be saved but hope for the patience to win my freedom.
Grant me that 1 may not be a coward, feeling your mercy in my success alone; but let me find the grasp of your hand in my failure.
-Rabindranath Tagore, Fruit-Gathering
At this moment, I have gratitude for space.
I took 3 consecutive PTO days off this week for myself. Something I haven’t been able to do for the past 19 months. A time to reflect and digest the world and my place in it. A luxury that I am grateful for. Just like how a healthy diet is rarely attainable for the poor. Achieving emotional balance can be expensive and I’m fortunate enough to have the means to sit in the middle of nowhere to write.
Today I did something I have never done before. I went on a hike, by myself. This was only the second time in my life I’ve ever gone on a hike and the first alone. Hiking isn’t really my thing. I gravitate towards activities with set goals and outcomes and it is often difficult for me to sit, walk, or run with no clear objective other than to passively take in the world around me.
But today, I did just that. And my ignorance and subpar fitness level was on full display for said world.
I picked an alpine lake to hike to. Recently, I have become more enamored with the notion of alpine fishing and camping. When I indulge in escapism on YouTube I typically will watch some of my favorite fishing channels (shoutout to NW Fishing Secrets) and if alpine lakes are available, they are definitely the go to. Something about the seclusion mixed with fresh air and crystal clear water has spoken to me more as I have grown older.
So I embarked - equipped with my oversized backpack, 2 fishing poles, tackle box, freeze dried meal, multiple snack bars, peanuts, 3 sources of water, a camping stove, a propane tank and a fishing net. And the delusion that I could complete this alpine hike with the above strapped to me, let alone without them.
I got my ass kicked.
And not just any ass kicking. This was one of most grueling physical experiences I’ve had in years. I must have taken 30 breaks on what felt like a stairway to heaven. Each step seemingly more vertical than the next. Sweat ran from every pore of my body. Fully on par with the infamous Jordan Peele gif from Key and Peele. And with each break I took, more and more people passed me. It was younger people at the start then came some middle aged folks quickly followed by couples that were likely deep into retirement. All while I sat on every other switchback with my comically large backpack with fishing pools hanging out of it and a fishing net dangling from the side.
I honestly thought about turning back at least 50 times. “I have a few more days left. I’ll come back later with a vengeance.” But in what was likely the most pathetic Hallmark story of all time, I continued on as more and more elderly couples passed me by with ease.
But I persisted and eventually found my alpine lake - serene and crystal clear. I was so fundamentally exhausted that I could barely muster up the energy to actually fish. And as my typical fishing stories go, I casted, I lost lures, and I caught nothing.
One of my biggest takeaways was on the initial descent back though. Yes, I achieved the end destination. Yes, I overcame my poor physical conditioning and ill-conceived plans to bring an entire fishing artillery up a mountain. But what felt best was telling weary hikers who were on their own way up that they were close and to see their faces light up with a final burst of energy. It felt good to encourage people who went through the same journey I had – albeit with better conditioning – to continue forward with momentum. To play a small role in an emotional tail wind up an otherwise barrier-filled climb.
I draw parallels to medical residency training and faculty work. So much of our work is either encouraging residents to finish their climb or to actually help them up that climb. When I slowly hiked up that mountain it was both those going up and going down who encouraged me. “You’re almost there”. “See you at the top”. And while encouraging is important and representation in every sense is needed on every level, so much still falls on the one in their journey.
I think one of the dangers in any mentoring or teaching is the very real foil of “if I could do it you can too”. This may be true but it rarely lands the way it’s intended unless there is a very real relationship and parallel already existing. I remember one girl who passed me on the trail joking how many times she had to stop as well. It was a cute effort to relate to my very real physical pain in that moment but she could not fathom how pathetic and weak I really was at that time. As she passed me on the trail I wouldn’t see her on a stop until the final destination.
Residency training is tough. Being a physician is just difficult, period. Each physician must make a decision to push past the myriad of negative thoughts and obstacles that present themselves. Some we can remove or alter as medical educators and some we cannot. Sometimes we can only sit and acknowledge the difficult trail traveled.
So much of what we do as mentors and educators is to time the right words or to know when to speak at all. I just know it’s something I believe in and hope to improve upon myself as time hikes on.