The Humility of Age

There is a humility that accompanies age, shuffles along beside it, tugs on its sleeve to attract attention. Or is it insecurity? Or maybe resignation? It’s a gradual thing -for me at least- and it surfaces mainly after a busy and sleepless night on call when the stark, brutal demons of decisions made, or actions taken, stalk the leaf-bare branches of my exhausted mind. Thoughts, undefended in the early dawn, creep like lengthening shadows disguising all the colours that attend each birth and decorate each soul that cries out from its unintended visit to an over-crowded Emergency Department.

These are not the shadows of mistakes, nor the visitations of guilt for broken trust; they are not the heart-heavy burdens of ignorance, nor the all-too-frequent penalties of stolen time… These could be the excuses, of course: none of us is perfect, nor omniscient. Feet do drag, spirits do wane with over-use. To deny that Responsibility is obese with obligation and liability, or that it is uniquely manifested each time would be to deny humanity -and Medicine itself…

No, the spectre that haunts my night and follows me into each room is more subtle than that. It has no name – or none that I have ever heard at any rate. It sits in the corner smirking each time I enter a room; it holds its tongue and yet follows me with its eyes; it pins me to the wall with unanswered questions, hand waving impudently to ask its own. I don’t know why it’s there…

And yet I do; we all do: any of us who offer knowledge or presume to. It’s the monumentally Existential Question, the true moment critique: am I what I say I am? Not who I claim to be -that is easily verified. There are others as accredited as myself around to vouch for my identity. No, rather, am I the proper one to solve the problem: the Magus? The Shaman? Or am I a fraud, and my opinion merely that: one approach out of an infinite number, chosen at random from the hat I happen to be wearing at the time? Or worse, the only opinion I possess -pinned and pressed into legion shapes as the occasion demands? Sufficiently disguised, would it fool even me..?

I wonder about these things not because I suspect their truth, nor even concede their possibility, but rather because not every problem I encounter is sui generis. There are commonalities that link many situations in Obstetrics -and Gynaecology as well, for that matter- and one solution, sufficiently moulded, will often suffice. Recycling an idea -dressing it up in different clothes- does not necessarily negate its value. Using the same keyboard design on a typewriter and a computer does not invalidate the usefulness of either.

Experience teaches me that a calm analysis of each interaction, a survey of the data available, and a decision based on the findings presented to me, more often than not lead to an acceptable solution. With that, I am not haunted: I can peer however obliquely into the past for innumerable examples of its success. I do not bathe in this; I merely acknowledge it.

In the cool dawn after-glow of endless decisions and a night of dodging the panic-thrusted knives of patients and their concerned loved-ones, I am more troubled by -No! I am amazed at- the trust accorded me despite the often panic-laden atmosphere I enter. And I ask myself what makes these strangers take me into their confidence? Why should they trust me: another stranger, an unknown quantity? Is it desperation? Or Hope?

And can I, once again, perform as I have in the past..? Not just with babies -there are also many questions born of a busy night. Each requires context; each requires thought… When I was younger, I used to read Carlos Castaneda -you know: stuff like The Teachings of Don Juan…– and I remember something from one of his books: “We either make ourselves miserable, or we make ourselves strong. The amount of work is the same.” I think he had something there. Maybe he, too, was on call for something important…

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