The tumultuous diversity of America is great gift. Our dynamism as a country surely depends on the constant exposure to new ideas and ways of thinking. On the other hand, it comes at a cost, too. Community cohesion seems to be the cost we are paying for this wonderful engine of our country.
One of the binding forces of community is ritual. Traditional cultures have rituals for all major life events. These rituals bind us to one another and help us feel rooted in our people and place in the world. One such ritual I often feel is missing in our culture is that of passage of into adulthood.
I think many of us reach adulthood at different times in our lives. Clearly 12 years old is no longer the time for recognizing our transition into adulthood. Yet, I think clarity would be helpful. Those of us in Medicine often seem to have a prolonged entrance into adulthood due to the many years of schooling and training.
When did I become an adult? At 18? When I graduated college, or medical school, or residency? Maybe, for us Millennials, the transition to adulthood happens when you have to start paying off your student loans? I had a long slide into adulthood, slowly gaining more and more responsibility.
A little ritual to mark a moment might have provided some clarity.
Is responsibility what marks our transition to adulthood? I am not so sure. I always had a fairly large amount of responsibility, often more than my peers. Yet, it did not make me feel more “adult.”
Growing up, adults are the ones who have the answers. They teach us the rules of life. They provide structure and certainty to young, expanding minds. I know more thing than I ever have, but often feel like I have fewer and fewer answers to the questions which matter.
I still don’t really feel like an “adult.” I certainly don’t feel like I can offer anyone else any certainty.
Yet, I do know what it means to feel old now. Unlike adulthood, I learned what feeling old feels like within a matter of 2 months. After the first, burning, searing weeks of grief gave way to a smoldering, tired blanket of grief. Our first daughter dying made me feel old. All of the sudden, I was world-weary and inexplicably brain-and-soul-tired.
It seemed as though the world had gone gray, and taken me with it. Everything took more energy than it had before. Then, the hospital-pharmaceutical complex came and demanded I keep performing my RVU tricks. Any hope I had had of finding some comfort and solace in work and my supposedly noble profession was dashed.
I have hurt more deeply than I knew possible. Yet, life keeps going. Now, I visit my grief at times. Sure, sometimes I feel guilty I can not feel it for a few days to even a week at a time. Sometimes, when I feel guilty about having joy and pleasure in life again, I got back to the day we had to say good bye. I remember holding her as she stopped breathing. Soon, I am softly crying, and I know I haven’t stopped feeling her loss.
The grief of losing my daughter was by far more painful of the two wounds I sustained at that time. No one should have to lose a child, but people do. Sadly, it is more common than many realize. A path exists, there are books, and people want to be supportive (even if they are often bad at it). Maybe because of this, I have found the process of coping with her loss and healing from it to be simpler, if not easier, than coping with my disillusionment with Medicine.
You Can’t Turn Back The Clock
The repeated grief of coming face to face with my disillusionment with a calling I had had actually grown to believe in seems to be never ending. The Hospital-Pharmaceutical Complex seems to take joy in reminding me of its callousness and love of profiteering. It never fails to slip comfortably under the already low bar where my expectations are.
While I have come more to terms with the reality of modern doctoring, it still makes me sad. Sure, sometimes I am angry, too. But really, it is mostly sadness. I don’t have the energy to be angry at a giant faceless industry. That sadness seem to be the well which feeds my feeling of elderliness.
Before, I felt like I was participating the arena of Medicine. I was an eager young pupil, ready for action. Now, I view the going-ons of all the little hospitals as an old man on a bench dispassionately watches a cat stalk a squirrel in a park. It is a drama, but a small and distant one, separate from the man’s life.
Sure, it will be sad for the squirrel, but the world is simply this way.
Welcome to Adulthood
Maybe, I wonder, this is what adulthood is. It is not rituals, nor accomplishments, nor financial responsibilities. It is the world teaching you it is not a place of endless possibilities, at least no longer for you. Is adulthood the place and time where we realize life can be just as cruel as it is wonderful?
Do we become adults when we transition from an excitement about how the world could be to a acceptance of how it is? No longer the young revolutionaries, we become harnessed bureaucrats and accept our fate?
Maybe then, I was lucky to make it to 32 before I became an adult. I had a long and wonderful childhood, full of joy and discovery.
On my better days, I hope to return there.
Maybe that hope means my transition to adulthood isn’t so foregone, after all…