les deux.

it strikes me as i am trying to contemplate this odd decision that rather than deciding between job types and geographical locations, I am actually almost trying to decide between becoming two entirely different people.

After all, what defines a person more than what they do day in and day out for years at a time… Does anything define who a person is more than what type of work they do, what occupies their time, what they do in their time off?

One thing I have learned from my extreme diversion from home to Salt Lake City is that, while I am still myself in many basic respects, I have changed dramatically by virtue of this work and my surrounding environment.

The things I do and they way I spend my time have been altered in such a significant fashion that it will be an enormous change of self to simply go home…and a similar change to go away to start again. Strangely, it will be almost the same degree of change in either direction…

I have become so many of the things I have always craved and admired in this life. I have spent my free time in the mountains, in awe, and pushing my limits. I have learned moderation in aspects of my life that have begged for restraint. I have become more fit and healthy. I have worked hard, no matter what. It has been the first setting in which it was truly and impressively difficult. After hearing "the next step will be challenging" over and over, I had become numb to the idea that something could be so difficult as to almost break me…

I have taken sort of an immature pride to refusing to take antidepressant medications during residency, refusing to become part of the striking statistic… and recently, with 3 months remaining, I have been wondering whether I can survive without some other assistance besides what strength I have within myself to give… I honestly do not know if I can do it.

How ironic is depression? It is a strange disease which strikes people who seem to have had unfortunates hands dealt, but also others at very unlikely times. Mothers after delivering healthy babies who are doing well, in supportive environments…? People who have been successful in careers or athletics? At this point, there is no question in my mind that I am depressed. The apathy and unhappiness is overwhelming. And why? That is the perplexing thing about the disease. Because the more I try to persuade myself that I should not be so as I approach the end of residency and very exciting and liberating point in my life, the worse is the heavy cloud of it…

In this setting and mood, I am trying to decide (more than anything else) where happiness lives. Is it in adventure? Starting fresh and new, brimming with excitement, in an intriguing new job away from the many burdens of "clinic." Free from the familiarity and troubles of home, but also with easy access to the unmatched pleasures of it? Or is it in comfort and familiarity? Is it at home? Is the "easier road" the road to happiness because I will not be suffering so many of the pitfalls of the hard road. At the sacrifice of immersing myself once again in the new?

I search for advice and wisdom in others experiences, but it is empty. Some people seem to be unsettled with comfort and the sense of home, always craving adventure and excitement. Their year is not complete without a month-long adventure. Others seem to be desperate for their home and bed at the end of a single week of vacation away from home.

Part of the difficulty with my situation is that I have these two conflicting natures, each of them almost equally strong and passionate. I seem to crave both home and adventure simultaneously. I am afraid that if I go home, I will never had the strength or opportunity to leave and explore more. At the same time, I am afraid that if I stay away and stray another "lifetime" further away, it will be that much harder to sacrifice the things I have learned to love and need away from home… Strange thing.

I have always had the blessing and curse of being "laid-back." My sister is the only person who can understand that this characteristic in me does not make me devoid of specific interests, but that I have a gift of being able to enjoy almost any decision while suffering intensely through the decision process itself. In this way, I know that whichever decision I make will have many pleasures and difficulties, many reservations and misgivings, second-guesses. But either will be good in its way.

The troublesome thing in the decision I have laid in front of me is precisely that… not that I don't know myself well enough, but more that I don't know what I want to become well enough.

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"When you finally go back to your old hometown, you find it wasn't the old home you missed but your childhood."

-Sam Ewing

"There was a new voice which you slowly recognized as your own, that kept you company as you strode deeper and deeper into the world, determined to do the only thing you could do - determined to save the only life you could save."

-Mary Oliver