Thanks, giving

So Thanksgiving has arrived and I have much to be thankful for. I have a beautiful family that I helped to build and an amazing wife who built it with me. I have a job I am passionate about and look forward to every day, even if my 2 year old's 6am wakeup makes me curse the gods of sleeplessness. I have a home that feels like home.

But I am also thankful for some other, less spoken things. I am Thankful for my attendings who have the grey hairs and years of knowledge and time and patience to have taught me everything I know about medicine. I am thankful for the patients who have done just as much teaching without trying. I am thankful for my health- something no one in my profession takes for granted.

I've been thinking, these days, about decisions and patience. A good decision can take years to pay off, but when it does there is no better feeling than the wait. Medicine feels like a good decision to me, and 9 years into the career, still in training but near the end of the tunnel, I know how grateful I will be for the decision to be on this crazy path. The truth is, I watch people every day suffer from bad decisions. Some of those decisions are made just beforehand- like not showing up to the ICU as a loved one dies, then feeling guilt in the final hour when the visit is finally made. But most of the decisions I see patients suffer from are ones made years before- like sleeping with a prostitute in Southeast Asia and contracting Hepatitis C, or using IV Heroin and ruining many lives along the way only to be left a shell of the person who once was, or not telling children about a cancer and watching their rage and helplessness as they find out with only weeks left to live. I have witnessed all of those scenarios and more.

We are a society fixating on instant gratification. It seems as though many people have lost sight of the patience our parents and grandparents exhibited when they worked long, hard hours at jobs that may not have "thrilled" them every day but in the end paved the roads and lit the lights of the 1950's American dream. My grandfather, for one, snuck out of Russia on a hay wagon, crossed the Atlantic and worked odd jobs for his entire life. He wasn't the dad of the year, but his son, my father, was a graduate-degree-educated success. My mother's parents worked odd jobs as well- her dad sold cigarettes door to door back in an age when such jobs were real. And out of the ghetto my mom came, and a successful career followed. The point is, my parents are a common 2nd generation story, which followed on the heels of long-term 1st generation thinking.

On this Thanksgiving I ask you all to be as thankful as I am for what is good and think equally hard about how to make decisions that are worth waiting for.