First and last days to remember


Precision is what’s being stressed,

The date I started or left.

            I made some phone calls

            To my old college halls

And I remembered much of the rest

                       

I’m applying to work at a Federal installation.  They have their rules, and they want to know my background in the MMDDYYYY format.  Which is OK if you’re just out of med school or residency, but it’s been a long time for me.  I had sent my CV with just the month and the year.

My government employment dates came up easily in the set of old orders sheets I’d never thrown away.  But I had to call a lot of academic institutions and ask for the Registrar’s office.  Fortunately I could find the phone numbers for the switch board online, but searching the sites didn’t turn up the dates I needed: when I started classes and when I finished them.

As the day wore on I got my emails back and the memories came flooding in.

September 18, 1968, I began studies at Yale University in New Haven, Connecticut on a hazy, hot September day.  I’d been in town for a week and had met the students on my floor.  I was a theory and composition music major then.  I thought I would be a composer. 

I graduated from Yale on June 12, 1972 with a degree in Anthropology.  The country was in chaos, Richard Nixon was beginning his slide from power, the day was hot and sunny but not very clear.  Hurricane Agnes was building in the Carribean.  My mother and stepfather came from Denver and were sitting in the crowd at Morse College.  I wore an academic gown with MOM written in rivets on the back.  My hair was in a ponytail.

Three hundred and sixty-four days later, June 11, 1973, I walked into the University of Colorado at Denver building in downtown Denver as a premed student.  I didn’t have to declare my major because I was classified as a Special Student.  I had one Bachelor’s degree that wasn’t likely to bring me any money and I didn’t see the sense of getting another.  I knew that if I were to be a doctor I would need to go for the grades like a shark goes for a seal.  I entered that building with determination and stubbornness.  Of course I had no idea what being a doctor would be like.  I was 23 and I knew I could learn anything even if I had to do by blind, dumb rote.

May 21st 1975 I walked out of that building for the last time, through the back door, past the library, down the wheelchair ramp to where I chained my ten-speed.  The sun was shining and the air was smoggy.  I said goodbye to the other premeds who had their bikes parked there, people who had fought and struggled beside me.  In the two-year premed sequence fifty percent dropped out each semester, it was appalling how few finished.  But about one quarter of those who finished the courses got into med school.

On September 25th of 1975 I rode my single speed bicycle the mile across Michigan State’s East Lansing campus, over the tracks to the Life Sciences Building to start my medical career.  The day was warm but clouded over.  I left the bike unlocked outside front door, and I went into the lecture hall where I would spend the majority of the next two years, trying, as my daughter Jesse says, to drink from a fire hose.  The dean addressed us, and it felt as if he were talking to each one of us personally.  To put things in the right perspective, he said, if any one can play banjo for our blue grass group, please see me afterwards.  I didn’t realize he was saying an effective healer must have a balanced life.

I remembered my med school graduation date.  March 11, 1979, is a heady date that will live forever in my memory.  My father and my brother flew in from Denver.  I hitchhiked in from Montana, where I’d been doing a clerkship on the Northern Cheyenne reservation.  The weather was well below freezing and the sky was clouded over.  The students had gathered from all over the country and it felt like a reunion in our collective euphoria.  I had a moment of panic just before I walked. I had been a student for the previous 23 years, and if I actually graduated I wouldn’t have that identity. That existential crisis passed with a wave of endorphins when I was handed the cool looking scroll that wasn’t my diploma.  My brother and father and I went out to Chinese that night, and my fortune cookie said, “You will have great power over women.  Use it wisely.”

I started my Family Practice residency on July 1, 1979, on a clear warm day in Casper, Wyoming.  I was naïve, and I had much to learn about social norms, respect, life, death, risk, healing, politics, cowboys, oil field workers, sociologic dislocation, alcoholism, being a team player, and not being a hero.  I rode my bicycle to the clinic.  I stepped through the front door and into an ACLS class.

On June 30, 1982, I walked out of that clinic building for the last time.  The day was clear and warm and windy.  I was 32, I was a young doctor with a wife and a baby daughter.  My ponytail was gone.

Five days later we arrived at the ACL Indian Health Service Hospital outside of San Fidel, New Mexico.  The sky was bright, clear blue with a very few pure white clouds.  Bethany and Jesse stayed home while I walked the five minutes to the hospital. 

Then it seemed like one breath in and one breath out, and it was July 13, 1985.  I had two daughters, and the Canoncito Band of Navajo were throwing my going away party.  They gave me sand paintings and the exquisite silver and turquoise belt buckle I wear to this day.  As I walked across the gravel parking lot of the clinic I looked back and I understood, for the first time, what they mean when they say the Land of Enchantment.

The official day I started in Winnebago, Nebraska was July 14th, but I had a week of orientation in Aberdeen, South Dakota.  I didn’t actually walk into the aging brick building 23 miles south of Sioux City on a hot summer day till July 21st.  I was still full of ideals and I had a sense of purpose, a calling.  I came in through the clinic door on the west side, and it was through that door I left on May 10, 1987 with less idealism and more cynicism.

I looked through my old orders sheets, and the day I was ordered to my detail at the Tuba City Indian Health Service hospital was May 11.  In actuality they gave me four travel days, now with three children, to get from Iowa to Arizona.  The sun was high and we were sweating in the car.  I helped unbuckle the kids and carry them inside.  We walked past a family of albino Indians and stepped out of the dry desert heat into the air-conditioned hospital. 

I have July 10th listed as my separation date from the IHS.  I took what was called Terminal Leave, using as much of my accumulated vacation I as I could at the end of the contract, so really we packed up the car the last day of June, in the cool of the early morning, and drove away, north and east, the sun in our eyes.

My first day at Morningside Family practice was July 27th.  I was relaxed from not working for a month.  I drove my green Karmann Ghia.  I entered the back door.  The day was humid and the morning was warm.  The air conditioning was working too well in my office.  I sat on my new chair in front of my new desk and talked with Cheryl, my new nurse.

Twenty-three years later I am slowly packing up my things and moving them out a little at a time.  My beard is grey and my hair is thin.  The children are grown and out of the house. 

When I walk out on my last day, May 21st, I want to remember every last detail.

I’m not retiring.  I’m graduating.

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