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Second Opinion: The Most Important Thing in Life (Hint It's Not Medicine)

Leap, Edwin MD

doi: 10.1097/01.EEM.0000453169.77652.16
Second Opinion

Dr. Leap is a member of Blue Ridge Emergency Physicians, an emergency physician at Oconee Memorial Hospital in Seneca, SC, a member of the board of directors for the South Carolina College of Emergency Physicians, and an op-ed columnist for the Greenville News. He is also the author of three books, Working Knights, Cats Don't Hike, and The Practice Test, all available at, and of a blog, Follow him @edwinleap, and read his past columns at





We take a beach vacation every May. We home-school, so our schedule is a little more flexible, and we can enjoy the coast before the masses descend. This year, however, was special. I worked a lot of extra shifts over the winter, and I write my own schedule in whatever way I like now that I am working locums. We had long wanted to stay on vacation for more than a week, and this year our wish came true. We planted our winter-weary, school-sick, work-fatigued selves at the beach for three glorious weeks.

Frankly, we didn't know quite what to do. We rushed to fill our time in past years, and we watched the weather to be sure we could enjoy every second in the sun. We ate out more, and we sat still less. We vacationed frantically, you might say.

Our time together this year was still finite, but we did not feel it press so closely on us. We slept late and cooked our meals in our rented house. We played games until late in the evening, and we biked as much as we could to as many places as possible (only coming close to heat exhaustion once).

It was May, and we were in the Atlantic, so the water was cool but not cold. The sand was a hot blanket, the pool was heated, and our bodies began to come alive with warmth and plenty of vitamin D. We were tanned and lean from exercise, not fatter as our evening ice cream should have made us. We were happy, together, as all families are meant to be. In fact, that trip was a little like my image of heaven, in which the good things go on and on but never become mundane or boring, a place where love precludes any annoyance or frustration, and the same delightful cycle of rest and play is forever untarnished. Time stopped for a while at Hilton Head this spring, and it felt as if our lives floated in a magical suspension as one reality was replaced with a higher reality of life at its very best.

One of the best things about the trip, one of the most powerful gifts and realizations, however, came when Jan reminded me of a fascinating fact. This trip was the first time in 24 years we had slept together in the same bed all night for three continuous weeks. That hadn't happened since I started residency, and we were newlyweds. Between night shifts and travel and shifts ending at 1:00 or 2:00 or 3:00 in the morning, we had often missed the intimate comfort that comes from sleeping together through the night.

It is the price of a career in our specialty. Despite the assertions of specialists who always seem surprised at late night and early morning consults, we know that people are sick and die at all hours. The consequence of that fact is that someone always has to be up and available. As noble as it is, that reality extracts much from our lives as flesh and blood humans who crave sleep and touch, humans who can endure loneliness but do not enjoy it for long.

All of us are proud of our work and our dedication. Proud that we can wake from a nap on a dime and make obscure diagnoses, or intubate at 4 a.m. after sewing a lip back together. Proud that we can go for hours on Pop-Tarts and coffee or whatever other heinous concoction does the trick. And our spouses are proud of us, as we are of their courage and fortitude when we are away.

But that doesn't mean it isn't hard. I have a very real sense that none of it is the way it was meant to be. Death and sickness are as wrong as sleeping apart from my wife. It's a thing to ponder. And if you can find a way never to leave the side of your love in the watches of the night, I encourage you to think long and hard. It would be a precious gift. It is almost impossible for most of us, but we can dream.

When we left the beach, it was not really with sadness. (There was, admittedly, some brief anger as we tried to close the luggage carrier in the pouring rain.) Rather, we left with the joy and rested hearts that always come when we rediscover love and simplicity, when we rediscover one another. We were ready to leave, I suppose. The children (rather, the teens) were filled with joy when we returned to our hillside home, nestled in a jungle of Blue Ridge foliage, overgrown from weeks without resistance from humans and our machines. And they were very clear: They missed their mountains, for all that the beach was grand. When you're born from two West Virginians, you have a gene for mountain grandeur, to be sure.

Returning home, we petted the dogs and cats and sifted through long-neglected mail. The kids reconnected with friends, and summer began in earnest. And for two more nights, before I was off again, my wife and I slept side-by-side in the last remaining days of vacation, listening to one another breathe and holding hands in the wee hours.

I think we should all pause now and then to spend lavish amounts of time together. And if that means making less, owning less, or signing up for one less committee, it's probably worth it. Our life is far more wonderful, far more precious than shifts and payrolls, schedules and papers.

Leave it all behind for longer than normal if you want to glimpse heaven. Lie on the sand or climb the mountains. But be careful. It might change your life forever as you rediscover that for all its wonder, medicine is not the most important thing in your life.

Not even close.

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