Sometimes when I look at my older patients, lying lethargically in their fetal position, sheets rumpled about them, IV lines abound, and bruises covering their bodies from all the recent blood draws, failed IV sites, heparin, insulin shots, I imagine myself in 70 years, in the same position, and the thought scares me to no end. I cannot fathom wanting to be kept alive in such pain, sadness, in such chaotic surrounds devoid to diurnal cycles, of life and health. I think so much of medical technology in the latter years serve to prolong suffering rather than to deliver relief. When I look at my intact skin, lean limbs, bruiseless, scarless chest and abdomen I cannot help but feel dread for the inevitable process by which all this will be marred, maimed, slowly, until I am but a wrinkled, purple lump in a hospital bed.

Always in my preceptor's office I feel the stares of the 40-50 year old daughters of the patients on my legs and skirt. While I, equally as surreptitiously, observe their varicose veins, protuberent abdomen, non-existent waistline, and feel that same dread. That I need not 70 years to lose what I have. The inevitable will be reality in mere 20 years.

I think being young in this profession, while having the luxury of being pristine, has the added disadvantage of seeing the future at its worst. When the accumulation of toxic habits result in the illness of being old and helpless. And it is far from an encouraging sight.