Given all that tripe, I did have a decent day today. I managed to get in an arterial line after three tries. The attending that I’m working with—who has a reputation for making interns cry—thinks that I’m probably no dumber than a box of rocks. (Which, believe me, is a complement.)

Small triumphs. Little victories.

One of these days, I might manage to get a little self-confidence. What is this world coming to?

8 Asians introduces me to the acronym SDU, which means single, desperate, and ugly. I find this acronym highly amusing since I find it so self-applicable.

I am also reminded of something that I think S (not S.!) told me once: desperate is so not sexy. Or maybe it was N. I sometimes get all these women who rejected me mixed up.

So I have, in fact, tried to cultivate the demeanor of someone who is not desperate. It’s been so long that I’ve almost forgotten that I’ve been consciously trying to do it.

But sometimes reality pimp-slaps you upside the head. I mean, doesn’t the fact that I’ve been single all this time undermine the notion that I’m not desperate?

I suppose I could just put a spin on it. I just haven’t met the right girl yet. Riiight. That’s the ticket. My standards are just too high. Yeah. Or I just haven’t been looking.

I mean, there is some truth to that last notion. I have been living a sort of twilight existence this last half decade or so. I work all the time. I deal with death and disease. That alone is enough to sort of anesthetize the soul, really.

And then bad shit happens. When my dad had his big fat LAD, I took it pretty badly. Mostly because I held it all in for quite a while. I actually stopped blogging for almost two months. But that shit got me thinking about mortality big time, and I don’t think I’ve ever really gotten over it. My dad is doing pretty well, but none of us are getting any younger. The fact that there aren’t any little kids at Christmas kind of gets me down. If I were ever to have kids, I’d want them to meet my dad and remember him. But only Atropos knows when those threads run out, really.

But that reflex to just shut down and burrow in gets me every time.

What really threw my mind for a curve ball was the fact that my cousin D died about a year and a half ago. She was just a little younger than me, 29 at the time. I had gone to her wedding just a few years before. We weren’t the closest of cousins, but we pretty much grew up together. I still remember those days when we were all little kids and we’d go out to Fallbrook to my aunt-and-uncle’s place and play badminton or something. Or when they’d come out to Harbor City or even to Eagle Rock. When I finally moved down to San Diego, I saw her a bit more. We had sushi about two months before she died. That was the last time I saw her. We made a deal to hang out more.

That’s probably the last time I couldn’t stop crying. Even though I tried to let it all out, and not hold anything back, it still ached as I wept, like something was yanking my insides out. I remember that awful clawing feeling at my chest as they lowered her casket into the ground, as I watched her brother, her mom, and her dad just bawling, just trying to hold each other up. Just thinking about it fucking kills me.

I walled-up pretty good that time, cocooned in my own ball of self-pity and dread.

I think about the people I’m taking care of lately. You would think, that after all this time, I would’ve gotten used to death. But maybe it’s just the reflex of the living, to fear death. There’s one poor woman whose lungs have just been obliterated by smoking, and now she’s on a ventilator. The chances of her getting off the ventilator are pretty much slim-to-none. It’s guaranteed to be slow, drawn-out, painfully protracted experience. Today, her brother saw her for the first time. The last he had heard was that she had gotten discharged and was actually doing better. Unfortunately, that lasted for all of twelve hours, and she ended up back with us. I had a hard time looking him in the eye, telling him what had been going on, and what we had been doing. That look of shock on his face kind of haunts me, to tell you the truth. You’d think I’d know how to deal with that by now. At least I don’t choke up any more and need someone to hold my hand and help me out.

Then there’s this other lady whose life has been seriously unnaturally prolonged. She showed up in 2006 with lung cancer that was already all over the place. Metastatic to the brain, the bones, the liver. When you’re at that stage, we usually measure life expectancy in weeks. Months if you’re extremely lucky.

But she persevered, and demanded everything that modern medicine could throw at her. And we probably crossed a line somewhere. That point when everything you’re doing can only hurt. Sure, you can intervene, but in the end, it doesn’t really mean a goddamned thing.

Somehow, she convinced a surgeon to open up her chest and lop off the part of her lung that was tattered and torn up by tumor. Never mind that the mets in her brain were getting bigger. She got hard-core quasi-experimental chemotherapy that left her weak as a kitten.

She got two extra years out of the bargain. Maybe it was worth it. But I don’t know. Ultimately, we’re just delaying the inevitable. She’s dying. Not in the existential way we’re all dying, but actively dying. The cancer has managed to chew it’s way through the part of the airway that the surgeons had to sew up after lopping off part of her lung. And she and her family aren’t even close to accepting the undeterrable fact that she just ain’t gonna make it. You always have the chance to die very badly—with ribs cracked apart, blood spewing from your mouth, shit and piss all over the place, and you struggling for air, or die well—peacefully, with dignity, and a chance for your loved ones to remember you at rest. I hope she makes the right choice. (Oh yes, there is a right choice.)

You would think, this far into things, I’d have gotten used to it.

Maybe, it’s because, ultimately, we’re all narcissistic, and I can’t stop thinking about that day when I finally come to a full, complete stop.