When it’s bad, it’s bad:

One of the patients on the ward has every single risk factor for a heart attack and, right now, he is experiencing chest pain.

The neurology resident has two patients on his service that he wants to immediately transfer to psychiatry: “They overdosed on Medication X in suicide attempts; they’re medically cleared and all yours.”

The general surgery resident is angry with psychiatry because he has admitted the same patient to his service four times in the past two months: “He stabs himself in the belly because of his psychiatric problems—but we have to deal with him.”

The board in the ER is full and there are five people waiting for evaluation.

The nurses on the psychiatric ward are distressed because a woman is screeching at the top of her lungs, demanding discharge from the hospital right this second!!!

There are still three new consults to see: An elderly man with thirteen medical problems is delirious and agitated. A woman just delivered her first child and she’s confided in the nurses that she is thinking about killing her newborn son. A young man survived the car crash; his girlfriend did not. He’s depressed and sullen.

And I hadn’t had the chance to snack on anything in the past eight hours!

Somewhere along Highway 20, I stopped singing.

Of course I had already noticed the beauty that surrounded me: The caps of snow on the dark grey mountains glittered under the yellow-white sun. A single puff of cloud floated in the celestial sea of endless blue. The millions of trees crowded together as far as the eye could see. The waters of the rivers crashed blue-green over boulders and pebbles alike towards the ocean.

It was spectacular.

I stopped singing, though, because I remembered—again—that all of this would soon disappear.

More accurately, I remembered that my experiences would soon disappear.

As I weaved my way through the mountains, I tried to capture each passing moment. I so desperately wanted to remember all of the details—the way the broad, glossy leaves of the trees tremble from the wind and scatter the light from the sun, the whooshing of the water over the rocks, the perfect reflection of the arid hills on the glassy lake, the shadows from the mountains stretching over the two-lane highway—and catalog them neatly into my brain for future recollection.

I was so busy thinking about remembering the moments rather than experiencing the moments.

Before I was born—before I was even a thought in the minds of my parents—these mountains and trees and sky and rivers and lakes existed. The sun floated above them, the wind breezed through them.

After I die, they will continue on. I have come; I will go; they will stay.

While I listen to a patient mourn the loss of his wife from cancer, the snow continues to melt atop the distant mountain.

While I briskly eject a man from the ER for asking for potentially addictive medications that he clearly does not need, the trees continue to shiver at the touch of the cool alpine wind.

While I write admission orders for a woman at 3:30am, the moonlight silently falls upon the still lake.

While I indulge in my feelings of frustration and stress with my inability to do four things at once, nature and time move forward at their graceful, patient paces.

The world out there—up in the mountains, by the lakes, near the rivers—is so different from the world in major metropolitan areas. That world is so different from the worlds within our own heads. There is something about standing alone within the shadow of a large mountain while peering down at a expansive lake in the company of millions of trees that puts things into perspective.

Why do I get so anxious about stuff?

What really matters?

The memories in my head from my trip around the Cascade Loop have already lost their fidelity, I know. The teal hue of the lake I see in my mind isn’t the same shade of the actual lake. The fragrance of the mountain air is already gone. The sound of the waterfalls crashing onto the boulders in the rivers is dulled.

This is loss. And I feel sad.

And although I cannot take nature with me, nature has become a part of me—even if only through fading memories. The hubris that can accompany overeducation and academic laurels quickly disappears upon witnessing the glory and power of the natural world—how can anything I have ever done compare with the astonishing splendor that lies all around me? What is the significance of my stress compared to the unending change that the elements exert on each other? How can I possibly complain about my life when that same life has allowed me the opportunity to witness the stunning beauty that is around me all the time?

If you’d like to see photographs from my trip around the Cascade Loop, you may see them here. I’m more facile with words than with cameras.

(Part of the ongoing Relationship Series.)