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During my next visit with Emma, we talked about life and where it was taking me. I recalled Henry Adams trying to compare the scientific force of the combustion engine and the existential force of the Virgin Mary. The scientific questions were settled for now, allowing the existential ones full play, yet both were in the doctor’s purview. I had recently learned that the surgeon-scientist position at Stanford—the job for which I had been heir apparent—had been filled while I was out sick. I was crushed, and told her so.

“Well,” she said, “this doctor-professor thing can be a real grind. But you know that already. I’m sorry.”

“Yeah, I guess the science that excited me was about twenty-year projects. Without that kind of time frame, I’m not sure I’m all that interested in being a scientist.” I tried to console myself. “You can’t get much done in a couple of years.”

“Right. And just remember, you’re doing great. You’re working again. You’ve got a baby on the way. You’re finding your values, and that’s not easy.”

Later that day one of the younger professors, a former resident and close friend, stopped me in the hallway.

“Hey,” she said. “There’s been a lot of discussion in faculty meetings about what to do with you.”

“What to do with me, how?”

“I think some professors are concerned about you graduating.”

Graduation from residency required two things: meeting a set of national and local requirements, which I’d already done, and the blessing of the faculty.

“What?” I said. “I don’t mean to sound cocky, but I’m a good surgeon, just as good as—”

“I know. I think they probably just want to see you performing the full load of a chief. It’s because they like you. Seriously.”

I realized it was true: For the past few months, I had been acting merely as a surgical technician. I had been using cancer as an excuse not to take full responsibility for my patients. On the other hand, it was a good excuse, damn it. But now I started coming in earlier, staying later, fully caring for the patients again, adding another four hours to a twelve-hour day. It put the patients back in the center of my mind at all times. The first two days I thought I would have to quit, battling waves of nausea, pain, and fatigue, retreating to an unused bed in down moments to sleep. But by the third day, I had begun to enjoy it again, despite the wreck of my body. Reconnecting with patients brought back the meaning of this work. I took antiemetics and nonsteroidal anti-inflammatory drugs (NSAIDs) between cases and just before rounds. I was suffering, but I was fully back. Instead of finding an unused bed, I started resting on the junior residents’ couch, supervising them on the care of my patients, lecturing as I rode a wave of back spasms. The more tortured my body became, the more I relished having done the work. At the end of the first week, I slept for forty hours straight.

But I was calling the shots: