Regret - A Story in Four Parts

Introduction and Prologue

This is my most recent Substack submission in a while.

My reason for the long delay?

Like most people who don’t write for a living, I have been busy with so many things – my work as a busy anesthesiologist and chairman of a large private practice group, a position on the planning commission in my small Marin County town, my family…but if I am honest with myself, these are just excuses and not the real reason why. The truth is I have been stuck in trying to tell these stories for a long time. Although I have written about many of these events and themes before, I am revealing new ones and expanding others.

I want to thank my new friend, Captain Stephen Chamberlin, ret. of the U.S. Coast Guard for inspiring me to get writing again and giving me a welcome and much needed push. Steve should be justifiably proud of a lifetime of experience and adventure in service of our country, and I am honored and privileged to work on some collaborative projects with him. Please subscribe to his Substack, as he is a gifted writer and poet, and well worth the follow.

These stories are about regret, one of the most corrosive and negative emotions we are capable of feeling. We all have moments and episodes in our lives that we regret. Who hasn’t acted badly on more than one occasion and wished we had done or said something differently?

Who in retrospect failed to act when they wished they had?

I had the opportunity to move to Seattle in 1983, a year after graduating from Stanford with a degree in International Relations, and a fun year spent working for the Stanford Alumni Association as the Staff Director for Stanford Sierra Camp, their family summer camp and fall and spring conference center. When the year ended, I had no real idea about what I wanted to do with the rest of my life, as I realized that I didn’t want to go to law school, or work in the government.

I was not unique among my friends in this career uncertainty, as the economy wasn’t great and the thought of going to graduate school or taking a job in finance or consulting as many other members of our class did just wasn’t appealing. The internet did not exist at this time, and though there were technology and engineering jobs at companies like Hewlett-Packard, or IBM, “tech” as we now know it was in its infancy.

Many of my friends from camp had decided to move to Seattle and live in a big old house called “the buck sucker”– named for its drafty rooms and huge utility bills - following the advice of Betsy Davis, a friend of ours who had found employment at a relatively small new company in Redmond called Microsoft. Several of them stayed there for years, had wonderful careers and did quite well financially.

It is useless to speculate on how my world would have been different had I gone with them, but I had other plans. Through a series of coincidences, new acquaintances, and a life-altering experience trying in vain to save two fishermen who had capsized their boat and suffered cardiac arrests in the freezing waters of Fallen Leaf Lake, I decided to become a physician instead. I have written about how I made that decision, returned to school to become a pre-med and then a medical student, completely redirecting my life in one of my previous stories. I hope you read it.

How would my life have been different had I followed my friends and gone to Seattle instead? Who knows? All events flow from the hundreds of decisions we make every day – the little ones as well as the big ones. It is a never-ending branching of the tree of life, and each path has its own ramifications. In fact, the word “ramification” is from the Latin, ramificare - to form branches. Once we choose, we can never go back to the exact same point. Like Heraclitus wrote, “No man ever steps in the same river twice, for it is not the same river and he’s not the same man”.

Despite my perseverating on all the “what if” questions that cause me to occasionally lose sleep and annoy my wife, Dana, to no end, I can’t help myself. Had I gone to Seattle, I certainly would not have my current life, my wife or my children, and I would not have enjoyed such a rewarding medical career.

Maybe I would have been a terrible Microsoft employee and would have been quickly fired? Maybe I would have hated it? I will never know, and I shouldn’t dwell on such things… yet I do. My decision to become a doctor is NOT one of my regrets, nor were my decisions to marry Dana or have my family. Those are blessings. Yet, within this seemingly charmed life, I do harbor deep regrets. Why are these regrets so emotionally powerful? Moreover, why do I hold on to them so tenaciously? What will it take to relieve myself of this heavy burden?

Apologies?

Therapy?

We all pray for deliverance from our inner demons, and I hope for myself and anyone reading this piece that relief is possible. We are, at end of the day, human and subject to the vicissitudes of life. It can turn on a dime.

I wrote this piece and will post it in several parts. It has a prologue followed by three stories from my past. The first story will cover the sudden and completely unexpected death of my father and the unexplainable and unforgivable re-marriage of my mother to a man I can charitably describe as the antipode of my kind and loving dad. It is a tale of profound loss and disappointment, and I am still deeply regretful over what passed, and more importantly it remains difficult to resolve my anger and grief over my feelings of impotence and loss of innocence at such a young age.

The second story is about my best friend from high school, and one of the most talented and wonderful young men I have ever met. John Duncan Wallace died from AIDS at a tragically young age, as did so many other brilliant and talented men during the early years of the epidemic. My recollection of my last conversation with him hurts me to this day, and I still cringe inside at the details of what I feel was a betrayal of him and moral failure of myself as a friend. I remain haunted by my words and actions and my lack of empathy as he struggled with his newly revealed sexual identity. I am ashamed of what I said to him, and more importantly of what I didn’t say. As a callow and immature nineteen-year-old, caught up in my own trivial concerns and lack of awareness, I neglected the pain and confusion of one of my closest friends. I never had the courage or finally the opportunity to make it up to him, until it was too late.

The third story is about a young woman and a teenage boy I took care of as patients in the ICU at Harborview hospital in Seattle, early in my training. She was a victim of a horrible automobile accident that ultimately ended her life. He was a young man who attempted a suicide that went terribly wrong. Much of what I have learned about how to be a compassionate and caring physician stem from these encounters and how I failed to communicate properly with both of their families and how I wish I could have done things differently.

As doctors, most of us are far harder on ourselves than are others. Although my memory of these encounters is undoubtedly colored by the experiences and wisdom I have gained since, I still feel the sharp sting of my perceived shortcomings. I was an emotionally unprepared resident doctor who did not have the requisite tools of either insight or maturity, and others suffered for it.

Regrets Part 1 - Prologue

And now, the end is near
And so I face the final curtain
My friend, I'll say it clear
I'll state my case, of which I'm certain.

I've lived a life that's full
I traveled each and every highway
And more, much more than this
I did it my way…

My Way, Frank Sinatra

It’s a little after two o’clock in the morning and I wake up from a restless sleep with that uncomfortable and nagging feeling in my bladder – one that all men of a certain age are subject to. I stumble to the bathroom in the dark, tripping over my shoes and clothes left carelessly at the foot of the bed the night before. I am retiring earlier and earlier in the evening as I grow older. I used to marvel at my ability to stay up late, watching TV, reading or going out to parties and dinners.

Not anymore.

Six PM dinner reservations seem perfectly fine with me. If I am not on call at the hospital, or in the operating room, busy and accustomed to staying awake and alert, I am exhausted by the time the sun sets, and sleep beckons. Over thirty years of being an anesthesiologist has trained me to accept and even enjoy the rhythm of working late every third or fourth night, but it has also taken a toll on my body and my stamina which is getting harder and harder for me to ignore.

If I am not working, and the sun is down, so am I.

I stand and sway a bit unsteadily for what seems like an eternity over our fancy Japanese toilet that senses when I approach. It robotically raises its lid, bathing the bathroom in an eerie and alien blue light emanating from beneath the rim of the bowl. But the toilet is impatient, and I am slow to relieve myself, or both. It auto-flushes before I have even started, never mind finished. So, I must flush it again manually by fumbling for the control panel on the wall, which is a waste of water. I add worrying about the possible future lack of water in California to the growing list of concerns that pile up in my mind at this ungodly hour of the morning. I must get up for work in just three hours to a shower, a hot cup of coffee and a cold pre-dawn drive across the Golden Gate Bridge to the city for a full day in the operating room.

But now, bleary eyed at 2:19 AM, I head back into bed and find my dog, Jasper, has moved into my territory, fully stretched out. He inhales deeply, and exhales contentedly in a way that only sleeping dogs can. I shove his dead weight over and yank on the duvet and sheets that he has pinned down. They barely cover me, and I am crowded to the edge of the bed.

I can’t fall back asleep, so I watch him. He has quickly transitioned into REM sleep as his eyes behind his closed eyelids are darting from left to right and his paws are twitching as if he is dreaming about running on Shallow beach or chasing some small animal down the path into the woods at our family house in Inverness. Every now and then he emits a little whimper, and I am envious, marveling at his ability to live in the moment, free from worry about the past or the future.

No matter how hard I try, or how much I meditate or practice box-breathing, I cannot do that. I constantly worry about the past and the future – about the things that may be, but mostly about the things that I have done and the things that I failed to do and wished I did. About what I said or didn’t say. About the people that I have met and wished I had treated differently, and the relationships I have had and the mistakes I have made within them.

The list goes on and on.

Overall, I consider myself a happy, engaged and engaging person. Most people who meet and get to know me would agree. So far, I have lived a full and very successful life. I was privileged to attend a prestigious prep school and worked hard receiving an excellent education. I attended Stanford University, both undergraduate and medical school. Internal medicine internship and anesthesia residency followed, and I received several early research awards and spent seven years as a junior faculty member at the University of California in San Francisco. I have been in private anesthesia practice for the past twenty-five years and serve as the chairman of my large multi-specialty department.

Despite all odds, and my less-than-perfect childhood, I have been happily married for nearly thirty-five years, successfully raised three children to adulthood, love my work and am good at it, and have made many excellent friends and colleagues along the way. Yet, like most people, I carry with me burdensome rucksacks filled with misgiving, disappointment and regret. They may be checked at my mental baggage claim during the day, but at night I unpack them and meticulously inventory their contents.

This is a story about mistakes I have made, or more specifically in the immortal words of Frank Sinatra’s song “My Way”, the regrets I have had. And while my regrets may be few, they are heavy and weigh me down, and they are most certainly not “too few to mention.” To be honest, they have been on my mind for what seems like an eternity, and I can no longer confine them to the wee hours of the morning or keep them to myself.

What does it mean to regret something?

Where do we discover the many facets of this most corrosive and negative emotion?

How do we seek relief, recover and continue to live despite the grief and despair we carry within this dark and seemingly bottomless magic-show suitcase?

Regret is one of the most defining human emotions. It stems from our self-awareness combined with our ability to compartmentalize time. Though we have no way of knowing how other species communicate their knowledge of time, we are likely the only creatures on earth who can cognitively divide time into the past, present and future. I am not minimizing other animals’ extraordinary memory or predictive ability, or their capacity for empathy, devotion or even love. But we are the only species that can record and relay knowledge over time and vast distance.

We are storytellers.

Even more so, we can imagine different versions of reality. Something in our intellectual evolution as a species has gifted us this extraordinary ability. But there is a dark side to this ability. We can suffer a visceral reaction to a past disappointing event in our lives, to choices or actions we have made that can’t be undone, to words we have said that can never be taken back. We can’t go back for do-overs, despite our intense desire to do so. Perhaps this is why there are so many stories about time-travel. We desperately long for that do-over.

Regret is the manifestation of that longing. An unwelcome visitor to the home of our psyche, it is persistent, intrusive, and deeply sad. Some people are driven mad by it. It is the offspring of shame, of guilt and of self-loathing.