Four hours earlier, tears had crept down my cheeks as I put my sons to bed and went about the mundane tasks awaiting my attention. Tears of frustration, confusion, grief, tears for having snapped at my children, for having come up short in the ways I wanted to parent and communicate, for the rough spots in my marriage that had of late expanded into longer and longer stretches. For the kids I see every day and the poison I pump into their tiny bodies in the name of cure, and for the kids whose faces I do not know who are being ripped from their parents and hurt in ways far different but just as devastating.

Two hours earlier, I had gotten the call of a new cancer diagnosis in the emergency room and told my husband not to wait up for me. In the car, I contemplated whether to open the dam and let out the tears before facing this new family or to tamping it back to hold them in for awhile longer. I chose the latter. Now, driving home through deserted streets, a Bach symphony played on the classical station I had turned to. I have vivid memories of one night during residency, covering the ICU and admitting a patient who had arrested outside of the hospital. His prognosis was grim. For some reason, somewhere in the unit – whether in a neighboring patient room or the workroom down the hall – the song with the lyrics “we’re up all night to get lucky” played, and I have retained to this day the visceral bitterness I felt at their irony.

On this night I have turned on the radio to ensure I stayed awake for the drive home, choosing a classical station because no pop or news channels would be tolerable. The oboe cries with tones that seem designed to draw forth empathy, but shedding tears could not be farther from my mind or instinct. Now with an added reason for frustration and grief, my feelings have once again submerged to too deep a depth for recognition. Why? Because I went into work mode. When I arrived, the nurse showed me the latest labs and asked what I thought. It was cancer, I told her flatly, and she teared up while I listed the additional studies that still needed to be drawn.