In just a few hours we will head downtown to begin our fourth inpatient admission for chemotherapy. The final two-weeks of interim maintenance are upon us! Having “been there, done that” now three other times, it makes no sense that I am up at 2 a.m. to ruminate. This is a particularly ill-timed bout of insomnia: given that the days in the hospital are long, and the nights interminable, I would do well to take advantage of a few more hours in my comfortable bed, dark room, and peaceful surroundings. But instead, here I sit - the first of many hot cups of coffee in hand – in quiet anticipation of what is to come.

In some ways it’s eager anticipation…not quite the way you look forward to the dawn of a day of celebration. More along the lines of looking at the clock every hour all night long when you’re afraid of sleeping through the alarm and missing an early morning flight. Except that our journey today is a short 20 minutes by car. And there’s no worry of being “late” to clinic because appointment times are approximate (at best). And there’s no fear that our hospital room will be given away, as checking in for chemo is one of the best ways to guarantee room availability.

You’d never know by looking at (or through) our luggage that our destination is a mere 11 miles away. Suitcase 1: essential clothing and toiletries. Suitcase 2: balls, balloons, books, and other various and sundry boredom busters. Suitcase 3: a blender, workout equipment, food stores, really really good instant coffee, single serve creamers, and the world’s best travel coffee mug. Carry-on bag: iPad, portable gaming systems, cellphone, associated chargers, trash novel, People magazine. Hand-carried: one totally amazing and necessary pillow. Thank God there are no extra baggage fees!

In many ways, going to the hospital is a trip back home for me, having spent more than eight years there as a medical student and resident. There are many familiar and welcoming faces, sights, sounds and smells. MCV is a part of my fabric, my history. It is where I became a doctor, then a wife, then a mother. During the early morning hours, when Callen lapses into a now-predictable 2 hour sleep cycle, I head for the stairwell and climb the 388 well-worn steps from bottom to top as many times as my legs and lungs will allow. As I progress thru the ranks of floors, I reminisce: sub-basements and basements, the ER, radiology, ICU, OR, labor and delivery, pediatrics, women’s surgical wing, medical-surgical unit, cardiac, transplant, helipad. Each floor is evocative of past patient encounters: lives ushered in, lives saved, lives transformed (not the least of which, my own) and lives lost. I have run those hallowed halls and stairwells in various stages of sleep deprivation many times in the past, so in some ways this is merely a continuation of a journey begun there some thirteen years ago- and in some ways it is completely foreign territory. Yes, it is immensely helpful to know the geography, speak the lingo, and recognize the uniform. At the same time it is terrifying to know that terrain, understand that language, and wear that same garb.

Jim and I have spoken often of this dichotomy -how knowing what we know is a source of both comfort and consternation. For the most part we are able to navigate Callen’s care incognito, as “Mr. and Mrs.”, “Mom and Dad”, with only the occasional break in character, some slight tell suggesting more than a now four -month crash course in all things medical. Truth be told, no amount of experience could have adequately prepared us for this side of the patient-physician relationship. For parental, rather than practitioner, roles as caregivers to a critically ill child. For being on the receiving end of life-altering news, rather than the purveyors of it.

Is it really any wonder, then, that I awaken so often and so early? And on today of all days? I’ve been conditioned by years of motherhood and medicine. These have long been my hours to study, prepare, optimize, fortify. Decades of training being put to their best test. And now, to their best use.