Anger. Hatred. Resentment. Belief systems.

All irrational mindsets that are deeply rooted in all this.

How we respond will further define this vicious cycle.

But how do we respond? As an international community. As nations. As communities. As individuals.

France has vocalized this was an act of war. Ironic since war is precisely what they want. Is war ever the answer? Or does war only creates more anger, hatred, resentment. And when has war not created a power vacumn that bred more evil?

But. Is diplomacy ever possible with irrational minds? You cannot argue against another's belief system. Especially when it is so deeply rooted that they are ready or seek, to die, from it. If perspectives are different, there is no meaningful conversations.

Can anger ever be contained? Don't think so. Not when technologies and information exchange created a world with no boundaries. Not when the risk of lone wolf outliers further threatens the lack of predictability when they may not even adhere to the mandates of the central organization.  Not when the thread is irrational.

So how do we respond.

As usual, there probably is no single optimal answer.

There is likely some grounds for continued containment. To limit their resource. To limit proliferation of their extreme ideals. But to think they can be extinguished is likely naive.

There is likely some grounds for diplomacy, even if only to achieve an ongoing presence of international pressure against such thread. Form some form of unity. Better information sharing and security efforts could probably lead to, well, more security.

And there is probably grounds to continue to breed tolerance and compassion, to diffuse further anger, hatred, resentment. Continue to learn about our differences. Continue to find similarities.

At times like this, the natural reaction is an instantaneous radial aggressive angry response. It is probably better to carefully evaluate the options and potential implications. Answering anger with anger never works. When has that argument ever turned into a productive resolution?

This is an opportunity to grow closer as a people. Thread will always be among us. I see that all the time in my work. Most of it is unpredictable and irrational. Be vigilant. Form effective safety nets and protective mechanisms. Seek and diffuse potential threads. Show compassion and care.

And carry on.

Never sit on an opportunity to express myself or to show others what I am capable of.

Otherwise the next day days will just be filled with regrets of missed opportunities.

Don't have to be rude about. But also no need to be too polite. Maintain respect, but seize the chance if it's there for you.

Doors don't open by themselves.

Resist the urge to sit back especially in the midst of a downward spiraling mood.

Stand up and sing. Take the ball to the net and take the shot. Speak up. Call for the puck.

Nobody will thank you for being a bystanders.

Winners are not made that way.

Never sit on an opportunity to express myself. To show others what I am good at.

Otherwise, people will never know.

And what good is that?

I passed.

I didn't expect the results for perhaps another week. I was expecting the worse, actually. I wasn't a very pleasant exam. I didn't feel that it tested the knowledge and clinical skills we worked so hard to get. I was more flustered at whether I had interpreted their questions properly or whether I gave them the very answers their templates wanted me to give. I had never felt this poorly after an exam before. After the morning of the first part of the exam, I walked out feeling stunned. I'm sure I looked pale and ghostly. I wanted to cry. Christine kept asking me if I was ok. I didn't even care to look at her and answer her. I was sure I had failed it. I would be "the one" who failed it from our school in something like 10 years. After that terrible weekend, I was ready to accept the embarrassment, and had resolved to letting whatever happens happens. I'd be okay, I told myself. I have many options going forward. I'll just live with the shame for a  little while. Then it'll all be gone. And we'll live. Whatever happens.

So this morning when I saw my friends posting their happy news on facebook, I sat there, cereal in hand, wondering if this should be the moment that I meet my fate. I took a deep breath, thought to myself 'what the heck, might as well let it be', then opened the email link...

Whew. What a relief.

Is it joy? Is it excitement? Not really. It was very anti-climatic. I texted my family. Texted a few friends. Posted it on my facebook religiously as we are expected to do so with other major milestones of our lives. And waited for the congratulatory statements to flow in. Great. Now the world knows. I'm officially a certified Emergency Physician.

That last statement took some time for me to absorb. In fact that moment had hit me that morning when I prepared to leave for my flight to Toronto for my exam. Certified Emergency Physician. Seemed a tall order and actually took more a lot longer than expected to get here. I took many detours, many of which my own doing, for I had other ideas in life, other career paths at various points, other desire than medicine alone. But it's always been a floating target. I remember some of the most impressive teachers I've had when I was a medical student were Emergency Physician. As biased as it sounds, ER docs really are some of the most highly trained, knowledgable docs who really are expected to be able to do anything on the fly. Now in reality, they are really not that spectacular, and sometimes relies very heavily on good support from other colleagues and consultants. But from a skill set they are really the most comprehensive. When I was a medical student, I look to the core skill contents of the ER docs to be the set of skills that I must obtain to make a competent doctor. It took so many years to try to acquire those knowledge and skills, and I don't even feel I'm really there yet. But being board certified is a marker of at least getting there on the most basic level. It gives me a certain level of credibility, even though the exam itself really don't mean much of anything. But it's a symbol. There after many years of trying to get there, I think from a credentials point of view it means I have finally gotten here.

So now what? Well it really doesn't change anything. I've already started working in the ED since July. All this means is that I don't have to face the embarrassing possibility of having to tell my department that I had failed the exam and they have to reschedule all my shifts. As for what it means for my future, I haven't decided that either. I'm still trying to find a comfortable balance in where I'd like to work, what type of practice I want to be in, whether I want to keep some clinics going, and what else in my life I want to be thriving for going forward.

But one thing is more clear. I want to get back to my own life a little bit. After years of pondering my medical career, and a year of intense studying and residency work, I feel like I've really left myself behind. Sometimes when I come back to my empty apartment after a series of shifts, I'm not really sure what I want to do with my time anymore. All my hobbies had been set aside. My natural curiosity in anything other than medicine has been smothered. It's so easy to go from day to day just carrying out my work and errands in a robotic manner. My soul hasn't grew much the last few years. I haven't evolved much as a person. I've been lacking a lot in time for self-reflection.

Which is why I'm back here, on my blog. My last entry was almost 5 years ago, about the time when I first finished my Family Medicine residency. I'm not even sure if I'd be publishing my blog online at this moment. But I wanted to write. Writing makes me self reflects. Writing triggers my emotional self and allows me to dig back into my values a little bit. Writing makes me feel more in touch with myself again. It brings my world back to me, through my own eyes, my own mind. Keeps me in control a little better in a life (and now a career) with very fast moving parts.

Hope I can keep this up. Hope this keeps me up.

Newleaf. Now officially Newleaf, CCFP (EM).