Tethered

March 2nd, 2021 was my first day of freedom.

My first day to run wild.

I awoke naturally when my studio became flooded with rays of the rising sun as opposed to the siren of an alarm while the moon was still casting its shadow. I was in a sea of cardboard. I felt uncomfortable outside of the obligation to report to duty. The obligation that each of us bellyaches about now felt to be a creature comfort that I felt hugely vulnerable without. The day prior, I had relinquished my hospital ID badge and emptied the locker that had been showcasing a magnet that read, “I’D RATHER BE HIKING THE APPALACHIAN TRAIL”.

I had gotten my wish.

I was untethered.

And I was petrified.

My next 365 day trip around the sun would prove to be my most impactful to date, leaving me in hysterics precisely on March 2nd, 2022- the evening before my return to the operating room. To a Gardner crani. To locker #327. With my newly pictured ID badge in hand.

Would I remember how to keep my patients safe? Still have what it takes to instinctively manage a difficult airway? A Level 1 trauma? A liver transplant? What about a complex spine? Had I maintained the trust that I had earned from my colleagues over the past 15 years of my anesthesia practice? Was my return to the payroll proof that my adventure had come to an end?

The tamed felt unbearable.

I was tethered.

And I was petrified.

I feared my return to the very stability that I was afraid to leave for the unpredictability of the mountains merely a year before.

My safe space now felt threatening.

There is only one explanation.

It is change that we fear.

They sang in synchrony. My pager’s “Beeeep…beeeep...beeeep…beeeep…” and the text tone of Wilderness Bob’s message, that is. The epitome of dichotomies. I was back to the grind but now forever stamped with trail.

I moved through the once familiar corridors of UPMC Presbyterian as if I was night hiking amidst dense fog, eyes wide and steps calculated. “Where am I?”, I thought to myself. I felt separated from this environment by 10 years. At least. So much has happened… The frozen socks. The boulder climbs. The ramen for breakfast. The rattlesnakes. The rides from strangers. And I had touched the sign. The sign. I am so changed. There were flashbacks. I could close my eyes and be right back atop Mt. Lafayette, collecting water with my titanium coffee mug from a dirty puddle that yesterday’s rain had provided.

I wanted to go back.

I was happier when I had to work for my water.

I have never been so genuinely embraced as I was upon my return to the hospital. I’m talking real hugs, after hugs…after hugs. The kind that whispered, “I am so proud of you. I am relieved that you are safe. I admire you. I love you.” without exchanging a single word. Okonkwo damn near tackled me, “YOU’RE ALIVE!!”. I rested my head on McGrath’s shoulder, he understood that I had just been through war. Erin Sullivan reminded me of our conversation last March, of my tears and my trepidation, “Look at you now.”, she said. Steph Reim shared stories with me, “I trust you because you’ve shared your story with the world. The good and the ugly.”

There is no greater compliment.

With my ego in the trash, I made the space for my clinical confidence to sprout. When hiking through the morning’s fog, I knew that I was the first one on trail that day if I had a mouth full of spiderwebs. For if a crew had been ahead of me, it would’ve been their faces that were painted with the sticky silk.

Awareness. Astuteness.

The nucleus of a safe and fruitful anesthesia practice.

My first paid position was as a clerk at The Dollar General. I was 15 years old. And I was let go after an altercation with Arlene. Arlene was 50 years my senior and challenged by ability to competently calculate the tax accrued in a setting where all items cost the exact same amount. $1 dollar. Arlene met Deborah.

I’ve totally got this.

When you see the show-stopping, must-have, you-absolutely-don’t-have-anything-like-it metal bangle bracelet at Target, you have a Dopamine surge. You lose reason. And you place the bracelet into your cart. If we pause, let this visceral urge pass, and remind ourselves that we already have everything that we need, we avoid clutter. We keep it simple. Simple spaces yield clear minds.

And we also save a boat load of cash.

This philosophy, this “pause” is allowing me to work only 20 hours per week while maintaining a comfortable lifestyle. The Joneses are at war with themselves, not their neighbor. I have waved that white flag.

However, the halo of Dopamine that crowns a Mineo’s pie or a Dancing Gnome Lustra…forgettaboutit. I’m toast.

Perhaps more vulnerable than my 2,193.1 mile walk, is my admittance to cyberspace that I am the most out of shape currently than I have been in my entire adult life. 18 pounds in surplus of my pre-Georgia weight, to be exact. I’ve just done the physically unthinkable- how can this be? There is shame in feeling that I have fallen short of a physique that was expected of my return. That embodies a “thru hiker”.

I have nested. Rested. Healed. Congealed.

Shunned regular exercise.

And eaten my weight in french onion dip.

Is post-trail weight gain an inevitability? Zach Davis details this very topic in his publication, Appalachian Trials: The Psychological and Emotional Guide to Successfully Thru-Hiking the Appalachian Trail, “I reached out to former thru-hikers after finishing the trail, and the feedback I got was rather interesting. Not only do a lot of hikers put on the weight they had lost over the previous five to seven months, many end up doing so twice as fast as they had lost it. A good portion even tack on more weight than they had originally lost. And this weight gain occurred even when people resumed normal, non-AT, eating habits.”

I’m not alone.

My discipline will equal my freedom. Freedom from feeling uncomfortable in my own skin.

You can’t change yesterday. Start where you are.

A month from now, you will be happy that you did.

John Branche.

“Thank you for allowing all of us to follow along with your journey not only on the trail but throughout the rest of your life as well…I am honestly in awe of your bravery and courage…The sentiment that you put across to make sure that you are living your life today because tomorrow is never promised is the way that I would like to live my life…I would love to buy you lunch or even a cup of coffee, not in a creepy way, definitely more of a holy shit I am actually meeting Sarah Robison in person way.”, John shared with me in an email that he wrote on January 31st.

John, a New Jersey native and life long Pittsburgh Penguins fan, came across my feature in the Pittsburgh Post-Gazette online and took the time to share his sentiments to, a then, complete stranger. Flattery in its finest form.

Over toast and coffee, I answered John’s questions, humbled by his captivation and invigorated by talk of the trail. It was when he asked me how I was feeling last winter during the weeks leading up to my departure for Georgia, that the lump in my throat crept up. Each time that I attempted to speak, tears fell in the place of my words. It was February 27th, and as I silently reminisced of my position the year prior as I began to answer his question, I was brought back to the sacred time of the days leading up to my resignation. To my entry into an abyss.

To being untethered.

Despite being saturated with fear and uncertainty, it was the most beautiful time in my life.

I had never felt more alive.

My raw show of emotion allowed John to trust me when I pleaded, “I was no less scared than you. It was no easier for me. I just did it anyway.”

I was tethered.

Tethered to the journey.