We’re on vacation. This time, it’s an actual vacation, where you go away and spend time in another place. We haven’t done this in a long time. Since before residency. Since before E was born. We’ve been to my parents’ house. I’ve been to conferences for one or two nights. C has gone to artist retreats and film shoots. We have spent a night or two with family members. But a whole week away, with no work purpose, with no arms-length to-do list of overdue life tasks (dentist, taxes, roof leak) — this we haven’t done since 2010.

It’s day one and I woke up at 6:38am. I felt rested but restive. I reached for my cell phone, the phone I had promised to keep off, and searched for the YMCA in the beach town where we are staying. Maybe, I thought, I can get in a swim before everyone gets up. Because this is how my life usually works — everything is stolen from something else. I am a thief of time. I discovered that the YMCA is farther than I thought — 22 minutes away — and I thought to myself: If I go I will not be here when E wakes up. Because that’s how my life usually works — the days are counted in how many times E sees me when she wakes up and when she goes to sleep. Somewhere in my heart there’s an old man with an abacus and every time I miss bedtime or a morning cuddle, he peeks at me over the top of his ancient reading glasses and slides a blue bead over to the left.

So, not going swimming. My next thought was: “The vacation is almost over and I haven’t done anything meaningful with this time.” Which is when I realized how much I need this vacation.

C stirred next to me and it occurred to me how much of the time I have been stealing has been from her, from us. I have been in resolute denial about this — trying to justify in my mind all the ways in which her career ALSO demands of us and ALSO impinges on us (there’s the old guy with the abacus again), but the reality is that my schedule means she spends many nights alone. I settled back into my pillow and tried to inhabit time.

It was the rare day when E slept later than us by a significant amount. We were afraid to move, to step a foot onto the wood floor for fear of its creaking and breaking this new magic spell. We held each other and whispered about this and that. My stomach started growling and at a certain point we couldn’t stay in bed anymore. It’s amazing how much sound a few simple actions can make in a sleeping house. The cabinet creaked as I opened it, the bowls clinked against one another like a car backfiring, the silverware drawer opening sounded like a herd of ponies braying. Slowly everyone in the house — E, her cousins, her aunt and uncle — emerged from their beds and we made ready to head for the beach.

It was only E’s second time at the beach and she was in a state of ecstasy. Every time the surf lapped up over her ankles, she shrieked with delight. At moments, the delight was so great that she seemed unable to contain it. She would throw herself to the ground and roll in the sand until every inch of her skin was covered in sand, like a fresh donut rolled in sugar crystals. At one point, she suddenly broke into a run along the edge of the shoreline out of the pure sensation of being alive, until she was so far from me that I had to call her back.

The waves today were steep and hard and the undercurrent was strong enough to unfoot me several times. There was scarcely any territory on the shoreline where it was safe for a four-year-old to wade — only a foot or two separated the edge of the surf from the violent crash of the waves. Little E was like a sandpiper, running toward the receding surf and then scampering back up the beach as the next wave approached. And I was right there beside her, ready to hoist her up when a wave proved faster or taller than she anticipated. Each wave promised the sweet reward of her giggles and also the possibility of her being tumbled into the brine and carried away, a possibility which felt so close — too close — like a layer of weight added to each of my breaths. The Lord giveth and the Lord taketh away, I kept thinking. The ultimate wave.

Do all parents feel this way? I wondered to myself. Is this normal? I surveyed the other families around me for signs that they too were greeting each incoming wave with a combined sense of delight and the understanding that life is incredibly fragile. Younger children were certainly being supervised but everyone seemed to be having a good time, though what you can tell about a person’s internal life from the outside is nothing.

It’s hard to talk about this aspect of my job, but I have watched the waves carry many beloved children away and I don’t think I have really acknowledged the way this has changed me. In part because in comparison with their families, what right do I have to claim any piece of grief? When a patient dies, it isn’t really a life event for the doctor, even if it is. Even if they inhabit your dreams for months. Even if you think of them as you are watching your child leap into the surf on your first vacation in years.

I am realizing that for me, there is no vacation from that part of my life experience. At the sweetest core of parenting — and what, in this life, is sweeter than your child’s delighted laughter? — it vibrates. I cannot unknow what I know about nature’s indifference. Which is not to say that there’s can’t be a full range of positive experiences and emotions. Which is not to say that anxiety needs to limit me or my child. Which is not to say that I scooped her up out of the waves and ran. Today was one of those best days ever, one of the days that would be slowed down and put to feel-good music in the movie of my life. And it did not feel wrong or contradictory to acknowledge, in a wordless way, all that has been lost, and therefore all that must be held sacred and never taken for granted.

This year since the end of residency has felt tumultuous for me. I think I was expecting for things to “go back to the way they used to be,” whatever that means. I think I thought “it would get easier” as was so oft promised. Many stresses — namely time and money pressures — have been reduced somewhat, but caring for very ill children is just as hard and it should be. If it’s not hard, I don’t think you’re doing it right. (But if you don’t acknowledge how hard it is you can’t do it well for long.) Without being aware of it, I think I have been waiting for my innocence to return — for life to feel light again. But I am beginning to understand that certain things can’t and shouldn’t be peeled away. Certain things can’t be “left at work” because they become part of your emotional and spiritual and ethical being. Though I am sometimes envious of people who can contemplate pregnancy without running through a litany of possible complications or feed their children vegetables without calling to mind mental imagines of actual choking survivors, in reality I would not want my innocence back, in part because I want so much to be of service on a deep level to the families I care for and also because the suffering and loss I have witnessed inform the way I love, the way I care for my patients, the way I participate in community, and my desire to contribute to the repair of this broken world.

Tomorrow we’ll be back on the beach as early as we can get all seven of us up and fed. The waves will crash in and recede and I’m looking forward to dancing in them with E, in spite of but also because of all that might be lost.

Here is a picture of E, meeting the unending sea.