Tag: medical school

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The Odyssey

Do you ever think sometimes that the internal state of your mind reflects exactly the kinetics manifested in the immediate environment? I am sitting here trying to articulate the torrent of thoughts and emotions that have piqued over the last few days, but as the narrative becomes refined and my fingers strike the keyboard I’m at once pulled internally by another powerful distracting idea. Another wave of excitement, or sadness, or terror, or you name-it washes through my consciousness and I’m once again at a loss for words to describe it, or the preceding thought. This mania is a peculiar personification and imitation of my external environment over this last week. Preparing to move (and move everything in a 4-door sedan). Graduation. Wedding celebration. A dive-bar band performance. The (good!) surprise of the decade. Brunch and more brunch. Graduation celebration with family. Reconnecting to a friend group whose bonds were forged in the crucible that is first-year medical school anatomy. And this morning’s near sleep-less jaunt to borrow much-needed energy from, as I’ve said in the past, the greatest group of people there ever fucking was. Was graduation already (and only) 5 days ago?

Physically distancing just means an equal and opposite friendship tightening amongst us, the greatest weekly gathering of people on the face of the Earth. The only unifying commonality is the only one necessary for human existence: The radical inclusion of any and all who participate.

I feel like I’ve never been happier in my life and at the same time have had a lump in my throat for a week. My mind has gifted me intermittent and overwhelming sensations of gratitude, of which have externalized as these sort-of “mini-crys” over the last few days that come and go as quickly as the frenetic thoughts and emotions I’ve been victim to. No doubt a reflection of my innate egoism and strong desire for attention being fed an inordinate amount of love, but also perhaps stemming from a modicum of love I’ve (hopefully) transmitted, of which I’m grateful to have relayed back to me by the beautiful people who tolerate my precense in their lives. I’m reminded of the words a fellow classmate (now doctor and colleague!) expressed to me at graduation regarding this blog. “You’re an inspiration,” is a phrase that, for the paradoxically self-effacing narcissist like myself, finds simultaneously endearing and wildly undeserved. But overall, I find it is a patent reminder of the ethos I strive to live by: The desire to produce and reproduce, as much and as often as possible, unconditional generosity. To be radically and unapologetically vulnerable so as to be not just honest to myself, but further normalize emotions as healthy expressions of our human selves. And to know, viscerally, that the incalculable sum of my impact on others is not reciprocated proportionally – the molecularly small impact I effuse pales in comparison to the cumulative benefit of having the company of people who reek of inspiration.

My life this week has been flooded by proclamations of personal success amongst my unbelievably smart and talented colleagues. It demonstrates the utilitarian aspect of pomp and circumstance. As much as I admonish the self-aggrandizing, masturbatory exercise of glorifying “achievements,” the silver-linings exist. Even though the torrent of emotions elicited by smashing together 200 students who’ve not seen each other in person in over a year can be manic in nature, it provided me an opportunity (a self-avowed lover of theatrics) to grandiosely bathe in sentimentality. But more importantly, it provided another reminder of what “success” means to me.

I was (once again) floored/shook/surprised/honored by the kindness and spirit of my surrounding friends today. It’s funny – I was too shocked to see much of substance after receiving the positivity award this morning (it’s not a cult I promise). But when I have something prepared next week for my final NP MSP workout, I’ll be equally speechless as I helplessly blubber through a farewell on my penultimate day in Minnesota. As long as I don’t lose the damn thing this time!!

 

For me, I cannot help but I understand my own “success” as the simple and inevitable product of the folks I’m surrounded by. Mentors who’ve inspired me since I was in college. Classmates whom I’ve learned from (and commiserated with to no end – an equally important exercise) and most importantly engendered lifelong friendships with. Residents who’ve set a seemingly unachievable example of success in every aspect of hospital medicine, and future coworkers who so warmly entertained me in my new home (Tacoma here we come!!). Old friends who’ve endured my bitching about medical school content, and who’ve guided me to reality when the vacuum of academia became all-consuming. And my family. Regardless of the divides that may exist amongst us and between us, they are unequivocally a repository of love older than any other I know. So, I’m really only the company I keep. “Success” is a shared experience that, similarly to the externalities that define and refine each of our individual personas, represents only an infinitesimally small product of our own volition (at least in my case). Recognizing the contribution of others, authentically, not with performative virtue signaling, is a process I’m working in an attempt to engender humility otherwise innately absent from my character or that I’ve (unintentionally) dispossessed myself of. Suffice to say (as I’ve written ad nauseum here now, and already in the past) my comrades are the foundation of all things “me.” My “success” is simply the recreated amalgamation of theirs.

I probably practiced putting on that damn hood 3 times in the wings before I just said “fuck it.” I was as successful those three times as I was here. The damn cap almost came off throughout this entire ordeal and then like an idiot I walked behind the lectern on my way off the stage (though I’ll note I was not the only one to do so). At least I didn’t fall off the stage…though the terminal egomaniac in me would have been pleased to know that the attendees would have had a memory touchpoint from the ceremony involving me for the rest of their lives.

Our arduous journey of medical school is closed. This destructive, instructive, (re)constructive process of physicianship, an odyssey like no other, finds brief pause now. A foreshadowed exhale that once again will start the process of sculpting ineptitude into mastery, just as we’ve done in each stage of our journey thus far. And just as before, the stakes are increased. The prerequisite commitment demands, as always, a level of work that I’ve necessarily been unable to comprehend until such time as the responsibility to comprehend it is at once required of me. Another expansion of my medical expertise coupled with a paradoxically deepening and widening of the well that is the unknown. And, once again, ensuring I don’t flounder in the process. There exists (for me at least) a dialectic and evolving resolution/dissolution of increasing knowledge and practical expertise appositional to my internal feeling of incompetence. Each subsequent stage in training seems to embody both, with increasing magnitude, a sense of mastery and confidence while unveiling the broad and deep reservoir of yet-to-be-learned knowledge. College was my first foray into actually giving a shit about school, just in time to meet the demands of mastering (iffy on the mastery) gen-chem, o-chem, physics, etc. Acceptance to medical school provided me some confidence that I was capable of learning medicine, while ensuring my terror that I indeed was about to learn medicine. Two years of preclinical work assured me (or at least my school) that I had the medical knowledge to start scratching the surface of learning about medical practice during 3rd and 4th year – another terrifying proposition. And now, having just accrued enough confidence to say I know a thing or two about medical practice, here I am anxiously awaiting the ultimate phase of training where I learn to perform. Put into practice that which I’ve been merely a redundant, partially active observer to until now, and ultimately make decisions regarding peoples’ lives where the buck stops with me.

I have a bracelet I wear on my right wrist with the word “GRACE” on it. It’s an omnipresent reminder of the fundamental, quantum shift in my understanding of the necessity for unconditional love that occurred just half a year ago. There is a lot of lost time and memories between me and the folks pictured here, my parents, two of my siblings, their children. Time that can’t be recuperated but is never too late to stop losing. Perhaps with age, perhaps morbidity and facing mortality, but most likely expanding one’s consciousness through paradigm-shifting conversation, leads to abrupt changes in our awareness. But these changes can be transient without practice. Sometimes my practice involves just remembering what’s written on my wrist.

 

I know for certain only two things regarding this next chapter in the odyssey: I am, as in every preceding transition, feeling woefully underprepared and confident of success. But here I am, nonetheless. But most importantly: There is exactly nowhere else I’d rather be.

To all of you readers, friends, old and new, near and far, in Minnesota and everywhere – you are exactly perfect. I’ll see you all for the next chapter 😉

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Making Serendipity Happen

It’s a strange, contradicting, emotionally volatile confluence of events and circumstances that make today particularly…draining. Infinitely exacerbated, firstly, by a total lack of sleep. In hindsight I should have been prepared for that. I was scheduled for, and participated in, night shifts in the ICU all week. I trusted (naively, and with willful ignorance hoping to satisfy my re-invigorated predilection of doing absolutely nothing as often as possible) the anecdotal advice of a fellow 4th year who assured me that nights involved sleeping, ignoring pages, and leaving no later than 3am after having spent the first 8 hours of the shift mostly sleeping anyway. But you can be assured my supposed respite granted me exactly no sleep and no disregarding of endless pages, codes, falls, intubations, and deaths. It’s an ominous sign when in the first hour of the week the attending refers to you as an “intern” and refuses to accept that “quiet” is a forbidden adjective to describe the pace of the shift… I digress. Suffice to say that 10 hours of sleep between Monday and Thursday guaranteed a tumultuous response to both wonderful and saddening news on this day.

Match day is today (I guess yesterday as of me finishing this…). That day of the year when an unnecessarily stressful, anxiety-inducing system releases the results of its cryptic calculus that matches 4th year med students to residencies across the country. The catch is: the system knew well in advance of today what those results are. In fact, it was reveled on Monday if these students matched at all, cliffhanging their geographic location and program to exert more sadist control over its future doctors. VERY fortunately for me – the military match was almost 2 and a half months ago. A simple email (at my top choice!) that let me and my very small cohort revel in the fruits of our 3 and ½ years of exhausting undergraduate medical education. So, I spent last night gifting to my friends all of the positive energy I could muster (and Pizza Luce of course) to assuage what is an undoubtedly a nerve-racking night and following morning. Physically distanced tacit avatars adorned the screen of 200+ 4th year medical students’ computers this morning to join in ceremony as the results were delivered.

An impulse buy after having FOMO seeing all the ICU nurses and docs walking around with scrub caps. I had conflicted thoughts about (is anything ever straight forward?). I love the scrub cap and my curly hair, but they are absolutely mutually exclusive. It’s coming with me to Tacoma regardless.

 

I was not in attendance. I was driving quickly down to Rochester (the state patrolman thought he was “fair” giving me only a ticket for speeding, and nothing for my expired and insurance and license. I thought he was a prick for pulling me over at all). I drove to Mayo to meet my parents and advocate for my dad in the conversation between him and an oncologist. The first of many visits to a man whose abjectly horrendous bedside manner conveyed no empathy uttering “3-6 months” as a prognosis for metastatic cancer. It’s not in my professional, or even personal, interest to disparage a future colleague – but really what the fuck is wrong with you?

It wasn’t exactly a surprise to me. Hepatocellular carcinoma and cholangiocarcinoma are generally bad, and I’d already read the pathologist’s report from the lymph node biopsy that this is what they’d discovered last week. The same cancers thought to be confined to a now explanted liver 4 months ago. The term diagnosis is meaningless, however, without a prognosis. Who cares if you have cancer if it doesn’t do anything to you?

3-6 months – that was a surprise to me. And still is. My cursory search of UpToDate and PubMed hasn’t given me any actual data on how this “doctor” prognosticated a patient’s cancer for whom he hadn’t even suggested a treatment regimen yet. We would have to wait another hour before seeing an actual doctor, my father’s transplant physician who basically strong-armed the hospital to get him a liver, to be assured of (perhaps) a year, perhaps more, with the right chemotherapy.

The moments between the oncologist’s grave callousness, the hepatologist’s much needed encouragement, and the goodbyes said to my parents as the valet returned my dad’s truck were intercalated with moments of vicarious joy reading texts from friends sharing the match results. I oozed with excitement for my friends, but Newtonian reciprocity matched my joy with visceral heartache as my sleep-deprived and emotionally taxed neurons fired aberrantly. Thoughts of my friends starting their new careers all over the country denigrated to images of my father’s future – losing hair, strength, mentation, all over again – found cerebral real estate in my mind as we waited in the clinic lobby. And just as quickly my bleak imagination vacillated to hopeful future. I stifled tears as I thought of the pride I know he’ll feel being with me when I graduate. A moment that just a months ago, before the transplant, I justifiably doubted he’d survive to. A ceremonious event made all the more special now that this new lease on life may have been cut short once again.

“Making serendipity happen.” Our medical school dean shared this phrase moments before my class was revealed the match results. A sentiment guiding us to accept, whatever the results, our residency locations with an open-mind and heart, so as to ensure that we find our purpose in wherever we end up. How prescient, how serendipitous, it was for me to allow the words of a wonderful friend last Fall to teach me, ever so gently, the concept of grace. To hear those words in just the right way, at the right time, to allow grace and forgiveness to find a home in my soul. How serendipitous it was, in those precious few months between my father’s transplant and now today, that these new lessons helped me intentionally forge a bond that for decades has been delayed by my petulance, pettiness, and grievances – however “justified” those grievances were. The inertia of our identities as permanent is responsive only to the incessant bombardment of serendipity that allows us to accept growth and change – for the better.

I don’t know what the future will bring. I don’t know how I will exercise my newfound practice in unconditional love to my father, my family, my nieces and nephews. I don’t know how I will handle loss, when it comes, now that I’ve built (however frail) courage to be vulnerable to losing the receivers of that love. But I do know that the arc of fate is not permanent – the cultivation of our own serendipity is not divinely exacted on us but appears more often the more often we recognize it. It happens all the time, all around us. Sometimes we receive it as the subtle passing words of a friend discussing grace, or we share it unknowingly to an acquaintance. But those fleeting moments of serendipity are also just that: forgettable events destined to impact nothing unless we fan their flame. Unless we give those chance encounters our attention when we perceive them. Unless we give space to, and act on, uniquely profound sentiments or ideas. Or even simply say yes to a new friendship from a colleague’s email. Those moments in life that engender greater awareness, love, grace, and compassion surround us – as long as we keep open the space to let them in.

It’s difficult to write this, and harder to feel it, and harder still to stay awake. So I’ll leave it at that.

Take care my friends – you are all loved deeply!!

 

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The Peace Within the Struggle

The North Face Endurance Challenge: Wisconsin 50M – 7:45:11

Hello. Hi. Buongiorno. Good morning. Good afternoon. CIAO. How are you my friends?! What’s new with you? It’s been a minute (and then some). I hope you’re well. I hope you’re more successful at keeping up with your writing goals than I am. So much has happened between now and my last post. Rather than try to play catch up, I can sprinkle in some updates throughout the next few posts. Which I promise will be more regular and not just entirely dependent on my racing! Having said that – yesterday was a big day. A (Type II) fun day. One of those rare days where I smash a lofty goal and surprise myself at the same. A day where the universe conspires perfect weather, a previous night of ACTUALLY getting some sleep on an overnight shift, and a previous weekend of inspiring runs at the Superior 100 to help me get my dehydrated and undertrained ass from zero to 50 miles in a time I was damn proud of. Now, this is not a distance that’s new to me. But two years ago I was much more prepared, ran on as flat of a route as you can going for 50 miles, and was pushed only by completion. There is nothing that pushes the mind and the body like racing. Two years ago it hurt, but yesterday was suffering. In the good way 😀

I fell asleep about 10pm, got up at 3am, dipped a Cliff bar in an almond/cashew/chia/flax seed spread (thank you Holly Reiland and your Costco membership), guzzled some coffee, zombie drove 40 minutes to the start and found myself in front of the brightest flash camera known to humankind 5 minutes before the start of a 5am race. And my ridiculously stupid ass is still finding a way to smile.

 

But let’s back it up a little more. This last year of running has been met with some heavy training, breathroughs in fitness, but overall, a lot of frustration. I was knocked out of this race last year after coming off a fantastically fun mountain trail marathon in Colorado Springs at Pike’s Peak. I thought I was all set and ready to go for TCM Marathon weekend to bounce back into racing a month later, but those injuries cropped back up in a big way. A month or so of recovery and I was back-in-business with Boston training. And, as if predestined by some malevolent force in the cosmos, a similar ankle injury perked up to knock me out of that race too. Needless to say I was disappointed. Especially considering that I’d made it the last three years of consistent running without more than a sprained ankle. And that from just being careless! So, rinse and repeat, I scaled back the mileage, again chalked it up to overtraining and too many hills, and got ready to start my first medical school rotation in May (gasp!). I had made the adjustments of actually warming up before ALL runs, putting some strength training in the weight room, and drawing the alphabet with my toes for quite literally hours a day in an effort to strengthen these seemingly weakened tendons. And, once again, things got better. And the malicious sin wave of destiny threw my IPOS (injured piece of shit for those less familiar with the running lexicon) back onto the bike and out of the running shoes for a THIRD TIME IN LESS THAN A YEAR, this time with plantars fasciitis. And even then I was finding a way to get hurt! A spill on my bike in late July trying emulate a long run meant that not only did running hurt, but the vice-clamp headache and nausea of a concussion made just living a challenging. Being me is weird.

Time trials on 5 year old, $200 bike are unsafe as it is. But put that bike underneath a foolhardy and treacherously untalented injured-runner-turned-cyclist and you have a recipe for disaster. The moral of the story is to always, always wear your helmet. Someone like me has only precious few brain cells to spare, and they aren’t worth being transected by the road or by the bumper of a moving van (or in my case, both). Though that flimsy helmet will do nothing to save you from a month of horribly painful showers. Such is life.

This time, however, the variables had been narrowed to all but one. The one variable I thought absolutely I was immune to having to deal with. Shoes. As much as I loved Altras, they did not love me back. I tossed them for some Hokas and like magic, the ankle pain, plantars fasc, and everything else disappeared. And I was back to running as far and as fast as board studying would allow. Some late mornings meant I didn’t get to the trails as often as I wanted, and a small overuse pain (legitimately overuse pain, I know the difference now) meant a slightly earlier taper and shorter long runs than I needed to feel confident going into yesterday’s 50 miler. That, and working 6p-8a shifts the entire week preceding on my OBGYN rotation meant absolutely chaotic sleep. I might have slept 20 hours between Monday-Friday before the race. For some of you 4 hours a night might be plenty – for me that is barely more than a week’s worth of naps. 

I seem always to miss at least one thing in preparation…for every single thing that I do. Leaving to the grocery store? Forget my wallet. Going to a friend’s house to exchange some baked goods? Forget the actual baked goods. Heading out for a shift at the hospital on my bike and in my running shorts? Forget to pack UNDERWEAR in my backpack. Fully admitting to you all that I have inadvertently gone commando in scrubs. Yesterday was no exception. Jersey, shorts, shoes, socks, nutrition, all packed and ready to go. Even brought my headlamp…but forgot to check the batteries. For almost two hours I had never been so scared to fall on my face in my life. Just something to stow away mentally for next year. Hopefully remembering that doesn’t displace another key item. Here’s looking at you ‘Murica shorts.

 

But having not raced since March (a 10 mile tune-up before Boston that made me VERY confident of my abilities to do well out there…before the aforementioned injuries), I’d be damned if something like a little grad school was getting in the way of me heading out to Milwaukee. So I ran the 8.5 miles home on Friday morning from the hospital, showered, breakfast, hit the road for the 5 hour trek to Milwaukee, hit the sac, and woke up a few hours later to make it happen. I really didn’t know what to expect. I had run 50 miles before, but that was almost two years ago, and bum flat on the urban roads. I hadn’t run more than 20 miles in over 6 months. I hadn’t been on ANY trail in at least a month. But for everything I felt uncertain about, there were things I KNEW without a doubt. I knew I had friends who had just run 100 miles on the Superior Hiking Trail in the face of completely stupid elevation change and terrain. I knew that I myself was no stranger to suffering, and overcoming said suffering. And I also had a goal. To finish in less than 8 hours. For no other reason than it sounded more difficult than anything I’d ever done, but just in reach enough to try. As it turned out, as it always turns out in a race, someone’s trying to do the same thing you are. I’m lucky I found a few of those folks along the way.

Everything actually started pretty well – despite the fact that I was half blind for a few hours due to bad preparation. Even past 20 miles I felt well energized. Like I could keep up that pace all day. However, it wouldn’t take too long after hitting the turnaround just how weak my climbing legs are. A 70+ mile/week marathon roadrunner making a swan dive into even a moderately hilly ultra meant searing quad pain at every incline. The pre-race and early race smile had mostly been replaced by an exasperated and destitute grimace that was too dumb, hungry, and thirsty for the next aid-station coke to give-up.

 

The first of my newfound friends I found along the first half of the course. A wise ultrarunner a few years my senior, and with much more trail and ultra experience than me, provided wonderful conversation fodder along the sunny horse trails and cool, canopied paths within the state park. Our conversations rambled from admiring the beautiful weather, divulging our own paths into the sport, and our shared cynicism of the overzealous 22 year old who’d left us in the dust early in the race (he did NOT slow down like we predicted, and went onto to take 3rd). We paced each other all the way through the halfway point, where it would be my turn to let my unjustified ego take the reins and pull ahead.

This did not help me.

Running up those steep hills was relatively easy the first time around. But realizing the pain of doing them twice 30 miles into the race is something you just don’t anticipate when you’re as undertrained and foolish as me. I was going just fast enough to maintain an uncomfortable pace when I caught the next man in front of me. With over 20 miles to go I was not about to drop this pacer, lest I end up in a crumpled heap on the side of a trail begging for another handful of pretzels and some ice cold mountain dew.

This experienced ultrarunner and 50 miler beast was my damn guardian angel through the last half of the race. There’s no way I would have been smart enough to walk up the hills, and not a chance I’d have had the motivation to keep going by myself for 4 more hours. Another man trying to break 8 hours and with his help we crushed it. There’s always power in numbers folks.

 

Once again I found myself trading introductions (albeit with a much more subdued attitude and far less words), exchanging some minor life details (and perhaps a few major ones, I honestly don’t remember), and cheering on and congratulating not only the marathoners and 50k folks, but a few of the 50 miler racers we would trade spots over the next 15-20 miles. Even with the inspiration of my friends, the camaraderie on the course, and my quiet, burning desire to achieve my goals, the last 1/3 of this race, right up until the last aid station en route to the finish, was touch-and-go. Although the morning started perfectly, at 55 degrees and not a cloud in sight, things were warming up. And so was I. I was drinking 32 oz water every 3ish miles, as well as some coke at every aid station, and I was still completely dehydrated. In medical school we talk about innumerable ways in which the kidneys can receive damage, but ultrarunning is not on that list. Peeing painfully hot, brown liquid immediately after the race meant that I had to assimilate my medical knowledge into some guesses as to what in the terrifying hell was going on in my body. Accumulation of uncleared lactate from low glucose stores that was now acidifying my body (and therefore my pee)? Renal hypoperfusion due to blood shunting to my trashed quads in an attempt to eliminate waste products? Who knows. Simply put, I needed more fluid than I could have ever imagined. Put that on the list of things to not forget for next year…

After almost two marathons worth of running, seeing the finish line from a mile away still gives you some kind of 2nd (or probably at this point, 11th) wind. I’m normally pretty emotional at finish lines but the extreme dehydration and no less than a pound of salty pretzels ruminating in my intestines made anything other than moving almost impossible. Just the way I wanted to finish.

 

But through all that pain and exhaustion, thinking I might just pass out if I had to hit another uphill, the words of a fellow racer (and now course record holder and ultimate badass) Justin Grunewald came to my mind. If you don’t know the man, him and his wife’s story is heartbreaking and inspiring. I remember reading one ofhis post a few months back that described his wife’s battle with cancer. Buried in that post was a quote I wrote down immediately – ‘It’s okay to suffer, it’s not okay to give up.’ I’m not sure a day goes by when those words don’t resonate with me. From menial tasks like not wanting to take out the trash when its full, or folding clothes, to the physical and mental demands of studying medicine or racing an ultra, the mantra is a manifestation of everything it means to not only run, and race, but to experience life. Life is an endless serious of obstacles that are wrought with uncomfortable, dark, tiring moments that cloud our judgement and strangle our will and motivation. That’s okay. Suffering is the overall foundation to peace and contentedness. Happiness doesn’t exist in spite of suffering, it’s because of it. But only when you persevere. Only when you don’t give up. To be able to send my well wishes to the owner of this quote a few seconds before the gun went off emblazoned those words deeply into my mind for the next 8 hours. They would reemerge, tacitly, in my head, at the foot of each hill as I trudged, bent over, gasping for air, knowing that not giving up was the secret to finding that peace. 

I had a conversation with my best friend just a week ago that best summarizes this winding recapitulation of yesterday’s events. In essence, it was a rejection of the notion that anything we do in this life is truly ‘on our own.’ Or, that anything we do on our own is made vastly more efficient and more rewarding with the spirit of others with us. I’m no more responsible for achieving my goal yesterday than my friends generously hosting me the night before and after (and for the pedialite post-race that was next-level recovery). Nor would I have even imagined myself being able to do this without inspiration from the likes of the world renowned and local ultrarunners that give sustenance to the idea of, ‘Why not me?’ There is no doubt I would have found a way to suffer AND give up had it not been for my compatriots on the course with wisdom and pacing, and I wouldn’t have made it even a fifth of the race without each and every volunteer to help along the way. Yes, it was ‘my’ two feet that finished, but the ability to do so is credited entirely to every friend, colleague, and faraway inspiration who exude such devotion and serve as such powerful examples as to act as a proverbial springboard into a level of self-confidence I cannot achieve on my own. Each footstrike along the trail is given to those whom I’ve learned from, and continue to learn from. Especially when it hurts. Because at the other end of the hurt, at the crest of the hill, at the end of the treeline, is peace. Is the downhill. Is a finish line. So long as you don’t give up.

‘Til next time everyone!