I didn't realize it, of course, because it doesn't look different from the inside. I only realized it when I saw how others approached me, or deferred to me. I only realized it when I saw my younger self in the people talking to me, and realized who that must make me.
That person. The experienced one, the leader-without-being-a-leader.
Maybe it came from the mountain, long nights in deep woods with sick patients and not another paramedic in sight. Maybe it came from precepting, from having to stretch and grow and teach, and learn how to teach. Maybe it came from doing enough rock med events. Maybe just from running enough f'd up calls.
Whatever caused it, I know the effect: The relaxed, almost lazy confidence that I always looked up to. It's not arrogance, or a conscious "I've got this!" thought process. It is knowing that this is something you can handle.
Because I've seen this movie before. I've seen the alternate endings. I have a very clear idea of the ways in which it can play out. And I know what to do, usually from painful experience.
* * *
The flowsheets of assessment and treatmeny are mental paths, like a hedgerow maze in a garden. The paths loop in impossible ways, over and back on themselves, crossing and re-crossing. They lead to intersections, and cul-de-sacs, and four-way stops.
Maybe we can imagine little stone tables at these intersections; on them sit a variety of things that it has come time to use. A heart monitor. A CPAP mask. A small purple cardboard box. A bag of IV fluid and a grey-striped needle.
Maybe we walk these paths together, you and I, in the early evening, with the birds chirping and a warm breeze coming down off the distant hills and the gravel crunching softly under our feet. And we chat as we walk, and debate which turn to take.
Maybe it scares you, becase you don't know what lurks down these paths, what beast waits silently and patiently, sharpening horns on stone, softly chuffing hot breath, ears a-twitch.
And maybe it doesn't scare me, not because I'm not fearful, not because I'm so supremely confident, but simply because I've walked around this labyrinth enough to know most of the twists and turns.
And because I know that, at the end of the day, there is no cloven-hoofed minotaur waiting for us. Only a few more intersections with their stone tables, everyday and plain.
On one sits a blue vial and a red vial, and a couple of syringes.
On another sits a scalpel and a peculiar little tool, a double-ended hook, with a wide, flat U-shape at one end, and a narrow V at the other, tapering to a sharp point.
At the last intersection there is no table at all; instead a statue of a man kneeling over another. His elbows are locked, his hands clasped one over the other, pressed on the second man's chest.
On his forehead, a tribute to some long-dead sculptor's supreme skill, sits a single drop of stone sweat.