I sit watching from the bar, a middle-aged physician at her son's school for the weekend. Lulled by wine, away from work, I am seized by an unshakable urge to step up there after him. For a moment, a shutter in me goes up and I visualize myself singing with huge enjoyment and abandon. But this vision is soon replaced by one of me in my white coat, a stethoscope around my neck, bending over a patient in my office. I am that earnest, hard-working, sensible physician once again.

As the days go by, a wistfulness persists about my karaoke inhibitions. I am struck by seemingly unassailable evidence of the restrictions I have placed on myself and the toll of my years of medicine. Despite my joys in the profession and the sense of competency and usefulness it affords me, I recognize a loss. Worse yet, it is just the tip of the iceberg. Attempting to rationalize, I tell myself that I do have fun. I take vacations, go out for dinner, engage in hobbies. The truth is, however, that for the past two decades I have studied and labored so diligently to model myself after the sober, hard-working, self-sacrificing physicians of my youth and training that the once vivacious, fun-loving young woman is all but unrecognizable. I am competent and well-paid, and my work is socially applauded. But there is too often a feeling of sturdy black shoes, too rare a feeling of silken slippers.

The stereotype of the ideal physician is well known to me, with countless models throughout my training and various jobs. It involves not only expertise and humanism but endless time and devotion to one's work. "He is a giant among giants," was a phrase heard often in my residency program in the Bronx. "I'll do this job or else die trying," a chairman of mine was heard to say. With early-morning meetings and weekend retreats added to already long workdays, the acolytes of medicine are always in the temple.

What is this mantle with which I have covered myself? I have begun to feel like Sisyphus, shouldering the burdens of others up the mountain, only to find myself the next morning at the bottom of the hill again, ready to start anew. In my clinic, the typical middle-aged woman, worried about her health, skin, or cholesterol, prompts a textbook explanation of sunscreen protection or diet and exercise. But I feel as sterile as my explanations. I am too tired at night to appreciate my growing child, her pubescent rite of passage now begun. My bed is surrounded by medical journals, textbooks, and admonitions: I should read, I should study, I should call that patient back. The priestly metaphor begins to gnaw at me. Already, the two children hugging my knees are ready proof of my failure to take the ultimate vow of celibacy. My life and soul seem split in pieces; not even the professional part of me gets the food it needs. I want to step back from the altar, leave the church.

During the next year, events such as a serendipitous, moonlit ski on a frozen lake and a stumble onto Pablo Neruda's poetry begin my reawakening. Walks in the twilight around my house and a hike in the Tetons remind me of the beauty that I miss each day, locked in my windowless clinic. The earthy and deeply human quality of Neruda's poems about everyday life and love revitalizes my sensibilities. Listening to Igor Stravinsky's Rite of Spring one afternoon, I am reminded of my twenties, when books and art and music were what I lived for. The music is powerful, sensual, alive with life and death. I feel a tightness in my chest and an excitement listening to it.

To my delight, this interior nourishment slowly reaches my medicine.

My patient is a youthful 84-year-old man. Cherubic of face, gray-bearded and wrinkled, he is still more full of life than others one third his age. "Tell me, Doc," he asks seriously, "have you found anything on the tests that will shorten my life?" I am able to smile and reassure him that for now he can continue his photography travels to Giverny and the Africa that he so loves. I remind him that he has already had more life and good health than most and that we will face the inevitable together when the time comes.

My second patient is a shamefaced young woman covered with countless thin razorblade cuts over breasts, belly, arms, and thighs that are visible testimony to her self-loathing. With her, I sense the vast difference between my personal self-criticism and her destructive behavior as well as our fellowship in this imperfect world. I am able to bear with her in her pain.

Most wonderful of all, I find myself more in touch with the wild dances of my 10-year-old daughter, who is just this side of womanhood. We do less relational loafing in front of the television and spend more time talking and cooking together. And I remember Neruda: "in the impure poetry of old clothes, a body with food stains and its shame, with wrinkles, observations, dreams, wakefulness, prophesies, declarations of love and hate, stupidities, shocks, idylls, political beliefs, negations, doubts, affirmations, and taxes" [1].

I would give up this priesthood for the chance to stand before the microphone and sing "My Satin Doll"-if not like Ella Fitzgerald, then at least with the part of me that is fully engaged, arms out-stretched as if to embrace the world, luminous with the joy of life that is a respite from my workload and the demands of my profession.

The cowboy has finished, and the microphone is waiting.