Ding, ding my phone chimed.  In what's become a reflex, my wife chimes "Helen!"  I only have a few people I text and by orders of magnitude, my cousin accounts for the bulk of my text messaging.  I pick up my phone and read the text message.  "How are you doing?"  I can almost hear the emphasis in her voice that she would place on the word 'you' if she were in person.  She's my cousin whom a little more than a year ago, I wouldn't have recognized walking down the street.  But her and her sister came down about a year ago when the end was rapidly approaching for my brother.  I lost a brother but gained two sisters.  I hate to think in those terms but I can't really help it.
     I didn't really know how to answer her question because the simple fact was that I do not know how I was doing.  It's a time of great transitions for me right now which also means it's a time of reflection and looking backwards seeing from whence I've come.  I have my first licensing exam in about 6 weeks.  The tenure of my classroom learning officially ends.  Now I enter the clinical world for hands on experience 24/7.  Actually, call is 28-hours long so it's really more 28/7, if you can figure the math on that one.  My son is learning how to drive.  My dad is transitioning into his role as retired cancer battler.  (Notice I don't use the word 'survivor' yet.  We don't know if it will stay in remission.)  And the 1 year anniversary of my brother's death is nearly here.  I have no clue how to feel.  Am I supposed to feel proud?  Have I turned a corner?  Relieved?  Have I turned enough corners?  Stressed?  Sad?  Angry?  None or all of the above?
     I didn't begin to unravel the answer to my cousin's question until I took a day off and puttered in my garden.  Shortly after my brother passed, I planted a tree in memory of him in my back yard.  In the confusion and hastiness of my grief, I planted the tree in entirely the wrong place.  I considered leaving it where it was.  It would serve as a tribute that life sometimes sucks.  It often doesn't work out the way we plan.  Besides, the thermometer is already approaching the mid 90s here and so it ain't exactly the best time to be transplanting trees.  But that really wasn't the memory that I wanted for the tree.  So on my day off, I moved it, dripping both sweat and tears. 
     I listened to music as I trudged through my task and I found that I finally got a song that has perplexed me for years (and of course, it's one of my wife's favorite songs proving that I'll never understand her).  It's an allusion to Icarus and his legendary flight of getting too close to the sun and perishing in the process.

If we burn our wings
Flying too close to the sun
If the moment of glory
Is over before it's begun
If the dream is won
Though everything is lost
We will pay the price
But we will not count the cost

When the dust has cleared
And victory denied
A summit too lofty
River a little too wide
If we keep our pride
Though paradise is lost
We will pay the price
But we will not count the cost

And if the music stops
There's only the sound of the rain
All the hope and glory
All the sacrifice in vain
And If love remains
Though everything is lost
We will pay the price
But we will not count the cost
bravado by n. peart

     I never understood the last four lines of each stanza.  How it contrasts gaining a dream while losing everything, keeping our pride while losing paradise, holding onto love but losing everything.  And then final two lines about paying the price but failing to count the cost perplexed me to no end.  Well, I get it now.  I can now answer my cousin's question with satisfaction, albeit grimly.  I am dimly yet acutely becoming cognizant of the magnitude of the cost of the past year of my life.  The price is far from trivial.  I wanted to become a doctor, to realize a dream, but not like this.  Learning pain managment from your dying brother?  Learning the extent of what it means to be a difficult patient from your dad?  And given that cancer is the second leading cause of death and spans every organ system, you'd be surprised at how often it comes up in lectures whether it's pathology, pharmacology, radiology or even ethics.
     THIS is why they tell us never to treat our family or friends.  Hell, it might even be illegal here in Texas.  We can't remain objective, conflict of interests, blah, blah, blah.  What in the hell would you do if your dying brother begged of you, "make the pain stop"?  You pay the price and try not to think about the cost.