I’m wide awake, in the middle of the night. So many thoughts have been rushing through my mind.

I find myself thinking about adaptation, about how we come to terms with what was once unthinkable, unimaginable, an impossible reality.

At one time, I never could have possibly conceived that I would be seeking a second opinion regarding a tracheal re-section. Let that daunting option fully sink in.

A radical, aggressive, open airway surgery, fully chosen as a viable alternative to having my airway repeatedly dilated over and over and over again. An extremely risky procedure, with a more prolonged recovery than my frequent dilatations to date.

A procedure with absolutely no guarantee that my subglottic stenosis will not restenosis. Is there no end?

This prolonged nightmare started in early 2002. I had what appeared, at the time, to be a severe asthmatic attack.

A referral to a pulmonologist ensued. Cue the complex psychoeducation regarding the effective management of adult-onset asthma. Add yet another treatment protocol to my already full treatment regimen of managing relapsing-remitting MS, Hashimoto’s thyroiditis, and recurrent major depression.

I can handle this, I tell myself. What doesn’t kill you makes you stronger. Mind you, I could already bench-press a Buick at this point, having already endured unbelievable physical and emotional anguish.

To date, I had already endured multiple episodes of severe depression, periods where I no longer wanted to ever wake up again. I had also endured the horror of temporary blindness, complete paralysis, and total incontinence during terrifying MS exacerbations. I had experienced multiple periods of both hyperthyroidism and hypothyroidism with my autoimmune thyroid disorder.

Periodically, I would visit my pulmonologist for the management of my newly-diagnosed, and completely unexpected, asthma. These appointments are interwoven with those routinely scheduled with neurologists, endocrinologists, and psychiatrists.

I’ve completed my doctoral training in Clinical Health Psychology at this point, as well as my pre- doctoral internship in clinical psychology. I’m halfway through my completion of a grueling postdoctoral fellowship in psychological pain management.

The next step of this arduous training will be obtaining my psychology licensure. A most recurrent theme is ardently persisting throughout my life: I am concurrently both doctor and patient.

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