The month is November, and it's time once again to reflect upon this idea of Thanksgiving. The holiday comes and goes so quickly that we usually don't give much thought to its significance. I guess it means different things to different people, and some of us seem to miss it altogether. That's been true for me at some points in the past.

But not this year. I've thought a little about this, especially after a conversation I had with a medical colleague. I had called him about a patient I was referring to him, and I asked about one of his partners who had just retired.

"He's doing fine," he had told me. "Traveling with his wife and enjoying not carrying a beeper. No more hospital staff meetings, no more fighting with insurance companies. Hmm. Sounds pretty good, doesn't it?"

"It doesn't sound too bad," I answered. "And what about you? When do you think you'll retire." He is in his late fifties, and I imagined he had given this some thought.

He had chuckled, and after a short pause, had said, "Not any time soon. Two kids still in college. But you know Robert, I'm thankful. I've got a good job, people that I enjoy working with, patients that seem to appreciate me, and most days, I'm still having fun."

He was silent, then cleared his throat and said, "Anyway, I'll be looking for that patient, and send you a report. Thanks."

We hung up, and I was left thinking about what he had said. And then I thought about my own professional circumstances, and where the past thirty years had taken me. And I realized I had a lot for which to be thankful.

First, I am thankful for the Providential hand that opened the doors for my career in medicine. As I look back upon the twists and turns in this journey, I am convinced this could not have been my hand nor my efforts that have brought me to this current point in time.

And I am thankful for the wisdom and guidance of my father. He was not a physician, and he never prodded any of his children in a particular vocational direction. His admonition to each of us had been to find something honest to do with our lives, make sure that we had fun doing it, and then to do it well. I hope he knows I listened to him.

Having found the niche in the medical profession that best suited me, becoming an ER doc, I am profoundly thankful for those nurses, techs, doctors and secretaries who have taught and shepherded me through many hours and many ERs. I learned early on that I didn't know everything, and that I needed to look for and accept help from any quarter. From unexpected people and in unexpected ways, I have had my bacon pulled out of the fire many a time. More often than I care to remember or dare to confess. I know I have had the good fortune of working side by side with some of the best people in this field, and I hope a little of that has rubbed off on me.

And most importantly, I am thankful for the people who have trusted their health and sometimes their lives to my keeping. Sometimes these have been friends, or casual acquaintances. Usually, they have been complete strangers. Whatever the relationship, at that moment in time they have trusted me with something precious, and that is an awesome and sobering thought. I have tried to never minimize that reality. Each time I see a patient in an exam room, or in our trauma room, I know they have made a conscious and considered decision to be there. That is humbling.

So, thanks to the comments of my friend, I was able to think about these things and then put them to paper. I have been very fortunate, and it has been nothing that I deserve.

Happy Thanksgiving, and happy thanks giving.