I am perched alongside resting volcanoes, gazing down pine-covered, arid hillsides into a valley where there are meadows and houses, roads and cars. I know this vista like an old friend. Like me she shows signs of wear, fine creases where before the topography was smooth and unbroken like innocent skin. I do not notice. Mountain breath on my face, I recognize the puffs of cumulus now appearing as a premonition of thunderstorms gathering, but these are typical here. They will pass.

How many times have I sought perspective by scrambling to this vantage point, lungs straining in the thin air, my unease pushed into my legs as they pump, step after step, over rocks and pumice and roots? How many stories have I brought here, worried over in my mind like stones in the stream until they should smooth out?

Today feels different.

I am no longer an angst-filled adolescent, pitting my independence against the desire for love. Long ago I decided on my career, severed ties with toxic relationships, chose to move away, reconciled my yearning to move back. I am happily married and have typical maternal anxieties about my children, but today’s pilgrimage isn’t about me.

Gaze flowing over the rock faces as they change color, dark plum to gray to cream and speckled with green, I remember how I yearned to see the world in black and white. I so admired the friends who did not hesitate in anything, decisions at the ready, confidence to spare. Their self-assurance beckoned me like fire, singed me in the end. A warning.

A lifetime of introspection brings me back to this same vantage. To think I used to look for conflict so I could form an opinion about it, testing my morals and knowledge of world affairs and measuring my self-worth, a bit, on how articulately I could defend my position. That wasn’t me, I realize now. That was who I thought I should be. An aspiration, like a constellation, with points of brilliance but a picture you had to squint to imagine was actually there.

And now? I built my life on the handholds and footholds I knew would hold, steps of surety in a trail that could be slippery. I had no heart for politics. I cared deeply – sometimes too deeply – and found my way to a career in which this was more a boon than a liability. I loved to solve problems. I loathed capitalism. I am a doctor for many reasons but perhaps chief among them, because all the signposts pointed the same way.

Near where I sit there is an earthquake fault. You can stand on the edge and look down into the crevasse, imagining the magma that bubbles many layers underneath your feet, threatening to rend this half of the world from the other, a stone’s throw away. The valley shows no such sign of distress from this vantage, but anyone who has grown up around dormant volcanoes knows the tumble and shudder of this unpredictable venting, a pointed reminder: nothing is certain.

I did not guess at the depth of the fissures that threaten civilized society. Like the houses below me, in a fertile valley with a rim of solid-appearing mountains around them, I thought I had found my forever home.

With science as bedrock and a constant trickle of knowledge,
medicine seemed protected from the whimsy of political fire.

Most volcanoes erupt in a cycle of hundreds or thousands of years – and not in our lifetimes. The number of buildings below me testify that no one expects this one to blow. But it is hard to ignore the rumblings of magical thinking over science, of fear over evidence, of narcissism over communal welfare, bluster over nuanced thought. Tectonic plates are shifting. What I see now, taking in the granite thrusts and rolling mountainsides, is not just forest and trees, but the paths lava has taken – may take again – as it makes its way down from the mountaintop.

Claire Unis MD MFA is a pediatrician and author of a memoir about drawing on diverse experiences in the process of becoming a doctor, titled Balance, Pedal, Breathe: A Journey through Medical School. She facilitates writing workshops, narrative medicine sessions, and discussions of literature for her medical group in northern California. Her writing has appeared in Intima, East Iowa Review, Awakenings Review, and The Examined Life. Find her at www. claireunis.net, or on social media, @literaryartinmedicine.