For many years I trained at a trauma center and as a surgeon I saw daily how fragile our lives are. Every day families worlds were upended by accidents and life events. At a certain point I left trauma and started doing scheduled orthopedic procedures, surgeries that people planned for and life was very different from the world of trauma. I thought possibly a way to control what goes on in my world. In the 90's I started doing Independent Medical Exams and again I am witness to patients whose lives are greatly impacted by accidents and life events. Today, as I listen to the KCRA news with reports of several tragic accidents in the Sacramento area I am reminded by how fragile our lives are. No point to this today other than I am contemplating the impermanence of life.