The scars on my side are ten years old. I pass the anniversary in San Francisco, and bike to Four Barrel at 7 am for a coffee to celebrate. Sitting outside in the chilly morning air, with my e-bike on hold next to me, I look around at how much has changed, and how much hasn’t. Just under ten years ago I spent 45 minutes walking the two blocks to this coffee shop, pausing on a fire hydrant to cry, uncertain of whether to continue or return home. I was in pain, and alone, out of reach of medicine or friends.

Ten years later the scars on my side are an afterthought. The double slashes of two chest tubes, done a week apart, are easy to miss. They aren’t the scars I notice in the mirror, dwarfed in visibility by the eight holes on the same shoulder, the remnants of twenty twenty’s reconstruction. And the shoulder scars aren’t even the most recent, themselves overshadowed in freshness by the three on my stomach from this January. Ten years has brought a lot of change, some of it good and some of it the gradual wear and tear of life, the slow abrasion and sudden breaks.

I haven’t forgotten everything, though. The second chest tube scar has faded, but the memory of the incision hasn’t. It remains the most painful experience of my life, an evening I hope not to top. The more recent scars, perhaps more invasive, were at least planned, and I was properly sedated. Our hospital list grows much faster than our emergency room list, for which I am grateful. I am grateful for so much, really. For medicine, for health insurance that spans countries, for friends who’ve given advice by phone and carried us home on their backs. For friends who’ve offered up sofas, and brought food. It’s a long list, and good to remember on anniversaries like this, even as I forget.

And so, biking across the city I used to live in on this chilly March morning, I try to be grateful for the distance, for the progress we’ve made since. Our ten year anniversary comes shortly after this less auspicious one. Our cat is almost twelve. Our daughter will be two in June. We’ve lived in Hong Kong more than half the decade since, something that would have been hard to predict. And we still love New York, planting good memories over and around the painful ones, as the years accumulate.