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As the year draws to a close, thoughts inevitably become reflective. I reflect on the year just past and on the one to come. There were big changes for me, both personal and professional. This year I celebrated the 30th anniversary of my 39th birthday. I recovered from Covid. I also celebrated 40 years of marriage to the woman of my dreams, my true soul mate. Next year, I will begin the seventh decade of my life and I foresee big changes, retirement or at least a major slowing down of clinical practice being one of them. It has been a good run.